The Relationship Between Tonsil Stones and Bad Breath

Summary
Tonsil stones are more common than you may think. Tonsil stones and bad breath are very closely related. In fact, research shows that most people who have been diagnosed with chronic fetid tonsillitis also suffer from chronic halitosis. Predisposing factors that can lead to the formation of tonsilloliths and effective ways to treat tonsil stones and bad breath are also discussed.

Introduction Bad breath can be caused by many different conditions, infections or diseases. For instance, upper respiratory tract system infections (URIs) usually can lead to nasty odours emanating from the mouth or the nasal passages. URIs are acute infections that involve the nose, sinuses, pharynx or larynx. Strep throat or sinusitis are examples of infections of the upper respiratory tract. URIs can sometimes become chronic or can reoccur very frequently and this often has the undesired consequence that halitosis becomes chronic too. Chronic or recurrent URIs are actually one of the causes of chronic caseous tonsillitis, otherwise known as tonsilloliths, and commonly named tonsil stones. On the other hand, on many other instances, tonsil stones and bad breath are not a consequence of any chronic infections, but a consequence of other predisposing factors not linked at all to URIs. In this article I will talk about what tonsil stones are and the way they form, and I will explain the relationship between tonsil stones and bad breath. The main risk factors and conditions which can lead to tonsil stone formation as well as useful prevention methods and treatments will also be discussed.

Tonsil Stones and How They Form Our tonsils are naturally filled with nooks and crannies (called crevasses, pits or crypts). In those close spaces fungi, bacteria, dead cells, mucus, food remains, and other foreign objects can get trapped very easily. And this is how tonsil stones form; when all this trapped debris hardens, it calcifies and it becomes a tonsillolith (the condition whereby tonsilloliths form regularly inside the tonsils is medically known as chronic fetid tonsillitis, or also chronic caseous tonsillitis). Like the formation of a pearl, tonsilloliths form in layers, stratifying. For instance, a small chunk of food or mucus gets trapped in one of the pits. If it is not naturally removed by the constant movement of the tonsils (self cleaning action), these food particles or mucous will soon be engulfed by successive layers made of other matter and bacteria.

Within days, more layers will form; layers made of dead cells for example. Other layers will be formed from mucus, and some more layers will be made of bacterial biofilms. In addition, white cells usually present inside the tonsils will also form layers on the tonsillolith. A tonsillolith can this way grow larger and larger as long as there is enough room for it - unless it is naturally expelled at some point (spontaneous release of a tonsil stone can be a very embarrassing situation, particularly in a social environment). The fact that tonsil stones are literally filled with bacteria is the main reason why tonsilloliths smell so foul; in particular, the anaerobic bacteria that create volatile sulfur compounds are responsible for the most unpleasant odours. Research shows that tonsilloliths should be considered living biofilms (like dental plaque); incidentally, this is one of the reasons why antibiotics have little effect on patients who suffer from tonsilloliths, as bacterial biofilms are usually extremely resistant to conventional antibiotics (not to mention the fact that antibiotics cannot disolve the stones or cause them to be released. The consistency of a tonsil stones evolves too: from a soft gel, debris trapped inside the tonsils changes gradually to a hardened lump or stone (hence the name) as more layers are formed and the materials calcify over time. The characteristic strong smell of a tonsillolith (whether it has hardened or not) is mostly due to the volatile gases produced by the anaerobic bacteria living near the nucleous. Recent scientific studies have shown that the anaerobic bacteria deep inside the tonsillolith are metabolically active. Hence, a tonsil stone can be almost thought of as a living object that keeps producing nasty smells indefinitely, as long as the anaerobic bacteria inside the nucleus (where oxygen levels are very low) keep active.

What Causes Tonsil Stones to Form? (Predisposing Factors) Unfortunately, it is almost impossible to determine exactly why some people are prone tonsil stone formation within their tonsils. However, there are indeed a few factors that have been shown to play a significant role. Some factors may increase the rate at which tonsil stones form and some other factors may impair adequate elimination of the stones before they becomes large. Tonsil stones main predisposing factors:

Tonsil crypts that are large with exposed openings Recurrent throat infections Excessive mucus production

Dry mouth Acid reflux and IBS Allergies, sinus problems and post nasal drip Consumption of certain dairy products Unbalanced diet Unhealthy mouth Pregnancy

In particular, excessive mucous production, chronic sinus problems, post nasal drip, allergies, rhinitis and chronic throat infections such as tonsillitis (past or present) are factors that are thought to play a very important role when it comes to the formation of tonsil stones. Individuals who used to suffer from recurrent bouts of throat infections as a child, such strep throat, tonsillitis or any other type of infection involving the tonsils, are often left with permanently enlarged or scarred tonsil crypts, which can gather debris very easily, and hence are likely to contain tonsilloliths of different sizes within their crypts.

How to Prevent Tonsil Stones and Bad Breath It is clear that the more tonsilloliths the tonsils contain at any given time, and the larger they are, the higher the risk of suffering from horrendous breath. Therefore, given that tonsil stones and bad breath go hand in hand, it is important that individuals who suffer from chronic halitosis examine their tonsils very carefully so that debris and tonsilloliths within the tonsils can be ruled out as a cause. It is often the case that tonsilloliths are not visible upon direct inspection, as they are hidden below soft palate membranes, deep below the tonsil crypts. Although touching the tonsils with the hands directly is not reccommended, there are alternative methods and techniques that can be used to help dislodge the tonsilloliths as well as prevent their formation. Gently applying some pressure on the tonsils with the help of a q-tip, frequent gargling with a herbal tea or salt water, as well as regular use of an oral irrigation system (always at low pressure), are examples of methods that can be used at home to help remove debris, and dislodge tonsil stones from inside their pits.

Tonsil stones and bad breath can be easily managed at home and most people can keep halitosis at bay by using a few of these simple techniques. However, for those that are not succeeding at treating bad breath and tonsil stones from home, there are currently several professional treatments with a very high success rate which can quickly solve the problem. Laser resurfacing of the tonsils - called laser cryptolysis - is a procedure with a very high rate of success, which aims to smooth out the surface of the tonsils so that the risk of debris getting trapped within the folds and pits is dramatically reduced. On the other hand, there are also other surgical procedures which are aimed at removing large (giant) tonsilloliths from the tonsils, which would be otherwise impossible to remove by any other means. More information at:
http://www.cure-halitosis.com/is-there-a-connection-between-tonsil-stones-and-bad-breath/