From the Guidelines
Calcification behind the tonsils, also known as tonsilloliths or tonsil stones, can be managed through regular oral hygiene practices and home remedies, and in most cases, do not require medical intervention unless they cause significant discomfort, persistent bad breath, or difficulty swallowing. The management of tonsilloliths should prioritize non-invasive methods to reduce morbidity and improve quality of life. According to the clinical practice guideline: tonsillectomy in children 1, the focus should be on reducing the frequency and severity of sore throats, which can be achieved through good oral hygiene practices.
Some key recommendations for managing calcification behind the tonsils include:
- Brushing teeth twice daily, flossing regularly, and using an alcohol-free mouthwash to reduce bacteria that contribute to stone formation
- Gargling with warm salt water (1/2 teaspoon salt in 8 ounces of warm water) several times daily to help dislodge existing stones and prevent new ones
- Using a water flosser set on low pressure to gently remove visible stones
- Gently pressing the tonsil area with a cotton swab to help expel stones
- Staying hydrated and avoiding tobacco products to help prevent tonsil stone formation
It is essential to note that while tonsillectomy may be considered in severe recurrent cases, the benefits of the procedure should be weighed against the potential risks and morbidity, as suggested by the clinical practice guideline: tonsillectomy in children (update) 1. The decision to undergo tonsillectomy should be made on a case-by-case basis, taking into account the individual's overall health, the severity of their symptoms, and the potential impact on their quality of life.
In terms of the immune function of the tonsils, it is worth noting that they play a crucial role in initiating immune responses against antigens entering the body through the mouth or nose, as described in the clinical practice guideline: tonsillectomy in children (update) 1. However, this should not influence the management of calcification behind the tonsils, which should prioritize non-invasive methods to reduce morbidity and improve quality of life.
From the Research
Calcification behind Tonsils
- Calcification behind tonsils is known as tonsilloliths, which are rare dystrophic calcifications resulting from chronic inflammation of the tonsils 2.
- Tonsilloliths are primarily found in the palatine tonsil and are caused by dystrophic calcification due to chronic inflammation 3.
- They can be asymptomatic, but sometimes produce symptoms such as non-specific chronic halitosis, irritable cough, dysphagia, otalgia, and foreign body-like sensation or foul taste 3.
Diagnosis and Management
- Tonsilloliths can be diagnosed using panoramic radiographs, which may show radiopaque images similar to intra-osseous abnormalities 2.
- Computed tomography (CT) can confirm the diagnosis of tonsilloliths by showing hyperdense images in the palatine tonsils 2.
- Treatment is not required if there are no symptoms, but surgical intervention may be necessary if the tonsilloliths become too large to pass on their own 4.
Characteristics and Dynamics
- Tonsilloliths can change in size and position over time, with some disappearing and others increasing in size 5.
- The calcification levels of tonsilloliths can also change dynamically, with some increasing and others decreasing in density 5.
- Lingual tonsilloliths are less well-known but may be common in clinical practice, and can be evaluated using panoramic radiographs and CT images 6.