From the Research
Tonsilloliths are typically managed expectantly, with small tonsilloliths being common clinical findings that rarely require surgical intervention unless they become too large to pass on their own 1.
Treatment Approaches
- For mild cases, gargling with salt water (1/2 teaspoon salt in 8 ounces of warm water) several times daily can help dislodge the stones.
- Gentle removal using a cotton swab, soft toothbrush, or water flosser on the lowest setting can be effective for visible stones.
- Maintaining good oral hygiene by brushing twice daily, flossing, and using an alcohol-free mouthwash helps prevent recurrence.
Management of Symptoms
- For persistent cases, over-the-counter pain relievers like acetaminophen (Tylenol, 500-1000mg every 6 hours as needed) or ibuprofen (Advil, 400-600mg every 6-8 hours with food) can manage discomfort.
- Antibiotics are typically unnecessary unless there's a true infection, as evidenced by the lack of recommendation for antibiotic use in the management of tonsilloliths 1.
Prevention
- Regular oral hygiene and gargling after meals can help prevent the formation of tonsilloliths by reducing the accumulation of food particles, bacteria, and cellular debris in the tonsillar crevices.
Severe Cases
- For severe, recurrent cases that significantly impact quality of life, an ENT specialist might recommend tonsillectomy, though this is reserved for extreme situations 1.
- The decision to proceed with tonsillectomy should be based on the severity of symptoms and the impact on the patient's quality of life, rather than the presence of tonsilloliths alone 2.