Tonsil stones, or tonsilloliths, may cause bad breath
Tonsil Stones, or Tonsilloliths, are smelly white lumps produced from the cracks and crevices of the tonsils. They usually have a cheesy consistency, but can sometimes be hard and stone-like. Tonsil Stones can be associated with bad breath and recurrent sore throats, or a persistently sore throat – chronic tonsillitis. Patients find them to be extremely unpleasant and the bad breath (halitosis) caused can be socially unacceptable. They are thought to form from cracks, crypts, fissures and holes on the surface of the tonsils, where food becomes trapped. Over time, and with movement of the throat in swallowing, breathing, etc., this food becomes squashed together, sometimes deep in the tonsils, and forms smooth, rounded lumps. As these lumps grow, with more food being forced into the crypts and cracks, they eventually start to squeeze out of the surface, and this is what the patient first notices. During this time, since food is mostly organic material, the tonsil stones start to rot – causing a bad taste and odour, which may cause bad breath. This rotting process also causes local soreness of the tonsils (inflammation). In turn, this can lead to chronic tonsillitis, a condition that is related to musculoskeletal disorder, lethargy, and, on occasion, Chronic Fatigue or Myalgic Encephalitis (ME) type syndromes.
Mr. Mike Dilkes provides the most current, optimal testing and treatments for tonsil and tonsil stones removal, based on medical research and consultations with leading experts in the USA and Germany.
Tonsillotomy – for tonsil stones, bad breath, tonsillitis
Tonsil stones can be treated by many techniques, including the use of picks, cotton buds, water jets, etc., to remove them. Patients usually want a long-term cure, however. This can usually be achieved by tonsillectomy. However, since most patients are adults, they tend to be well aware of the issues with traditional adult tonsillectomy – severe pain for 3 weeks, significant weight loss since eating is too painful for several days, and haemorrhage, which can be severe and require hospitilisation and emergency surgery. Hence, the technique of tonsillotomy – where the tonsils are vapourised away under local anaesthetic – using spray only, no injections. This partial removal aims to vapourise away the crypts, cracks, crevices etc which are the cause of tonsil stones, whilst preserving a significant amount of tonsil tissue, in particular the tonsil capsule. This means the muscular bed and blood vessels of the tonsils are not exposed – so pain is vastly reduced, and, in our series of over 400 tonsillotomies under local anaesthetic, not a single patient has needed admission or emergency re-treatment. Tonsillotomy removes up to 50% of the tonsils in any one attempt, depending on the size of the tonsils. To remove more risks bleeding and pain during the procedure. If the crypts and cracks of the tonsils are very deep, more than one tonsillotomy may be required to adequately treat the disease. 40% of patients do well with one procedure only. Tonsillotomy also treats tonsillitis – as the size of the tonsils reduces, so does the severity of tonsillitis. This is used in patients who need to minimise time off work, or do not want a general anaesthetic laser tonsillectomy.
This treatment is called a “lunchtime procedure.” You go to work in the morning, come in at lunchtime for the procedure, which takes 15 – 20 minutes, spend 30 minutes in recovery, having pulse and blood pressure checks, something to eat and drink, then go straight back to work. No time off is required during the next few days as the tonsil surface heals. Painkillers are not prescribed by the Hospital. Simple over-the-counter medication such as paracetamol or ibuprofen are all that is required. The procedure itself if performed sitting upright in a dental-type chair. The local anaesthetic spray wears off 10 minutes or so after the procedure has been completed.