Wednesday 4 April 2012

Removing tonsil stones doesn't have to be a surgical affair

So you've got tonsil stones. Do you need to go ahead and have a tonsillectomy? The answer is almost certainly no. 

If you occasionally discover that you've got tonsil stones in the back of your throat, it can be tempting to want to do something radical to make sure you never have them again. Occasionally, some oral health professionals suggest getting a tonsillectomy as a way to avoid suffering from these little, white, bad-breath-causing objects. But removing tonsil stones doesn't have to involve resorting to an operation.

In fact, all you really need is a good alcohol-free specialty mouth rinse and some patience. That way you can keep your tonsils, freshen your breath, eliminate tonsil stones and skip the surgery.

A recent issue of the Albany Times Union brought up the issue of when tonsillectomies are necessary. In an article written for the newspaper's High School section, senior Jennifer O'Connor described suffering from strep throat. She wrote that her tonsils have gotten quite large and folded, which perpetually gives her tonsil stones.

Having wrinkled, pocketed folds in the back of your throat is a condition called cryptic tonsils. "I read about it and I guess it’s a fairly common problem," O'Connor explained. "People that have this issue usually get their tonsils out, so I knew it was inevitable."

There's where she's wrong. It is quite true that cryptic tonsils can make it easier to develop small, white, sticky stones - also known as tonsilloliths - that can make breath smell awful. But people rarely get a tonsillectomy as a way of removing tonsil stones.

In fact, in general this operation has become less and less common. An article published in the Journal of the History of Medicine and Allied Sciences explained that the tonsillectomy/adenoidectomy (T&A) was once extremely common: "Between 1915 and the 1960s, T&A was the most frequently performed surgical procedure in the United States."

However, evidence for the utility of these surgeries declined. Whereas doctors once thought that the tonsils were the place where bacteria entered the body - "portals of infection," they called them - today, we know that these organs are a vital part of the immune response to pathogens.

So, yes, seriously infected tonsils may warrant surgery. But if you simply have chronic bad breath and tonsil stones, your best bet may be to take care of your oral health with specialty toothpastes, mouthwashes and mouth-wetting lozenges.

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