Dr. Katz speculates that the stones are prevalent nowadays for a number of reasons. “As people get fewer and fewer tonsillectomies, the potential for tonsil stones grows,” he said. “Also, many prescription medications have dry mouth as a side effect, which causes anaerobic bacteria to go into overdrive.”
While tonsil stones are relatively common, they remain little understood among many ear, nose and throat specialists. Sufferers are used to hearing from doctors that there’s nothing wrong with them or that the particles trapped in their tonsils are simply the dregs of last night’s dinner.
“My daughter used to cough them up,” Dr. Katz said. “I went to U.C.L.A. to have it checked out, but no one ever told us what a tonsil stone was.” He took her to a friend who was an ear, nose and throat specialist and was told, “It’s just a piece of food.”
Perhaps because tonsil stones are not typically considered a pathological condition, few research reports have been published about them. Nevertheless, the stones can cause an array of uncomfortable side effects, including sore throat and ear pain, not to mention the maddening sensation of a foreign body in the throat. In a 2008 case report from India, doctors described removing a giant tonsillolith that was making it painful for a young patient to swallow.
Some research suggests that tonsilloliths also have the potential to take a toll on sufferers’ social lives. In a 2007 study at the State University of Campinas in Brazil, doctors found that tonsilloliths were present in 75 percent of tonsillitis patients who had bad breath and in only 6 percent with normal breath.
But Dr. Toshihiro Ansai, an associate professor at Kyushu Dental College in Japan who has studied the link between tonsil stones and bad breath, does not think all stone sufferers need to be concerned. “Most halitosis is caused by periodontal diseases and tongue coat,” he said. “Tonsillolith would be a minor cause.”
While having tonsils surgically removed is the only solution likely to banish tonsil stones for good, Dr. Lee A. Zimmer, an otolaryngologist at the University of Cincinnati, hesitates to recommend tonsillectomy to stone sufferers right off the bat. (In some patients, tonsil removal results in complications and excess bleeding.)
