YOUR tonsils are gland-like structures in the back of your throat. You have one located in a pocket on each side. Tonsils are made of tissue that contains lymphocytes — cells in your body that prevent and fight infections. It is believed that the tonsils play a role in the immune system and are meant to function like nets, trapping incoming bacteria and virus particles that are passing through your throat.

Your tonsils are filled with nooks and crannies where bacteria and other materials, including dead cells and mucus, can become trapped. When this happens, the debris can become concentrated in white formations that occur in the pockets.

Tonsil stones, or tonsilloliths, are formed when this trapped debris hardens, or calcifies. They mainly affect the palatine tonsils, but can also occur in the lingual tonsils. Tonsil stones are among the major causes of bad breath. This tends to happen most often in people who have chronic inflammation in their tonsils or repeated bouts of tonsillitis.

WHAT ARE THE SYMPTOMS OF TONSIL STONES?

Many small tonsil stones do not cause any noticeable symptoms. Even when they are large, some tonsil stones are only discovered incidentally on X-rays or CT scans. Some larger tonsilloliths, however, may have multiple symptoms:

* Bad breath: One of the prime indicators of a tonsil stone is exceedingly bad breath, or halitosis, that accompanies a tonsil infection.

* Sore throat: When a tonsil stone and tonsillitis occur together, it can be difficult to determine whether the pain in your throat is caused by your infection or the tonsil stone. The presence of a tonsil stone itself, though, may cause you to feel pain or discomfort in the area where it is lodged.

* White debris: Some tonsil stones are visible in the back of the throat as a lump of solid white material. This is not always the case. Often they are hidden in the folds of the tonsils. In these instances, they may only be detectable with the help of non-invasive scanning techniques, such as CT scans or magnetic resonance imaging.

* Difficulty swallowing: Depending on the location or size of the tonsil stone, it may be difficult or painful to swallow foods or liquids.

* Ear pain: Tonsil stones can develop anywhere in the tonsil. Because of shared nerve pathways, they may cause a person to feel pain in the ear, even though the stone itself is not touching the ear.

* Tonsil swelling: When collected debris hardens and a tonsil stone forms, inflammation from infection (if present) and the tonsil stone itself may cause a tonsil to swell or become larger.

HOW ARE TONSIL STONES TREATED?

Most tonsilloliths are harmless, but many people want to remove them because they can smell foul or cause discomfort. Treatments range from home remedies to medical procedures.

* Salt water gargles: Gargling with warm, salty water may help ease the discomfort of tonsillitis, which often accompanies tonsil stones. Dissolve 1/4 to 1/2 teaspoon salt in eight ounces warm water and gargle.

* Antibiotics: Various antibiotics can be used to treat tonsil stones. While they may be helpful for some people, they cannot correct the basic problem that is causing tonsilloliths.

* Surgical removal (tonsillectomy): When tonsil stones are exceedingly large and symptomatic, it may be necessary for a surgeon to remove them. In certain instances, a doctor will be able to perform this relatively simple procedure using a local numbing agent. Then the patient will not need general anaesthesia.

* Maintain good oral hygiene: Failure to maintain a proper oral hygiene is the main cause for the formation of tonsil stones. The bacteria in the mouth causes the formation of tonsil stones from accumulated food particles and other debris. The bacteria can be reduced by regularly brushing your teeth using recommended toothpastes, changing toothbrush regularly, gargling using mouth wash or salt water, tongue scraping, etc.

Dr Sharon Robinson DDS has offices at the Dental Place Cosmetix Spa located at Shop #5, Winchester Business Centre, 15 Hope Road, Kingston 10. Dr Robinson is an adjunct lecturer at the University of Technology, Jamaica, School of Oral Health Sciences. She may be contacted at 630-4710 or visit the website www.dentalplace4u.com