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Although most small tonsil stones do not lead to significant symptoms, individuals with larger tonsil stones can experience unpleasant symptoms. The signs of larger tonsil stones (also known as tonsilloliths) are varied, but usually include bad breath, a sore throat, difficulty swallowing, earaches, swollen tonsils, and visible white debris at the back of the throat.
Your palatine tonsils resemble small, dimpled balls and are located on either side of your tongue at the back of the throat. These structures are part of the lymphatic system, functioning as front-line guards to defend the body against foreign substances and pathogens. On its surface, each tonsil possesses small crevices that are called the tonsillar crypts. Sometimes, food particles, mucus, microorganisms, and dead cells can accumulate in these crypts. If this material remains lodged in the tonsillar crypts, it is attacked by white blood cells and turns into hardened, pale lumps called tonsil stones or tonsillar calculi. For some patients, these tonsil stones can create problematic symptoms like persistent irritation, inflamed tonsils, a persistent sore throat, and chronic bad breath.
Bad breath is one of the primary indicators of tonsil-stone formation. Researchers estimate that approximately 75% of people with abnormally unpleasant breath also suffered from tonsil stones. In these cases, the high levels of bacteria and other microorganisms within the tonsil stones create bad breath, as these substances create pungent, lingering odors whenever you exhale or speak.
Additionally, some patients with tonsil stones also experience persistent sore throats. This is likely due to inflammation in the tonsils or to the presence of a larger, hardened tonsil stone that has become firmly lodged in a tonsillar crypt. A persistent sore throat may also indicate a concurrent infection such as tonsillitis as well. Depending on the size or location of your tonsil stones, you may also have difficulty swallowing. Earaches are also noted among individuals with tonsil stones. Although the tonsil stones are not touching the ear canal, you may still feel pain in your inner ear because of shared nerve pathways in your throat and neck.
Finally, some tonsil stones may be visible in the back of your throat as lumps of white material. However, most tonsil stones are hidden within the tonsillar crypts and can only be detected by a physician with the help of non-invasive scanning technology such as an MRI.
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