Tonsil Stones 扁桃腺結石

By: Joe Hing Kwok Chu

Tonsilloliths are commonly called tonsil stones. The tonsilloliths are white or yellow colored stones. The stones are composed of calcium salts such as hydroxyapatite or calcium carbonate apatite, oxalates and other magnesium salts or may contain ammonium groups. [1]

Causes:

There are many hypotheses on how the stones are formed. Many people think that the stones are caused by food particles lodged in the crypts of the tonsils. That is not really true. Actually, tonsilloliths are caused by chronic infection and inflammation of the oral cavity area especially the tonsils. The most common infections are caused by fungi or Filamentous bacteria like Leptothrix buccalis and Actinomycetales.

Chronic infection and inflammation of the tonsils causes the increase of shedding of epithelial cells (cells of outer layers of skin) and pus secretion. Pus usually occurs in the crypts during the early stages before the forming of stones. Chronic infection will increase the depth of the crypts. When crypts are too deep,  normal rinsing cannot remove the debris trapped inside the crypts. Stones are formed because the fungi, bacteria, pus, and dead skin cells are  trapped  inside the crypts, together with the minerals of the saliva and the minerals of the mucus from the sinus and the acid in the mouth, calcium salt and magnesium salts are formed.

People who are susceptible to tonsilloliths are those with:

1. frequent tonsillitis, cold, influenza or sore throat, or/and

2. food allergies that can cause chronic inflammation, or/and

3. poor oral hygiene, such as not rinsing the mouths after meals or/and

4. diets of spicy or deep fat fried food, or/and

5. frequent use of prescription medications that have dry mouth as a side effect, which causes anaerobic bacteria like Leptotrichia to multiply, or/and

6. weak autoimmune system which can caused by overworking and lack of sleep, or/and

7. thick saliva which can be caused byyinxu (yin deficient) 陰虛, overworking, lack of sleep, or not drinking enough water

8. frequent sinus infection or allergy that causes sinus drips.

Treatment:

1.  Identify any food allergies and avoid them.

2.  Treat any infection or inflammation.

3.  Correct the conditions orshenyinxu (kidney yin deficient)  腎陰虛 which causes thick saliva or shenyangxu (kidney yang deficient)腎陽虛 which causes allergy.

4.  Remove any pus or stone from the crypts of tonsils

5.  If the stones are too big or/and the affected  tonsils have become atrophied, the    tonsils may have to be removed

Note:

Hydroxyapatite: it is also written as hydroxylapatite. The chemical formula is Ca₅(PO₄)₃(OH). The formula is usually written Ca₁₀(PO₄)₆(OH)₂ to denote that the water crystal unit cell comprises two entities. It can be colorless, white, grey, yellow, yellowish green in color.

[1] Hiranandani LH. A giant tonsillolith. J Laryngol Otol. 1967;81:819–22. doi: 10.1017/S0022215100067748. [PubMed]

Food allergy: the food that are highest on the food allergy list are milk product and eggs. Most of the time those are the food that are allergic to the people who like them most. The common allergy sensitive food, depends on the individuals,  are: eggs, fish, shell fish, milk, peanuts, sesame seed, soy, sulphites, wheat and gluten^.[2]

The Leptothrix buccalis is a normal inhabitant of the mouth, and occasionally produces a pathological lesion of clinical interest. The organism probably belongs to the group of pleomorphic bacteria, though its exact position is not determined. It consists of fine threads, of wavy or spiral character, composed of rod- like segments. Occasionally spore-like bodies are found at the free ends of the filaments. The organism sometimes penetrates and multiplies in the crypts of the pharynx, causing a chalk-like nodule or deposit. Secondary inflammation may be occasioned.

[2] http://www.nal.usda.gov/fnic/pubs/bibs/gen/allergy.pdf

An article in NY Time: http://www.nytimes.com/2009/09/01/health/01tons.html?em

See this on an experience on tonsil stones..

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