DEAR DR. GOTT: I am a 60-year-old female in good health. For the past four years, I have developed tonsil stones that are frustrating. I don’t have them all the time, but when I do, they remain for days to weeks. The only way I can dislodge them is if I happen to sneeze really hard. When they do come out, they are shaped like tiny cauliflowers and have a really bad odor to them.
What causes them? What can I do to avoid getting them? How can I get rid of them for good?
DEAR READER: The tonsils, while appearing smooth, are filled with crevices where bacteria and other debris can become trapped. This matter can concentrate, harden and calcify, causing stones. The process tends to occur in people with chronic bouts of tonsillitis or who have chronic inflammation of the tonsils.
The only surefire permanent treatment is tonsillectomy. However, there are interim steps that can be considered. Nothing need be done if a person is without symptoms. With symptoms, routine saltwater gargles might work, or the stones might be dislodged successfully with a cotton swab or pick. Antibiotics might be prescribed in some cases, but drugs in this category can cause additional problems. When conservative measures fail, surgical removal of the tonsils may be appropriate.
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