Tonsil stones, or tonsilloliths, are small lumps of bacterial material, skin cells, oral detritus, the corpses of valiant white blood cells, and minerals. Tonsilloliths usually spring forth from the cracks in the tonsils. Creamy white and buttressed with minerals like calcium, it also has some methanethiol, which smells like badly aging cabbage, and hydrogen sulfide, which has the odor of eggs that overshot their due date by a wide margin. Break open a tonsillolith and you can capture the bracing fragrance of both these compounds, the terrible duo that make halitosis such a dreaded word in the social world. While these tonsilloliths put on weight in the tonsils they are seen usually dislodged when they get larger. Naturally, therefore, you don’t find them in people that don’t have tonsils. There is evidence that within the tonsillolith there is a shortage of oxygen (down to about 10 per cent of the level outside) and the presence of sugar from food (which increases the acidity within). These conditions make it easy for anaerobic and acid-loving bacteria. This suggests that treatment that increases oxygen and increases pH to make the milieu more alkaline may help. As could antibiotics, which target bacteria. You could use a swab or a pair of tweezers, too, but while suggestions also exist for directly putting mechanical pressure on the tonsils, it is a very bad idea, given the sensitivity of the area.
Yet another suggestion, involving the use of carbonated drinks, though it is not clear if the acid produced could be a problem later. But given that alkaline calcium contributes to the tonsillolith formation, an acid environment lacking in predigested nutrients, could help. You could get the tonsilloliths out using your tongue. An interesting – as yet untested – suggestion is to push your tongue up against the roof of your mouth to increase pressure on the tonsils. Apparently, sometimes, rather gratifyingly, the tonsillolith can pop out from the tonsil like a cannon ball from a gun. In extreme cases, people can opt for surgically removing tonsil stone. The most drastic method, removal of the tonsils (tonsillectomy), is not usually indicated or recommended, but will provide permanent relief. A more nuanced approach is laser cryptolysis. Here, a laser is use to burn away the tonsil’s surface, smoothing the area to stop stones from forming at the crypts in the tonsils. This stops the stones from being trapped – and growing into an embarrassing problem later.