Halitosis and Tonsil Stones
Halitosis (bad breath) is unpleasant not only for the affected persons, but also for the people surrounding them. It can affect one’s personality, and lower one’s confidence in social situations. Additionally, halitosis is often a sign of impaired oral and general hygiene of that person.
Common causes of halitosis are as follows:
1. Oral and dental problems: for example, dental carries, gingivitis (inflammation of the gum tissue), or other inflammation in the oral cavity.
2. Nose and throat diseases: such as tonsil stones, sinusitis, pharyngitis.
3. Diseases of the gastrointestinal system: for example, chronic peptic ulcer, gastroesophageal reflux disease (GERD)
Halitosis most commonly results from oral and dental problems. Thus, the patients with chronic bad breath should first be evaluated by dentists. Since diseases of the gastrointestinal system causing halitosis are rare, if no apparent dental origins of bad breath are found, the source of chronic halitosis is often nose and throat diseases, particularly tonsil stones.
According to one epidemiological study, tonsil stones can be found in approximately 6% of general population. The number dramatically increases especially in patients with chronic tonsil diseases. One pathological study revealed that tonsil stones are seen in as many as 75% of the patients who underwent tonsillectomy. Therefore, chronic halitosis due to tonsil stones is not uncommon.
The detection of tonsil stones requires careful examination by ENT physicians.
What cause tonsil stones?
Food debris, together with saliva and dead tissues in the mouth, are excellent food sources of anaerobic bacteria (bacteria that do not require oxygen for growth). These bacteria produce hydrogen sulfide (H2S – the “rotten egg” gas), as by products of their growth, which result in bad breath.
When food debris is trapped in tonsillar crypts, it becomes concentrated and hardened over time. This tends to occur more commonly in patients with chronic tonsillitis (recurrent inflammation of tonsils), because their tonsillar crypts are usually larger and deeper than those of normal people, thus, allowing more space for growth of anaerobic bacteria.
Halitosis can be cured when the cause is correctly identified and appropriate treatments are applied.
The most effective treatment of tonsil stones in the past is traditional tonsillectomy (total removal of tonsil glands). However, this type of surgery has becoming less popular, because it often causes excessive blood loss, severe postoperative pain, and typically requires 2-3 days of hospital stay.
Laser surgery has recently become a better option since it can avoid all of the above mentioned complications, while being able to preserve the patients’ tonsil glands.
When tonsil stones are in the crypts that are not too deep, laser tonsil resurfacing surgery can be done in the outpatient setting. If tonsil pathology is more severe, or tonsil crypts are very deep, the surgeon may decide to perform laser tonsil ablation (LTA). Although LTA needs to be done in the operating room under general anesthesia, the patients usually recover faster than those who undergo traditional tonsillectomy.
In addition to removing the tonsil pathology, the surgeon can use laser to restore the tonsils’ shape and functions (laser tonsilloplasty) at the same time of other procedures.
If you suffer from bad breath, please seek evaluation from your doctors. Halitosis can be cured if correct causes are identified and correct treatments are applied. The new you won’t have to lose your confidence in social situations anymore!
