Have you ever experienced or heard about the hell of kidney stone pain??
Confused and again checked the headline. Scroll down.
You are right, it’s about the Salivary stone and Tonsil stones only.
Earlier you may have heard a ton about kidney stones and gallbladder stones, but did you know that type of stones formed in your mouth also?
These stones can form deep within the salivary glands or in salivary ducts or even within the crevices of the tonsils.
People who have Salivary stones also encounter the same unpleasant and worst pain as Kidney stones (Renal Calculi).
On the contrary, in Tonsil Stone, there is no obvious pain, but their chief complaint is constant bad breath.
Which is the more common and serious one – Salivary Stone or Tonsil stone?
Salivary Stone is more common in Middle age Men.
Tonsil stone is more common in Middle age Women. People who have tonsillitis are more prone to Tonsil stones.
Most people don’t even realize they have Salivary (or) Tonsil stones.
It’s a trick question – Size and the Location of the stone decide the discomfort level.
Are salivary stones and tonsil stones the same thing?
Obviously No, The name implies the difference.
Salivary stones tend to build up in the Salivary glands beneath the tongue, on the inside of the cheek, and between the teeth and gums. In contrast, Tonsil stones form in the Tonsils (At the base of the tongue, side of our Throat).
Salivary stones (Sialolithiasis) are hardened mineral deposits that form in the salivary glands or salivary ducts. There are 3 major Salivary glands and 100’s minor salivary glands.
More commonly salivary gland stones form in the submandibular salivary glands(80%), but they can form in any of the other major and minor salivary glands also.
Usually, Salivary stone varies from 1 mm to less than 1 cm. They rarely measure more than 1.5 cm. Giant sialoliths are rare
Tonsil stones, in medical term Tonsilloliths, is white or yellow formations made up of bacteria and live biofilm that gets stuck in these tonsillar crypts and harden. Tonsil stones have a foul odor since they have a high amount of sulfur.
What causes Salivary stones?
Multiple factors are associated with the salivary stone formation and it is very difficult to point out a single cause.
- Inadequate fluid intake
- Medical conditions (Radiation therapy, Kidney problem)
- Medications (Diuretics and anticholinergic drugs)
- Trauma to the inside of the mouth
- Gum disease
What causes tonsil stones?
Tonsil stones may be caused by:
- Poor dental hygiene
- Large tonsils,
- Chronic tonsillitis (inflamed tonsils)
- Chronic sinus issues.
- Debris in your tonsil crypts( food residues from insufficient teeth cleaning or mucus from postnasal drip)
Symptoms of salivary Stones
- Pain (Face /Jaw /Neck)
- Pain aggravates before /while eating
- Dry mouth
- Difficulty in swallowing
- Difficult to open mouth
Symptoms of Tonsil stones
- White or yellow spots on tonsils
- Sore throat,
- Bad breath
- Swollen tonsils,
- A feeling that something stuck in your throat,
- Ear pain,
- Difficulty in swallowing.
- Metallic Taste in the mouth.
Diagnosis of Salivary stone/Tonsil stone
- Clinical examination
- X-rays- Very limited use.
- Ultrasound Scan
- CT Scan
A Sialendoscopy is an ultrathin endoscope that can be used to treat salivary gland stones and other salivary gland conditions. Not only for diagnosis but Small stones in the ducts can also be, grasped and removed using this special endoscope.
Image courtesy of KARL STORZ Endoscopy-America, Inc.
Very small salivary stones can be managed on their own.
Massaging the Gland( the affected area of your mouth ) can work if the stone is easily accessible. With a little pressure, you might be able to work the stone out.
Citrus fruits are commonly taken as a solution to both salivary and tonsil stones because it increases saliva production. This can push the stone out and solve your temporary concerns.
For small stones, all you need to do is suck on some lemon the next time a stone pops up as well.
Conservative treatments provide temporary relief, but most people may require minimally invasive surgery to resolve the problem.
If the salivary stone blocks the salivary duct, the gland can become infected, it’s known as sialadenitis. Salivary stones that are particularly bigger in size and persistent or difficult to remove, surgery may be required.
Sialendoscopy is a minimally invasive method that allows direct visualization of the salivary ducts of the parotid and submandibular glands.
Extracorporeal Mechanical lithotripsy
It involves repeatedly delivering shock (compression) waves at supersonic speed; hence, the name extracorporeal shock wave lithotripsy (ESWL). Fragmentation of the salivary stones followed by removal of the fragmented piece.
Gland preserving surgery (Ductoplasty)
These are minor surgical procedures that are performed under local anesthesia or day-care general anesthesia to remove large immobile stones when EWSL is not possible. A small incision is made preferentially transorally, but sometimes it is made transcutaneously for parotid gland sialoliths
The procedure of complete gland removal is indicated for symptomatic cases where conservative methods have failed.
- When it is difficult to remove a parotid or submandibular gland stone by conservative methods.
- When Multiple large salivary stones with recurrent sialadenitis.
- Any previous Complications during Sialendoscopic procedures such as entrapping of the stone retrieval basket.
Tonsils stones aren’t usually painful but they can be annoying (and smelly).
Most Tonsil stones are harmless, but that individuals prefer to remove them because they can smell bad or cause discomfort. Just like Salivary stones, here also the treatments range from home remedies to medical procedures.
Gargling with salt water
Cough – Energetic coughing can help loosen stones.
Manual removal– Cotton swab or Waterpik can be used to remove manually, but strict no for any other instruments.
Antibiotics– Some tonsil stone cases can be managed with antibiotics.it lowers the bacteria counts that play a crucial role in the development and growth of the tonsil stones.
It won’t address the underlying cause of the stones, and it shouldn’t be used long term,
Minor surgical procedures(Laser tonsil cryptolysis, Coblation cryptolysis
Tonsillectomy) may be recommended if persistent symptoms present or large stones or if there is any pain.
How to prevent Salivary/Tonsil stone formation?
Just like kidney stones and gall bladder stones that can form in our bodies, these salivary/Tonsil stones also formed insidiously.
- No proven methods to prevent Salivary/Tonsil stones.
- Practicing good oral hygiene
- Stop smoking
- Gargling with salt water
- Drinking plenty of water to stay hydrated
A dentist might even notice asymptomatic salivary stones on a person’s x-ray during routine checkup.
If you suspect that you might have difficulty in chewing and severe bad breath, pain then it may be due to Salivary stones/Tonsil stones. Contact Sakti Dental today to book an appointment and learn about the best dental treatment options for you.
Dr. Shiva Sankar is the Clinical Director and Orthodontist at Sakti Dental Clinic, Tirunelveli with over 18+ years of experience in dentistry. He is also a Professor in the Department of Orthodontics, Rajas Dental College affiliated to, Dr.MGR Medical University. Dr. Shiva Sankar frequently publishes research papers in leading scientific national and international journals.