Holes in Tonsils

Tonsils are lymph nodes located on each side of the back of the throat. They play an important role in preventing infection.

They also play a crucial role in the oral cavity and lymphatic system. Certain diseases and infections can be prevented with the help of tonsils.

However, there are instances when the tonsils become infected and irritated. An infected tonsil is medically known as tonsillitis. Some people have holes in the tonsils. It is also called crypts on the surface of the tonsils. ^{(1, 2, 12)}

During the mastication process, the foods are not all swallowed. Some of them are stuck in the holes of the tonsils or crypts. As time passes by, the food particles stuck in the crypts increases, which possess a health hazard not only to the tonsils but to the entire oral cavity. Eventually, the debris become hard as stones leading to a condition called tonsillar stones. The holes in the tonsils serve as a breeding ground for all types of organisms including disease-causing bacteria. ^{(2, 3, 4)}

The tonsils protect the sensitive tissues of the lungs and intestines from harmful substances. Tonsils are made from lymphocytes, which are cells that help fight and prevent infection. Tonsils function like nets. They trap the incoming bacteria so that they will not invade the body.

However, there are instances when tonsils can’t perform their job well. Instead of helping the body, they end up as a hindrance. That is why sometimes the tonsils are removed, especially if the patient is experiencing recurrent infection. ^{(1, 4, 6, 7)}

Image 1: A closer view of the holes in the tonsils with white spots.
Picture Source: www.healtreatcure.org

Photo 2: Outlined the different types of tonsils and their locations.
Image Source: img.tfd.com

Image 3: A comparison between a healthy tonsil and a swollen tonsil.
Photo Source: entkidsadults.com

Photo 4: Tonsils with multiple holes.
Picture Source: www.healthedition.org

Image 5: A patient with large tonsil stones.
Photo Source: i.ytimg.com

Types of tonsils

• Adenoids (pharyngeal tonsils) – It is a single tonsil found on the roof of the pharynx. Children have big adenoids but as they grow up, the adenoid tonsils become smaller until such time that it is virtually invisible. If the adenoids tonsil gets too large, it will cause chronic respiratory disorder and snoring. ⁽⁵⁾
• Tubal tonsils – a normal person has two tubal tonsils, one situated in each opening of the Eustachian tube. These tonsils are hidden deep at the back side of the oral cavity.
• Palatine tonsils – They are located at the back of the throat, one on the right side and one on the left. They are the tonsils prone to inflammation. The appearance and shape changed. They can become enlarge and there is also a possibility of holes or crypts.
• Lingual tonsils – They are located at the root of the tongue. You cannot see these tonsils in your mouth during examination in front of a mirror. ^{(2, 5)}

Causes of holes in tonsils/crypts on tonsils

1. Cancer – Patients with throat cancer usually have holes in their tonsils.
2. Strep throat – it increases the possibility of having holes in the tonsils. Strep throat is caused by Streptococcus bacteria. It gets in the throat leading to the inflammation of tonsils (tonsillitis). The throat becomes sore and eventually the patient will have white pockets on the surface of the tonsils after the infection. ^{(3, 6)}
3. Mono – It is a severe viral infection affecting the tonsils. If not treated right away could lead to holes in the tonsils. Pockets are likely to develop if the infection is recurrent.
4. Smoking – Cigarette smoking can cause holes in the tonsils, especially if there is an ongoing infection in the tonsils. Cigarette contains a lot of chemicals that can irritate the tissues in the throat. Chronic cigarette smoking will eventually lead to holes in the tonsils.
5. Holes in the tonsils with white spots and pus – if your tonsils are infected such as in the case of tonsillitis, a white pus will most likely accumulate in the holes of the tonsils. The holes will be filled with mucus, bacteria, food particles, and calcium deposit. You will also notice whitish chunks on the tonsils, especially on the surface of the tonsils and back of the throat. You will then notice tonsil stones. If the tonsils are severely affected, the patient will complain of discomfort and intense pain.
6. Scar formation – The formation of scar is a body’s healing response, especially from skin deep cut. However, scars are made from fibroblast, which looks different than that of healthy cells. If your tonsils have cut, there is a tendency of scar formation. The scarred tissues in the tonsils may form holes. ^{(2, 7, 9)}

Symptoms of tonsil stones

• Bad breath (halitosis)
• Pain when swallowing
• Recurrent infection of the tonsils (tonsillitis)
• A feeling of foreign body at the back of the throat
• Metallic aftertaste in the mouth ^{(6, 7, 8)}

How do you get rid of tonsil stones and holes in tonsils?

What is the best way to get rid of tonsil stones? What you can do to prevent holes in tonsils from getting infected? The treatment for tonsil stones primarily depends on the size of the tonsil and its possibility to create harm to the patient.

Usually, tonsil stones that are asymptomatic require no treatment at all. However, if the tonsil stones create discomfort to the patient, it can be dislodged using picks or swabs. Gargling of salt water can also help improve the condition of the patient.

If you are going to consult your doctor, he/she will usually prescribe antibiotics. However, some antibiotics may have adverse effects to the patient. If the tonsil stones grow out of control causing severe pain and discomfort, the doctor will then suggest to have the tonsils surgically removed. The procedure is called tonsillectomy.

It is performed under general anesthesia and the patient will have discomfort and sore throat a few days after the procedure. ^{(1, 2, 10, 12)}

What you can do to prevent holes and stone formation in the tonsils?

• Maintain a good oral hygiene. Take care of your teeth and oral cavity. Make sure you brush your teeth at least two to three times a day.
• Observe proper brushing technique. When brushing, you should include not just the teeth, but also the tongue and the palate.
• Use dental floss regularly to remove dirt that cannot be reached by the regular toothbrush.
• Stay away from vices, especially smoking tobacco products.
• In the case of recurrent tonsillitis, the best remedy is to have the tonsils removed. ^{(1, 2, 11)}

References:

1. https://www.webmd.com/oral-health/guide/tonsil-stones-tonsilloliths-treatment-and-prevention#1
2. http://www.healtreatcure.org/tonsils/holes-in-tonsils-white-spots-large-small-strep-throat-get-rid/
3. https://medlicker.com/1281-holes-in-tonsils
4. http://howtocure.org/tonsil-holes/holes-in-tonsils-causes-pus-collect-food-no-pain-strep-holes-behind-tonsils/
5. https://www.wowremedies.com/holes-in-tonsils-causes-treatments/
6. https://www.medhealthdaily.com/holes-in-tonsils/
7. https://healthfully.com/cure-holes-tonsils-5158949.html
8. http://healthncare.info/holescrypts-tonsils-strep-throat-pictures-treatment/
9. https://www.healthtap.com/topics/what-causes-holes-in-tonsils
10. https://www.drgreene.com/qa-articles/treating-tonsil-stones/
11. http://treatmd.org/tonsils-holes/holes-in-tonsils-causes-white-chunks-normal-sore-throat-strep-how-to-get-rid/
12. http://www.parents.com/baby/health/other-issues/tonsils/