What Are Tonsil Stones?

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Sometimes, feeling like you have a lump in your throat has nothing to do with strong emotions. Sometimes, it’s just tonsil stones, those pebble-like white things that some people periodically find nestled inside their tonsils. Just what are these gross throat squatters?

The answer is both simple and complicated. Tonsil stones are normally white-ish yellow and can range in size from microscopic bits to chunks several centimeters in diameter. These tonsilloliths—the official medical term—are made of material that accumulates in the crevices of the tonsils.

You see, tonsils aren’t just smooth mounds of tissue. They have folds called tonsillar crypts that form pits in the tissue. The tonsils act as the body’s defender against any foreign substances that come in through your mouth, and tonsillar crypts increase the surface area of the tonsils to give them more of a chance to catch anything coming in that the body needs to mount an immune response to. A normal tonsil usually has dozens of crypts.

Just how tonsil stones are formed within those crypts is a little more complicated. Mental Floss spoke to three different otolaryngologists (ear, nose, and throat doctors) on the subject, and each of them provided slightly different answers.

An Atlas of Human Anatomy for Physicians (1919), The Internet Archive // Public Domain

Like any tissue in your body, tonsils are constantly regenerating. Just like your skin peels, that dead tonsil tissue gets sloughed off. It normally ends up going down your throat, but it can also get trapped in these crypts. There, bacteria from your mouth can start to grow on it, turning that material into a semi-hard stone that Dr. Erich Voigt, the director of general otolaryngology at NYU Langone Health in New York City, likens to “a cheesy ball.” (Apologies if we’ve now ruined cheese for you.)

Tonsillar crypts are the perfect environment for bacteria, because they’re poorly oxygenated but rich in blood supply. “It becomes an opportune area for the bacteria to populate and adhere to each other, and they form what’s called a biofilm structure,” Dr. Yosef Krespi, an otolaryngologist who practices in the North Shore-LIJ Health System in New York, tells Mental Floss. A tonsil stone is just a lump of biofilm, he says. In a 2008 study, he and his colleagues examined tonsilloliths in the lab, finding that structurally, they look a lot like dental plaque, another biofilm in the mouth.

But Dr. Jay Shah, a pediatric otolaryngologist at Cleveland’s University Hospitals Rainbow Babies and Children’s Hospital, explains that the yellowish lump you remove from your throat isn't exclusively bacteria. When researchers have examined what tonsil stones are made of, he says, “there’s calcium, there’s sulfur—there’s a whole host of other elements within them,” he explains.

That's not to say the bacteria aren't involved. Scientists studying the microbial makeup of tonsil stones have found that the types of anaerobic bacteria commonly found around and inside tonsilloliths are associated with producing volatile sulfur compounds, which is why people with really bad cases of tonsil stones can suffer from bad breath.

While Voigt and Shah emphasized the tissue and keratin (proteins found in the lining of the mouth, as well as in hair and skin) from the tonsils that gets trapped in these crypts as the source of stones, other studies have noted that trapped food debris in the tonsillar crypts can cause tonsilloliths. One study even suggests they could be formed by trapped spit alone.

Often the tonsil stone that you see in your throat isn’t the whole thing, according to Krespi. You may only be seeing a portion that has broken off from the “mother” stone that’s still lodged down in a very deep tonsillar crypt, he says, meaning that you’ll continue to see stones. Voigt, however, says that while some patients do have recurring stones, for others, the problem is temporary and may go away after a few weeks or months.

Everyone has tonsillar crypts, dead skin cells, and bacteria in their mouth, but not everyone gets tonsil stones. “The biggest question is, why do some people get them and some don’t? We don’t know,” Shah says. Some people have bigger crypts than others in their tonsils, and, since it’s easier for stuff to accumulate in larger crypts, those people seem to be more likely to have a problem with tonsil stones. But large tonsil stones are very rare, and you’re much more likely to be dealing with a few harmless small tonsilloliths than a sizable stone. In general, tonsil stones are more common if you have a history of tonsillitis or just have large tonsils that have a lot of big nooks where bacteria can get trapped.

It’s hard to say just how common tonsil stones are. Some studies estimate their prevalence at around 8 percent of the population, while others suggest that they might affect as much as 25 percent of the population. Both of those might be low estimates. The researchers Mental Floss spoke to reported seeing them regularly in their practice, even in patients who weren’t aware that they had them.

The fact that there isn’t firm data on how many people deal with tonsil stones may reflect the fact that they don’t usually require seeing a doctor. As the authors of one large study on tonsil stones from a Japanese dental hospital noted in 2013, tonsilloliths are “relatively commonly encountered in daily clinical practice, but patients rarely have complaints related to them.”

Tonsillolith, Wikimedia Commons // Public Domain

Because while it can be alarming (or, depending on your perspective, fascinating) to look into your throat and see white specks in the back of your mouth, tonsil stones are typically harmless. One ear, nose, and throat doctor likens them to acne of the tonsils. They’re a little gross, but for most people, tonsil stones don’t come with any major side effects.

In serious cases, big tonsil stones can cause trouble, leading to ear pain, difficulty swallowing, and other discomfort, but that’s fairly rare. Most people with tonsil stones manage to handle them without any medical intervention, removing them with a Q-Tip, a finger, or gargling with salt water. While a doctor has specialized tools that can be used to safely remove tonsilloliths, as long as you’re not poking something sharp into your tonsils or pushing them deeper into those crypts, you’re probably fine. If you’re prone to tonsil stones, Voigt suggests gargling with a 50/50 mixture of hydrogen peroxide and water to clean out your tonsillar crypts. You can also use a water pick for the same task.

The only way to totally get rid of tonsil stones permanently is to remove the tonsils entirely. But for most people, gargling or a periodic Q-tip session works fine–and makes for some pretty good video.

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Looking to Downsize? You Can Buy a 5-Room DIY Cabin on Amazon for Less Than $33,000

Five rooms of one's own.
Five rooms of one's own.
Allwood/Amazon

If you’ve already mastered DIY houses for birds and dogs, maybe it’s time you built one for yourself.

As Simplemost reports, there are a number of house kits that you can order on Amazon, and the Allwood Avalon Cabin Kit is one of the quaintest—and, at $32,990, most affordable—options. The 540-square-foot structure has enough space for a kitchen, a bathroom, a bedroom, and a sitting room—and there’s an additional 218-square-foot loft with the potential to be the coziest reading nook of all time.

You can opt for three larger rooms if you're willing to skip the kitchen and bathroom.Allwood/Amazon

The construction process might not be a great idea for someone who’s never picked up a hammer, but you don’t need an architectural degree to tackle it. Step-by-step instructions and all materials are included, so it’s a little like a high-level IKEA project. According to the Amazon listing, it takes two adults about a week to complete. Since the Nordic wood walls are reinforced with steel rods, the house can withstand winds up to 120 mph, and you can pay an extra $1000 to upgrade from double-glass windows and doors to triple-glass for added fortification.

Sadly, the cool ceiling lamp is not included.Allwood/Amazon

Though everything you need for the shell of the house comes in the kit, you will need to purchase whatever goes inside it: toilet, shower, sink, stove, insulation, and all other furnishings. You can also customize the blueprint to fit your own plans for the space; maybe, for example, you’re going to use the house as a small event venue, and you’d rather have two or three large, airy rooms and no kitchen or bedroom.

Intrigued? Find out more here.

[h/t Simplemost]

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What Is the Citizenship of a Baby Born on an International Flight?

Nadezhda1906/iStock via Getty Images
Nadezhda1906/iStock via Getty Images

It's pretty standard medical advice: a pregnant woman shouldn’t travel via airplane 36 weeks or later into her pregnancy. Despite that precaution, an occasional bundle of joy may still add an unexpected passenger to the flight manifest. As if giving birth at 40,000 feet wasn't already a stressful experience for a new mom, things can get even more hectic upon landing: Depending on the details surrounding the birth, her newborn’s citizenship could be up for debate.

There is no universal rule for how a country determines the citizenship of a newborn. Some countries just follow the jus sanguinis (right of blood) law, which means a baby’s nationality is determined by that of one or both parents. Others observe that rule and jus soli (right of the soil), where a country grants citizenship to a baby that’s simply born on its soil, regardless of the parents’ origin. These countries are mostly in the Americas and include the United States and Canada. And with the expansion of air travel, these laws had to extend to the heavens as well.

If a baby is born over United States airspace, the jus soli rule means the child would be granted U.S. citizenship, according to the Department of State Foreign Affairs Manual. Depending on the circumstances, the child may also be a candidate for dual citizenship if its parents are from a country that grants citizenship based on blood—though that would depend on the countries involved.

This same simplicity doesn’t extend to a jus sanguinis country, though. This means that an American mother can’t attain French citizenship for her baby just because she gave birth over French airspace. The baby would simply revert to the parent's U.S. citizenship, since the United States also generally follows jus sanguinis when a baby is born to U.S. citizens in a foreign country. Since jus sanguinis is the far more common rule around the globe, most babies born on a flight over international waters or foreign airspace will likely wind up taking the citizenship of its parents.

If there’s a case where the child could potentially be stateless—such as when a mother herself has no official citizenship and the baby is born in international airspace—the baby would likely take the citizenship of whatever country the plane itself is registered in, according to the United Nations’s Convention on the Reduction of Statelessness agreement.

Despite all these complex laws, mid-flight births are exceedingly rare—so rare, in fact, that most airlines don’t even keep track of the number of babies born in the air. An expecting mother likely wouldn't even be able to get onto a flight in the first place, since many airlines have rules that prohibit women from flying after they've reached a certain point in their pregnancy.

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