Cryptic tonsil is a benign condition characterized by the presence of caseum (a whitish residue) on the tonsil. It can be the cause of foul breath, inflammation of the tonsil or infections, which justifies treatment when oral hygiene measures do not come to an end.

Definition

Located at the back of the mouth, on either side of the uvula, the tonsils are small almond-shaped masses belonging to the immune system. With age, their surface presents more or less deep grooves called crypts.

The cryptic amygdala is characterized by the presence of white or yellowish residues trapped in the crypts, forming small grains on the surface of the amygdala. We also speak of “caseum on the tonsils”, because this smelly substance, responsible for bad breath, is not unlike cheese (cheese or cheese in Latin).

Of pasty consistency, the caseum is likely to calcify, gradually forming hard concretions designated as “stones” or “tonsil stones”, or under the learned name of tonsilloliths (tonsill, synonymous with amygdala and Litho, rock).

The causes

Food debris and exfoliated dead cells can become lodged in the crypts. In people with cryptic tonsils, the washing of the crypts that occurs naturally when drinking is not enough to remove these residues, which accumulate and promote the proliferation of bacteria.

The exact cause of this phenomenon is not known. 

Diagnostic

Specialists in oral pathologies (ENT doctors, dentists, etc.) can recognize the cryptic amygdala by its appearance.

A dental panoramic or other imaging exams may be helpful, especially in cases of tonsil stones.

The people concerned

Cryptic amygdala is a relatively common condition, especially in people between the ages of 40 and 50, regardless of gender. About a quarter of the population is thought to have tonsil stones. The proportion is higher in people with bad breath (halitosis).

Risk factors

Poor oral hygiene promotes the production of caseum on the tonsil. The role of recurrent inflammations of the amygdala is also suspected.

The first symptoms of cryptic tonsil are often subtle. The course is chronic and most often benign, but local or general complications cannot be ruled out.

Unpleasant sensations in the throat

The cryptic amygdala is often manifested by discomfort and unpleasant sensations: bad taste in the mouth, itching or tingling, feeling of having a foreign body in the throat, discomfort when swallowing, rarely a feeling of suffocation …

Bad breath (halitosis)

Not systematic but frequent, bad breath is linked to the foul odor of the caseum. It can be experienced as a hindrance to social life and is one of the most ill-tolerated consequences of the cryptic amygdala.

Other symptoms

• Inflammation of the tonsils (chronic tonsillitis)
• Repeated sore throat or sore throat
• Aphonia 
• Irritative cough
• Ear pain (earache)
• Digestive disorders (regurgitation …)
• Headaches
• Fatigue…

Different techniques can be used to clean the tonsil and get rid of the caseum.

Curettage

When it is not very encrusted, the elimination of the caseum can sometimes be carried out by gentle pressure of the amydgale or by curettage using a cotton swab moistened with mouthwash. These manipulations can be carried out at home, but due to the gag reflex they cause, the intervention of a professional may be necessary.

L’irrigation

Gargles with salt water or mouthwashes can be tried but are not very effective. They prefer the use of an oral irrigator (dental jet or water flosser), set at low pressure so as not to irritate the tonsils.

Laser treatment

Practiced by the ENT doctor in stubborn and troublesome cases, laser smoothing reshapes the amygdala in terms of surface area so as to open the crypts and reduce their depth. Several sessions, performed under local anesthesia, are generally necessary.

Tonsil removal

The use of surgery is rare but may be recommended when all other means have failed or in the event of chronic infection.

Natural methods

The essential oil of parsley can be recommended to fight against bad breath, because it captures and transforms the sulfur compounds at the origin of foul odors. Other herbal remedies (thyme, true chamomile gargle…) could provide some help to fight against the proliferation of bacteria or to soothe chronic inflammation of the tonsils.

A homeopathic medicine, kalium muriaticum 9CH, is also offered against caseum.

It is easier to prevent the onset of caseum than to get rid of it! Good oral hygiene is essential to prevent food particles from stagnating in the mouth, which promotes the proliferation of bacteria. By brushing your teeth regularly and correctly, by rinsing your mouth after each food intake and by avoiding snacking just before bed are simple measures, you will avoid many problems!

We will also limit the development of bacteria by drinking regularly to avoid having a dry mouth, and by eating a healthy diet, including foods that promote the production of saliva (lemon juice, etc.), probiotics (yogurt, etc.), etc.