Cryptic tonsillitis is a medical condition in which calcareous deposits, made of calcium carbonate, form and harden in the crevasses, or crypts, of the palatine tonsils located at the back of the throat. These deposits, called tonsilloliths, tonsil stones, or zots, can cause discomfort, sore throat, and halitosis, or bad breath. If small, however, they are often asymptomatic.
Cryptic tonsillitis affects children more than adults, but it is a common ailment in general. Tonsilloliths are hard and white or yellow in appearance. They can be caused by dead white blood cells, bacteria of fungi, food particles, excess saliva or mucous, or smoking without a filter. They are usually diagnosed through inspection, sometimes through imaging techniques such as x-ray or computed tomography (CT) scans.
While cryptic tonsillitis often goes unnoticed, it can cause symptoms including a metallic or foul taste in the back of the throat, halitosis, frequent coughing, choking or difficulty swallowing, pain in the ear, and infection. A 2007 medical study found that 75% of subjects suffering from halitosis, but only 6% of those with normal breath, had cryptic tonsillitis. In rare cases, giant tonsilloliths reaching a full centimeter in diameter can form.
There are various treatments for this condition, depending on its severity. Tonsil stones can often be removed with the tongue or by tensing the throat or stimulating the gag reflex, causing the tonsils to tense and expel the stone. Drinking a lot of water or club soda, regular tooth brushing, and gargling with mouthwash can also help loosen and dislodge tonsil stones. If small stones form deep within the tonsils, they are difficult to dislodge, but most of these do not cause serious symptoms, and work their way to the surface eventually.
In severe cases, cryptic tonsillitis may be treated by surgical removal of the tonsil stone with an oral curette, a thin scraping tool. Laser resurfacing, in which the surfaces of the tonsils are smoothed to remove the crypts, is an option for chronic cryptic tonsillitis. The most aggressive treatment, used only as a last resort, is tonsillectomy, or surgical removal of the tonsils. Tonsillectomy can weaken a person's immune system, so it is avoided whenever possible.