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What to Do About Cryptic Tonsils

Cryptic Tonsils


Updated May 23, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Cryptic tonsils are pockets in the tonsils that accumulate food and other debris, cause bad breath and occasionally sore throat. Cryptic tonsils are also called tonsil stones, tonsilloliths, fetid tonsils and chronic caseous tonsillitis.

Cryptic tonsils look like white beads on your tonsils or patches of pus. Because of this, the condition looks similar to strep throat or another throat infection. Fortunately, cryptic tonsils alone are not generally harmful to your health.

You can get cryptic tonsils because you have naturally "wrinkly" tonsils, which are more prone to trap food. Other debris can accumulate in these holes in your tonsils as well, including pus and a bacteria that produces volatile sulfur compounds and creates halitosis (bad breath). Of all the causes of bad breath, cryptic tonsils only account or about 3% of cases, though.

There are a couple of options for treating cryptic tonsils, depending on the severity of the condition. Some individuals use water picks to remove the debris, although there isn't much research on the safety of this practice. Special care should be taken not to damage tissue if using a water pick. Other objects such as tongue depressors or sharp objects should not be used to remove the debris as it may result in damaged tissue.

Another treatment for cryptic tonsils is CO(2) laser cryptolysis. This is an in-office procedure which uses a laser beam to ablate (get rid of) the pockets in the tonsils. The patient is given a local anesthetic to prevent pain and the procedure takes about 20 minutes. Cryptic tonsils and bad breath may be cured the first time this procedure is performed, but some individuals may need the procedure a second time.

The last option to treat cryptic tonsils is a tonsillectomy. Removing the tonsils is effective virtually 100 percent of the time, but the surgery has risks that must be considered. Tonsillectomy is usually only recommended if you have other problems related to your tonsils such as chronic strep throat or sleep apnea.


Medscape Today. Chronic Tonsillar Exudate. Accessed: October 5, 2009 from http://www.medscape.com/viewarticle/450141

Optics.org. Laser Therapy Cures Bad Breath. Accessed: October 5, 2009 from http://optics.org/cws/article/research/20867

PubMed. Relationship Between the Presence of Tonsilloliths and Halitosis in Patients With Chronic Caseous Tonsillitis. Accessed: October 5, 2009 from http://www.ncbi.nlm.nih.gov/pubmed/18037821

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