The co-author of this article is Jennifer Boidy, RN. Jennifer Boydy is a registered nurse from Maryland. She received a nursing degree from Carroll County Community College in 2012.
The number of sources used in this article is 11. You will find a list of them at the bottom of the page.
Purulent plugs in the tonsils (or tonsillolitis) are pieces of calcified substance that form on the back of the throat when bacteria, mucus, and dead cells enter the tonsils. If left untreated, suppurative plugs can cause bad breath, sore throat and ears, and difficulty swallowing. To prevent the formation of tonsillolitis, it is necessary to monitor oral hygiene, drink plenty of water and eat healthy food. In chronic cases of tonsillitis, tonsils are usually removed (tonsillectomy).
Attention:The information in this article is for informational purposes only. Before using any methods, consult your doctor.
A person throughout life is repeatedly disturbed by sore throat, discomfort. The reason for this condition is most often a common cold, which is accompanied by pain, tickling, irritation of the nerve endings, swelling of the mucous membrane of the pharynx. Such symptoms should not be treated on their own, because this can lead to the development of diseases such as tonsillitis, pharyngitis, laryngitis.
In the state of the body, tonsils play an important role, blocking and destroying harmful microbes that enter it with air or food. Tonsils take part in supporting immunity, perform hematopoietic function. In diseases of the oral cavity and pharynx, they primarily react, becoming inflamed and increasing. Often patients have white plugs on the tonsils, which require timely treatment.
Factors that contribute to the formation of plugs in the throat may vary for everyone. The exact cause will be determined by a specialist doctor using diagnostic methods such as a smear and a blood test. Soot and redness in the throat can be eliminated independently, but purulent plugs in the tonsils require special attention.
The etiology of the occurrence can be different, but any cause can cause inflammation of the tonsils. Most often, plugs in the tonsils are formed as a result of exposure to various microorganisms. They can accompany a sore throat and remain after it. Pathogens include diphtheria bacillus, adenoviruses, staphylococcus, pneumococcus, streptococcus. A smear from the larynx will determine the nature and nature of the pathogen, which will help in the appointment of treatment.
Tonsils in the tonsils do not cause noticeable symptoms if they are small. In some cases, they can only be detected with computed tomography or with an x-ray.
Large white plugs on the tonsils cause bad breath. It is the primary indicator of the disease. The appearance of a bad smell is associated with volatile sulfur compounds in the patient's breathing. The next symptom is an irritated throat. A feeling of discomfort and pain appears in the area of localization of traffic jams. Usually the caps in the tonsils are hidden, but sometimes they appear in the form of dense white deposits. Size and location affect swallowing, causing pain and difficulty. Corks can also cause tinnitus due to common nerve endings. With the hardening of bacteria and food debris, a purulent plug forms, which, against the background of the inflammatory process, can provoke an increase and swelling of the tonsils.
Traffic jams in a child on the tonsils or in women during pregnancy can cause some complications. Unwanted education can be dangerous both for the fetus and for the health of the expectant mother. Only the full activity of the immune system can prevent the occurrence of negative consequences. In such cases, women are prescribed rinsing, and after childbirth, the issue of complex treatment may be considered, including surgical intervention and removal of the tonsils.
In a child, traffic jams cause bad breath and impairment of well-being. In this regard, the baby can quickly get tired, nervous, act up more than usual, cry. Ignoring problems with the tonsils in a child can lead to impaired functioning of the nervous system, so it is important to contact a specialist in time for professional help.
What can not be done?
After the discovery of white pustules on the tonsils, some patients try to get rid of them on their own, which can only aggravate the course. Do not try to remove the cork in the tonsils on your own. How to get rid of them and not harm your health? Many people use rinsing, but with chronic tonsillitis it does not bring the expected benefits. The liquid contacts only the surface of the inflamed organ. She is not able to penetrate the gaps of the tonsils. Traffic jams remain, but discomfort decreases for a while.
You can’t try to remove abscesses by pressing a hard object on the tonsils. The secretions inside can clog even deeper when pressed. Additional trauma to the tonsils only exacerbates the course of the infectious process.
There are several ways to remove congestion on the tonsils, depending on the degree of discomfort and size. Special treatment does not require ulcers that do not provoke painful symptoms. At home, they can be carefully removed as they appear with tampons or sticks. Some effect can be achieved by rinsing with salt water. Warm salty liquid relieves discomfort. Large plugs in the tonsils are removed surgically.
In a clinic, a doctor can fight pustules in several ways. If their condition is not critical, then the tonsils are treated with a special antimicrobial solution with an antiseptic effect. After that, traffic jams can be forgotten for a while. Since one of the causes of the occurrence is angina, it is always necessary to treat this disease very carefully and to the end. If a person often suffers from it, and at the same time it is disturbed by traffic jams on the tonsils, the treatment is reduced to removing the tonsils.
Causes of occurrence
The main reason for the formation of tonsillitis plug is the presence of chronic inflammation and less often acute. When the throat is in good condition, the pathogenic bacteria that enter the lacunae of the tonsils are destroyed by the immune cells and do not cause illness. Also, purulent plugs do not appear.
If penetration of especially aggressive bacteria, such as staphylococci, occurs in the tissues of the tonsils, some changes develop that provoke suppuration. The cleansing of the gaps at this point is impaired, and purulent almond plugs appear at their exit. In addition to the inflammatory process, the following reasons can cause the formation of traffic jams:
- Poor oral hygiene. Because of this, a strong bacterial load appears on the tonsils, which violates the ability to resist the causative agents of the disease. In addition, microscopic food particles get into the gaps, which creates a favorable environment for the development of bacteria.
- General decrease in immunity. At this point, tonsils are not able to fully perform their functions, from which traffic jams form.
- Improper nutrition. If the diet is dominated by protein foods, as well as a lack of vitamins, there is a general weakening of the body and the immune system.
- Damage to the glands. If infection occurs in damaged tonsils, then inside the wound canal, as in gaps, a purulent process with the formation of a cork can easily develop.
Whatever the cause of purulent plugs, they require compulsory treatment with a doctor. It is extremely dangerous to independently remove serous masses from the tonsils.
It is not difficult to diagnose plugs containing pus in the tonsils by the presence of a number of noticeable manifestations of the disease. It has the following symptoms:
- a feeling of a foreign body in the glands - occurs if the formation is large,
- putrefactive odor from the oral cavity - purulent plugs have a characteristic unpleasant odor felt from the patient’s mouth,
- sore throat - occurs due to a constant inflammatory process and persistent tissue irritation with a purulent formation,
- white dots of various sizes on the tonsils - purulent plugs are clearly visible and look like white or yellow spots of various sizes. In rare cases, there are hidden plugs that are located in the folds of the tonsils and can only be detected by a doctor when examined using a special tool.
Seek medical help immediately as these symptoms appear. This will cure the tonsils without experiencing further development and complications. In exceptional cases, the disease can occur without temperature and pain.
- mediastinitis - with it, an inflammatory process develops in the deep tissues of the neck, as well as the chest, which poses a threat to the patient’s life,
- phlegmon of the neck (inflammation of the subcutaneous tissue of the neck) - pathogenic microorganisms from the tonsils penetrate the tissues and cause a violent inflammatory process, in which there is an abundant accumulation of pus. In the absence of urgent treatment, the probability of death is high,
- paratonsillar abscess - in the patient, a cavity filled with pus is formed next to the amygdala. Treatment of complications is possible only by surgical opening of suppuration,
- blood poisoning (sepsis) - with prolonged absence of therapy, pathogens spread throughout the body with the formation of multiple foci of purulent inflammation. In such a situation, it is extremely difficult to save the patient’s life even when conducting timely therapy in the most modern medical facilities.
Only if the treatment of purulent plugs on the tonsils is carried out correctly, it is possible to prevent the appearance of dangerous complications.
Caseous plugs consist of food debris, dead epithelial cells of the oral cavity and bacteria that decompose organic matter. In some cases, magnesium, phosphorus, carbonates and ammonia are present in plugs.
Usually, whitish-yellow tonsillolites are observed, but gray, brown or red formations are also found (depending on the substance prevailing in the traffic jams).
The formation of plugs in the tonsils is one of the main symptoms of chronic tonsillitis.
According to WHO data, chronic tonsillitis is the second most prevalent disease after dental caries, so white plugs in the tonsils are quite common.
It has been established that tonsillolitis in men is formed 2 times more often than in women, and is observed in all age groups except young children.
Accurate statistics on the frequency of distribution are not available, since only forms of complicated or often exacerbated chronic tonsillitis are recorded. At the same time, many researchers noted that tonsils without pathological changes are observed only in newborns, so plugs in the tonsils can be found even in healthy people.
The size of the cork varies from 300 mg. up to 42 gr.
Depending on the contents of tonsillolites, plugs can be:
- Purulent. They are observed in acute tonsillitis (tonsillitis), which occurs in a lacunar or follicular form.
- Caseous. Observed with wide lacunae of tonsils in healthy people and with chronic tonsillitis.
Reasons for development
The causes of the formation of plugs in the tonsils are not yet fully established. In 1921, Fine, considering the concept of chronic tonsillitis, suggested that the disease develops as a result of a violation of the process of emptying the lacunae.
L. T. Levin and other authors noted that the appearance of signs of chronic tonsillitis is accompanied by frequent tonsillitis in the anamnesis.
The appearance of plugs is associated with the structure of the tonsils - in each tonsil there are gaps (indentations), the depth and dimensions of which are individual in nature.
Purulent plugs in the tonsils occur with the development of acute inflammation caused by the penetration of pathogenic microorganisms (bacteria, viruses or fungi) into the tonsil tissue against the background of a decrease in immunity, hypothermia (both general and local), caries, chronic rhinitis or adenoids.
Caseous plugs in most cases are observed in the presence of chronic tonsillitis, which can be caused by:
- Not fully cured by the acute form of the disease. An interrupted course of antibiotic therapy or self-medication allows pathogenic microorganisms to settle in the tonsils, and provoke an exacerbation of the disease when the body's defenses are weakened (in case of any infection, overwork, etc.)
- Caries and periodontal disease. The presence of a constant source of infection in the oral cavity provokes an inflammatory process in the tonsils.
- Difficulty in nasal breathing, which is associated with curvature of the nasal septum, hyperplasia of the nasal concha and other disorders.
Also, the causes of the formation of caseous plugs include:
- frequent SARS,
- environmental factors.
Any inflammatory processes in the throat contribute to an increase in traffic jams in size.
The mechanism of the formation of plugs in the tonsils has not been fully studied, but it has been established that plugs in the tonsils are associated with structural features of the tonsils and their participation in the formation of normal immune mechanisms of the body.
The structure and localization at the intersection of the digestive and respiratory tract allows the tonsils to perform a protective function, as well as participate in metabolism and blood formation.
The palatine tonsils are mottled with small depressions that penetrate deep into the tissue, due to which the general surface of this organ increases. The walls of the crypts (branched hollows of the lacuna) in 3-4 layers are covered with epithelium, but there are also sections of physiological angization, where the epithelium is absent. It is in the area of these areas that microorganisms that have penetrated the lacunae come into contact with tonsil cells. Due to the limited penetration of pathogenic microorganisms, physiological inflammation is formed in the parietal region of the gaps, which stimulates the production of antibodies.
In the tissue of the tonsils are lymphoid cells - follicles, which take part in the fight against various infections.
The accumulation in crypts of tonsils of living microorganisms, their dead bodies and exfoliated epithelium leads to the formation of plugs.
Traffic jams in the tonsils irritate the nerve endings, cause a mild sore throat, provoke pain in the heart, cough and cause bad breath.
When infected with pathogenic microorganisms (often this is an adenovirus-streptococcal association) under the influence of weakening factors, limited inflammation in the crypts is activated and becomes pathological, spreading to the lymphadenoid tissue (parenchyma) of the tonsils, and purulent plugs form in the gaps.
The bacterial flora that is constantly present in the tonsils includes streptococci (especially hemolytic streptococcus group A), staphylococci, pneumococci, etc.
Caseous plug on the tonsil may not manifest itself in any way, but may be accompanied by:
- bad breath that occurs when decomposing food debris and other cork elements due to bacteria of hydrogen sulfide,
- a sensation of a foreign body in the throat (if the cork is large),
- unpleasant sensations at the location of the cork.
Such plugs themselves do not pose a great danger to the body.
Purulent plugs are accompanied by:
- Offensive odor from the mouth.
- Throat irritation.
- Soreness when swallowing.
- Swelling of the tonsils.
- White spots on tonsils. Since the corks themselves are often located deep in gaps, only a specialist can see them when examined, but they, like white spots, can be noticeable to the patient himself.
Since purulent plugs are formed in the acute form of tonsillitis, the disease is accompanied by general intoxication and fever.
The diagnosis is based on:
- History data. The otolaryngologist clarifies the patient's complaints, the frequency of transferred tonsillitis and acute respiratory viral infections, the presence of concomitant diseases.
- General examination, allowing to detect an increase in lymph nodes in the affected area. Pain on palpation indicates the presence of a toxic-allergic process.
- Instrumental research (pharyngoscopy). In chronic tonsillitis, it is possible to identify white plugs on the tonsils in a child, which are located on large pink or red loose tonsils, and plugs on medium or small smooth tonsils in adults. При остром тонзиллите выявляется отечность, гиперемия, расширение лакун и гнойные пробки в них (при фолликулярной ангине наблюдается картина «звездного неба»).
- Laboratory tests, including a blood test and a smear, to determine the microflora of the tonsils.
To confirm the diagnosis of "chronic tonsillitis" in some cases, a radiography of the paranasal sinuses and ECG is prescribed.
Caseous plugs in the tonsils, which do not cause unpleasant sensations, do not need treatment, since the tonsils are capable of self-cleaning.
With a sensation of perspiration, discomfort when swallowing and the presence of halitosis, cork on the tonsils in a child and in adults is treated with a conservative method.
Conservative treatment includes:
- Gargling with a medicinal solution. Thanks to rinsing, the general condition of the patient with chronic tonsillitis improves.
- Removal of plugs, for which vacuum suction or washing of the tonsils with antiseptic solutions is used.
Cleansing tonsils from plugs should be carried out exclusively by an otolaryngologist, because with improper methods for removing plugs located deep in the gaps, they can clog deeper into the tissue of the tonsil and injure it.
The presence of purulent plugs requires the use of antibiotics that prevent the spread of purulent infection.
- Ampicillin or other systemic antibiotics of the penicillin series are usually prescribed.
- Perhaps the use of azithromycin, sumamed, ceftriaxone and other drugs from the group of macrolides or cephalosporins with a wide spectrum of action.
General immunity is strengthened with the help of interferon preparations, tinctures of echinacea, amiksin, tactivin or immunal, and local immunity with the help of IRS-19 aerosol, lysozyme and Isofra nasal drops.
Vitamin C, B vitamins, and vitamin PP are also prescribed.
- infusions of sage, oak bark, chamomile or eucalyptus,
- saline-soda solution
- propolis tincture
To remove plugs, treatment with the Tonzilor apparatus has been successfully applied.
If necessary, physiotherapy is prescribed, including phonophoresis, UHF, microcurrents.
Laser lacunotomy is also used, in which the washed lacunae are partially laser sealed.
With the ineffectiveness of conservative treatment and the constant formation of traffic jams on the background of chronic tonsillitis, surgical intervention (tonsillectomy) is used.
Tonsil treatment for tonsils at home
Removing plugs from the tonsils at home is not recommended - it is rarely possible to completely remove them yourself. But in the treatment of chronic tonsillitis and in the fight against the formation of corks, popular methods are widely used that raise immunity, soften surface corks and facilitate their gradual rejection. To do this, use:
- Gargling with a solution that requires honey, lemon and beet juice in equal proportions (1 l), and 200 ml. water. The solution should be kept in the mouth for at least 2 minutes, rinsed about 7 times a day every day until the traffic jams and disturbing symptoms disappear.
- The use of tinctures of flower pollen and propolis.
- The use of the collection, which consists of rose hips, grass of Volodushka, calamus and peony root (20 grams each), root of Leuzea, ledum and St. John's wort (15 grams each), licorice, elecampane root and horsetail grass (10 grams each). The collection is brewed with 250 ml. boiling water and is drunk throughout the day.
Preventive measures include:
- daily oral hygiene procedures,
- treatment of caries and other diseases of the oral cavity,
- treatment of diseases related to the sinuses,
- rational nutrition and, if necessary, additional intake of vitamins,
- strengthening general and local immunity,
- timely vaccination and compliance with rules to avoid infection during periods of epidemic,
- hypothermia warning.
During the sore throat, it is recommended to periodically remove white plaque so that it does not lead to the formation of traffic jams. Do this once a day, rinsing your mouth with unsaturated saline with the addition of baking soda and iodine. After a comprehensive examination, the doctor removes the plugs using special equipment or a regular syringe, after which he introduces an antibacterial agent. ENT can also prescribe a lacunae wash and a course of antibiotics. Rinsing provides a lasting result and protects not only from the formation of plugs, but also from the occurrence of angina.
At the same time, immunity should be maintained by taking vitamin complexes. The professional advice of an immunologist is also important.
Traditional medicine recommends gargling and herbal teas for the treatment of traffic jams. The rinsing liquid may be based on iodine, salt, baking soda or medicinal plants (red beet juice, wormwood herb, oak bark, garlic, thyme, raspberry leaves, large plantain leaves, burdock leaves and roots, calendula flowers, medicinal sage, peppermint grass). In chronic tonsillitis, cloves that cleanse the lymphatic system are useful, and turmeric is a natural antibiotic that cleanses and warms the blood, normalizes intestinal microflora, and improves digestion.
You can still apply warming compresses, inhale the onion fumes, chew propolis. Herbal hot tea with lemon and honey will help remove jams in the tonsils. How to get rid of them at home and prevent their reappearance, the doctor will tell in more detail. You should stop smoking and review your diet. Fresh vegetables and fruits, first courses, light salads not only prevent the formation of corks, but also have a beneficial effect on the condition of the whole organism.
With angina, it is recommended to take the following actions to prevent the appearance of traffic jams: systematic rinsing of the throat, taking antibacterial drugs (as prescribed by the doctor), maintaining bed rest, drinking plenty of fluids.
Since plugs appear in chronic tonsillitis, prevention as such does not exist. Here you can remove the tonsils. Of the less radical methods - proper nutrition and proper oral care. Also, from time to time for preventive purposes, you can gargle with decoctions of herbs, a solution of salt with iodine and visit a doctor at least twice a year.
Traffic jam and plaque removal methods
If the tubes in the tonsils are small, then the patient may try to clean the tonsils on their own. Doing this is undesirable, but permissible. It is very important to properly prepare for the procedure, so as not to injure the tonsils and not even worsen the condition. There are several ways to remove purulent plugs at home.
Caseous plugs cannot be removed without a specialist, as they form deep in the gaps.
If you are not sure that at home you can carry out the procedure as it should, you should not self-medicate. In such a situation, you should consult a doctor.
This way to clean the tonsils is the safest, as it completely eliminates the risk of injury to the tonsils. With it, you should first rinse your throat with an antiseptic solution or water with sea salt. After that, the tongue is gently pressed onto the base of the tonsils and palatine arch, from which the corks come out. They should be tried to send to the oral cavity to spit out, and not swallow. If this fails, it is optimal to rinse the oral cavity with the same antiseptic.
Removing plugs with a toothbrush is quite dangerous. With this method, it is easy to injure tissue, which will lead to the spread of infection throughout the body.
Only a soft-bristled brush, new and treated with an antiseptic, can be used for manipulation.
After a thorough examination of the tonsils and gargling with an antiseptic composition, brush gently along the tonsils in the area of the traffic jams. If they are not deep, the bristles easily remove them. Pressure should not be applied during such cleaning, since if the brush damages the tissues, bacteria from purulent plugs will quickly spread throughout the body.
This method allows you to remove plugs of various sizes. It is highly discouraged to try to squeeze the plugs with your fingers first. Squeezing easily injures the tonsils and contributes to the spread of infection. The last time before cleaning the tonsils is to eat for 2 hours.
Also, before the manipulations, they brush their teeth, rinse the mouth with an antiseptic and wash their hands thoroughly with laundry soap. You can only wipe your hands with disposable paper towels to reduce the risk of bacteria entering the tissue.
Tonsils are cleaned in front of the mirror and only with good lighting. The cheek is carefully pulled away, and a sterile swab is pressed on the lower palatine arch (the tonsil is located behind it). You can also press on the glands themselves at their base, when it succeeds. If everything is done correctly, the cork appears on the surface of the tonsil and disappears. When the lumps of pus remain on the tissues, they are slightly tucked up with cotton wool.
During manipulations, severe pain is felt, which is the norm in this case. When, after 2 attempts, the cork could not be removed, self-medication is stopped and seek medical help.
The water flosser, which is used in dentistry for washing hard-to-reach areas, also allows tonsils to be washed. A solution with an antiseptic is poured into it and the area of the tube is treated directly. The pressure of the water, if the cork is not too deep, qualitatively removes the accumulation of pus. Before the procedure, rinse your mouth and throat with saline.
Rinsing allows you to clean the tonsils from external plugs, but this method does not guarantee complete cleansing and the absence of re-formation of plugs. For rinsing, it is useful to use a solution of sea salt, which is prepared at the rate of 1 tsp. substances per 200 ml of boiled, slightly warm water. You can also use water with 3 drops of iodine to rinse. With tolerability, Furacilin is prepared to rinse a composition of 1 tablet of the drug and 100 ml of water.
Rinses are carried out 2-3 times a day for at least 5 minutes in a row. With each sip of funds, gargle for at least 20 seconds. If the plugs do not come out, it is necessary to see a doctor to remove them.