01

In this article

  • They may cause bad breath or a foreign-body sensation
  • They are usually harmless
  • Recurrent tonsillitis or deep crypts may contribute
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Assessment and treatment

  • Good oral hygiene and salt-water gargles
  • Do not use sharp objects to remove them
  • Seek ENT advice if recurrent or troublesome
QUICK FACTS

At a glance

Definition: Food debris, cells and bacteria may collect in tonsil crypts and form small white or yellow deposits.

Key takeaways

  • They may cause bad breath or a foreign-body sensation
  • They are usually harmless
  • Recurrent tonsillitis or deep crypts may contribute

Clinical steps

  1. Good oral hygiene and salt-water gargles
  2. Do not use sharp objects to remove them
  3. Seek ENT advice if recurrent or troublesome

Red flags: Severe one-sided pain, fever, restricted mouth opening or breathing difficulty needs prompt assessment.

Quick FAQ: When should I see an ENT specialist?

Severe one-sided pain, fever, restricted mouth opening or breathing difficulty needs prompt assessment.

EXPERT INSIGHT

How I assess this in clinic

I first clarify duration, severity, whether symptoms are one-sided or bilateral, and their effect on daily life. I then perform a focused ENT examination and compare the findings with they may cause bad breath or a foreign-body sensation.

Endoscopy or audiometry is not required for everyone. I advise endoscopy when the nose, sinus, throat or voice box needs direct assessment, and audiometry/tympanometry when hearing or middle-ear function is in question.

A common misconception is that every ENT problem needs an antibiotic or an operation. Treatment should instead follow the diagnosis, functional impact, examination findings and evidence-based indications.

Do not wait when: Severe one-sided pain, fever, restricted mouth opening or breathing difficulty needs prompt assessment.

ReferencesEar, nose and throat careNHSSore throat (acute): antimicrobial prescribingNICEAbout Strep ThroatUS CDC

For patient education; not a substitute for individual diagnosis or treatment.