Tonsils and Bad Breath

Suffers of breath malodor often wonder if there is a connection between tonsils and bad breath. Usually, this is not the case, but in certain circumstances bacteria multiplying at the back of the throat in the tonsil area can cause a bad odor on the breath. This odor has one of two sources: the breakdown of healthy tissues caused by an active infection - pharyngitis - such as strept throat, or the breakdown of dead cells and food particles by anaerobic bacteria that are part of the normal ecosystem of the mouth. This article deals with the second scenario.

To understand the link between tonsils and halitosis, it's helpful to understand what the tonsils are and where they're located. We actually have three types of tonsils in the nasopharynx, the area at the back of the mouth and the top of the throat. The pharyngeal tonsil (also known as the adenoids) lies at the back of the nasal cavity high in the throat. The palatine tonsils are located at the back of the oral cavity and are visible when the mouth is opened widely. Lastly, the lingual tonsils are situated at the very base of the tongue. All of these tonsils are part of the lymphoid system - an important part of the body's defenses against invading and potentially disease causing organisms. The tonsils that most commonly give rise to an association between tonsils and bad breath are the palatine tonsils.

The palatine tonsils lie between folds of tissue called tonsillar pillars. The tonsils are composed of dense lymphoid tissue and each has between ten and twenty little hollows in its surface. The tiny hollows, called tonsillar crypts, collect shed epithelial (skin) cells from the lining of the mouth and throat, white blood cells (pus cells), both living and dead, and oral bacteria - a combination that can easily explain why tonsils and bad breath sometimes go together. Located as they are, in the back of the throat, these crypts have sinus drainage, saliva, chewed food, and cellular debris constantly passing by them. In some people, particularly those who have chronic sinus irritation with post nasal drip, material can build up in the tonsillar crypts, causing the aggregates that are the link between halitosis and bad breath. These aggregates are called tonsil stones or tonsiloliths.

Tonsiloliths are literally little balls of dead cells, debris, and bacteria. The bacteria, inhabitants of tonsils, and bad breath producers, find a ready source of food in the dead and decaying cellular material. Consuming the protein there, they produce foul smelling compounds called volatile sulfur compounds as they multiply. As long as the tonsil stones remain lodged in the tonsillar crypts, the bad odor will be produced; eventually the tonsil stones become large enough to be dislodged and swallowed. Then new ones will begin to form. For people who tend to develop tonsiloliths, the problem of stones in the crypts of the tonsils and halitosis is likely to be continuous over time, and require a regular program to combat breath malodor.