Our tonsils are among the first lines of defense against illness. They work like skimmers or nets, trapping bacteria and viruses as they pass through the throat. But they don’t always work the way they’re supposed to. On occasion bacteria, dead cells and mucous can become trapped in the crevices of the tonsils, gathering and hardening into small white or yellowish stones called tonsil stones.

These stones, also known as tonsiliths are accumulated bits of food, post-nasal drip and bacteria that collect in and around the tonsils. These accumulations gather into small, hard, yellowish stones that look like small, almost invisible white spots in the back of your mouth. They can also be caused by overactive salivary glands or a reaction to dairy products.

Not long ago, people simply thought these tonsiliths were bits of food or bits of plaque that got caught in the back of the throat — and indeed, they are very small, such that normal physical examinations may not catch them; in some cases, they won’t be seen until a more refined test is used, like a CT scan.

Do you have tonsiliths? That depends; symptoms can be embarrassing and unpleasant indeed. If you have tonsil stones, you can feel as though something is stuck in the back of your throat or that your throat is somehow “tightening.” You may have a metallic taste in your mouth, and you’ll almost always have chronic bad breath.

You can treat tonsil stones, though, and in many cases you can do it from home. Gargle thoroughly and establish a good oral hygiene routine, which can help take care of them. You can reach the back of your throat with your finger, a Q-tip, or the back of your toothbrush, and gently scrape them away. You can squeeze them out by brushing gently upwards with your brush, finger, etc., pressing gently as you do so. There are other methods you can get rid of them with, too, and you can find them by Googling, “tonsil stones,” or “tonsiliths” on the Internet.

If tonsiliths are particularly severe, surgery may be recommended. Cryptolysis involves having a surgeon remove tonsiliths with a laser, and then smoothing tonsil surfaces so that tonsiliths can’t regrow. Remember, though, even though this may seem like a good idea, when the tonsil surfaces are smoothed, this negate some of the benefits of the rough surfaces’ catching of bacteria and other foreign matter as a means to prevent infection and so on.

If the problem is particularly severe, you can of course have your tonsils removed. However, even though this will probably take care of the tonsiliths, it won’t take care of the bad breath you normally get, and it won’t even necessarily stop tonsiliths from forming. Surgery is expensive and painful, and it can take up to a month to completely recover.

Among the less drastic and arguably better ways to manage tonsiliths is to practice good oral hygiene and follow a healthy diet. Reduce dairy intake if necessary and brush your teeth after you eat and especially before bed. This will keep food from possibly accumulating that could cause tonsiliths to form. Gargle as part of your oral hygiene, and make sure you drink plenty of water, too. This will help keep tonsiliths from forming, but these tips are also good for your health in general.