bad breath (halitosis)

Q: I am a XX-year old woman in good health. All my life, I have had “large tonsils.” As a child, most of my colds involved a sore throat (pharyngitis) & often a strep infection, and, often what the doctor classified has “postnasal drip.”

For quite some time now, I have had halitosis. I practice good oral hygiene and have never had a cavity, but I can’t seem to get rid of my bad breath.

I was recently sick for about a month and a half with a bad cold/viral infection. During that time, I noticed that I had a thick, almost fuzzy whitish coating over my tongue and could do little to nothing to get rid of it. Ever since then, the coat has reappeared often in the mornings, but is easily brushed off when I brush my teeth, etc.

The reason I am writing is to see if you have any insight to add into WHY I have chronic halitosis, and even more importantly, HOW I can get rid of it. Is this an ear/nose/throat-related problem?

A friend of mine told me that halitosis can be caused by overly large tonsils, and something known as nasal concretions, which are basically pieces of rotting food trapped within the tonsils or sinus cavities. Is this information accurate?

tonsil stones?

Q: I hope this doesn’t sound too gross, but both my sister and I get white particles in the pockets of our tonsils. She thinks it is food buildup but I think it is the bacteria that the tonsils build up. The stuff is like cauliflower, kind of hard and with a foul odor. She thinks she needs to have her tonsils out. Can you advise us on this? We both have it regularly, but our throats are not really sore.

journal club: tonsillectomy

Extracts from The Cochrane Library: Tonsillectomy for chronic/recurrent acute tonsillitis

Martin J. Burton, DM, FRCS, Glenn Isaaccson, MD, and Richard M. Rosenfeld, MD, MPH. Otolaryngology-Head and Neck Surgery (2009) 140, 15-18

Adult tonsillectomy: Current indications and outcomes

Elizabeth K. Hoddeson, MD, and Christine G. Gourin, MD. Otolaryngology-Head and Neck Surgery (2009) 140, 15-18