Tonsil stones impact tens of millions of Americans, causing them to rank among the country's top oral care issues. Also called tonsilloliths, a Greek word that translates to tonsil stones, these hard off-white or yellow-white objects form in small pockets in the tonsils known as tonsil crypts. Tonsil stones are caused when bacteria, mucous, food and other oral debris collect in the tonsil crypts, where they produce notoriously bad cases of chronic halitosis.

Besides halitosis, tonsil stones frequently are responsible for the very irritating sense of something foreign being trapped at the rear of the throat. Many afflicted with tonsil stones are so concerned about these unwanted symptoms that they seriously consider the radical action of permitting their tonsils to be surgically removed in a procedure known as a tonsillectomy.

Tonsillectomies were formerly amongst the most common operations, especially during the 1950s and 1960s, when many children routinely had their tonsils removed. Today, America's surgeons perform about 600,000 tonsillectomies annually. Because the total number of tonsillectomies has declined, many more people still have their tonsils than in the past. As a result, tonsil stones are more prevalent today than they once were.

Although a tonsillectomy will alleviate the symptoms of tonsil stones, virtually all doctors regard the procedure to be a much too radical solution to the dilemma of tonsil stones. This is definitely the case for adults considering the procedure. As we age, the risk of unintended surgical complications, even from minor surgery, rises significantly.

Fortunately, surgery is rarely if ever necessary and treating tonsil stones without a tonsillectomy is generally uncomplicated. Those afflicted with tonsil stones are frequently able to remove the stones by themselves through coughing, massaging the throat, or with the assistance of a cotton swab or oral irrigation tool like a Waterpik. However, those with a strong gag reflex may find it necessary to visit an Ear, Nose and Throat specialist, or ENT.

Even when they have been removed, tonsil stones can and do come back. Several e-books now being sold on the Internet champion different natural treatment methods for preventing tonsil stones. Changes in diet, particularly those that focus on high fiber foods and eliminating the intake of milk and other dairy products, may also alleviate symptoms.

If natural treatment methods don't work for you, try an oxygenating rinse and nasal sinus drops. These will prevent the accumulation of bacteria and secretions in the tonsils and help prevent the recurrence of tonsil stones.

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Tonsil stones smell, something you've almost certainly noticed if you've ever coughed up a stone or accidentally bit down on one. But why do they smell?

According to Dr. Harold Katz, founder of the California Breath Clinics and an expert on bad breath, tonsil stones smell because of anaerobic bacteria that thrive in oxygen-poor environments.

Together with food particles and mucous from post-nasal drip, these bacteria collect in pockets in the tonsils called tonsil crypts. The putrifying odor comes from volatile sulfur compounds produced by the bacteria.

Bad breath produced by tonsil stones is some of the the toughest bad breath, says Katz, who recommends nasal sinus drops and oxygenating sprays and rinses as a way of combatting the problem. The sprays and rinses kill the anaerobic bacteria, while the sinus drops eliminate the mucous that is a key component in the formation of tonsil stones.