This week is showing a case of calcifications in the tonsillar crypts also known as tonsiliths. Tonsiliths are incidental findings on pantomographs. Tonsiliths clinically present as yellow-white stones in the tonsillar crypts. They range in size from millimeters to centimeters. These can be removed with forceps from the patients mouth. There is no harm in removing them and it may even improve the breath of the patient. A few studies have linked tonsiliths with halitosis (bad breath). I have been told tonsiliths ‘smell like death’ from a person who had them come out while rinsing their mouth with Listerine. This case shows multiple radiopaque entities superimposed over the angle and ramus of the left mandible. As this is an incidental finding, the only recommended treatment is to look clinically for the presence of them. If they are evident, you can remove them or leave them there (it’s your call).
For more information and other radiographs of tonsiliths check out the page on tonsiliths.