What Are Tonsil Stones?

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iStock

Sometimes, feeling like you have a lump in your throat has nothing to do with strong emotions. Sometimes, it’s just tonsil stones, those pebble-like white things that some people periodically find nestled inside their tonsils. Just what are these gross throat squatters?

The answer is both simple and complicated. Tonsil stones are normally white-ish yellow and can range in size from microscopic bits to chunks several centimeters in diameter. These tonsilloliths—the official medical term—are made of material that accumulates in the crevices of the tonsils.

You see, tonsils aren’t just smooth mounds of tissue. They have folds called tonsillar crypts that form pits in the tissue. The tonsils act as the body’s defender against any foreign substances that come in through your mouth, and tonsillar crypts increase the surface area of the tonsils to give them more of a chance to catch anything coming in that the body needs to mount an immune response to. A normal tonsil usually has dozens of crypts.

Just how tonsil stones are formed within those crypts is a little more complicated. Mental Floss spoke to three different otolaryngologists (ear, nose, and throat doctors) on the subject, and each of them provided slightly different answers.

A medical diagram of a tonsil
An Atlas of Human Anatomy for Physicians (1919), The Internet Archive // Public Domain

Like any tissue in your body, tonsils are constantly regenerating. Just like your skin peels, that dead tonsil tissue gets sloughed off. It normally ends up going down your throat, but it can also get trapped in these crypts. There, bacteria from your mouth can start to grow on it, turning that material into a semi-hard stone that Dr. Erich Voigt, the director of general otolaryngology at NYU Langone Health in New York City, likens to “a cheesy ball.” (Apologies if we’ve now ruined cheese for you.)

Tonsillar crypts are the perfect environment for bacteria, because they’re poorly oxygenated but rich in blood supply. “It becomes an opportune area for the bacteria to populate and adhere to each other, and they form what’s called a biofilm structure,” Dr. Yosef Krespi, an otolaryngologist who practices in the North Shore-LIJ Health System in New York, tells Mental Floss. A tonsil stone is just a lump of biofilm, he says. In a 2008 study, he and his colleagues examined tonsilloliths in the lab, finding that structurally, they look a lot like dental plaque, another biofilm in the mouth.

But Dr. Jay Shah, a pediatric otolaryngologist at Cleveland’s University Hospitals Rainbow Babies and Children’s Hospital, explains that the yellowish lump you remove from your throat isn't exclusively bacteria. When researchers have examined what tonsil stones are made of, he says, “there’s calcium, there’s sulfur—there’s a whole host of other elements within them,” he explains.

That's not to say the bacteria aren't involved. Scientists studying the microbial makeup of tonsil stones have found that the types of anaerobic bacteria commonly found around and inside tonsilloliths are associated with producing volatile sulfur compounds, which is why people with really bad cases of tonsil stones can suffer from bad breath.

While Voigt and Shah emphasized the tissue and keratin (proteins found in the lining of the mouth, as well as in hair and skin) from the tonsils that gets trapped in these crypts as the source of stones, other studies have noted that trapped food debris in the tonsillar crypts can cause tonsilloliths. One study even suggests they could be formed by trapped spit alone.

Often the tonsil stone that you see in your throat isn’t the whole thing, according to Krespi. You may only be seeing a portion that has broken off from the “mother” stone that’s still lodged down in a very deep tonsillar crypt, he says, meaning that you’ll continue to see stones. Voigt, however, says that while some patients do have recurring stones, for others, the problem is temporary and may go away after a few weeks or months.

Everyone has tonsillar crypts, dead skin cells, and bacteria in their mouth, but not everyone gets tonsil stones. “The biggest question is, why do some people get them and some don’t? We don’t know,” Shah says. Some people have bigger crypts than others in their tonsils, and, since it’s easier for stuff to accumulate in larger crypts, those people seem to be more likely to have a problem with tonsil stones. But large tonsil stones are very rare, and you’re much more likely to be dealing with a few harmless small tonsilloliths than a sizable stone. In general, tonsil stones are more common if you have a history of tonsillitis or just have large tonsils that have a lot of big nooks where bacteria can get trapped.

It’s hard to say just how common tonsil stones are. Some studies estimate their prevalence at around 8 percent of the population, while others suggest that they might affect as much as 25 percent of the population. Both of those might be low estimates. The researchers Mental Floss spoke to reported seeing them regularly in their practice, even in patients who weren’t aware that they had them.

The fact that there isn’t firm data on how many people deal with tonsil stones may reflect the fact that they don’t usually require seeing a doctor. As the authors of one large study on tonsil stones from a Japanese dental hospital noted in 2013, tonsilloliths are “relatively commonly encountered in daily clinical practice, but patients rarely have complaints related to them.”

A tonsillolith next to a ruler showing it to be slightly less than 1 centimeter wide
Tonsillolith, Wikimedia Commons // Public Domain

Because while it can be alarming (or, depending on your perspective, fascinating) to look into your throat and see white specks in the back of your mouth, tonsil stones are typically harmless. One ear, nose, and throat doctor likens them to acne of the tonsils. They’re a little gross, but for most people, tonsil stones don’t come with any major side effects.

In serious cases, big tonsil stones can cause trouble, leading to ear pain, difficulty swallowing, and other discomfort, but that’s fairly rare. Most people with tonsil stones manage to handle them without any medical intervention, removing them with a Q-Tip, a finger, or gargling with salt water. While a doctor has specialized tools that can be used to safely remove tonsilloliths, as long as you’re not poking something sharp into your tonsils or pushing them deeper into those crypts, you’re probably fine. If you’re prone to tonsil stones, Voigt suggests gargling with a 50/50 mixture of hydrogen peroxide and water to clean out your tonsillar crypts. You can also use a water pick for the same task.

The only way to totally get rid of tonsil stones permanently is to remove the tonsils entirely. But for most people, gargling or a periodic Q-tip session works fine–and makes for some pretty good video.

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Who Was Heisman and Why Does He Have a Trophy?

Ronald Martinez/Getty Images
Ronald Martinez/Getty Images

Before anyone brings home the hardware, let’s answer a few questions about John Heisman and his famous award.

Who Exactly Was John Heisman?

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His name is mostly associated with the trophy now, but Heisman (right) was a player, coach, and hugely successful innovator in the early days of football. After playing for Brown and then Penn as a collegian from 1887 to 1891, Heisman became a coach at a series of schools that included Oberlin, Buchtel, Auburn, Clemson, Penn, Washington & Jefferson, Rice, and, most notably, Georgia Tech.

For What Football Innovations Does Heisman Get Credit?

Just some little trivial stuff like snapping the ball. Centers originally placed the ball on the ground and rolled it back to their quarterbacks, who would scoop it up and make plays. When Heisman was coaching at Buchtel (which later became the University of Akron), though, he had a 6’4” QB named Harry Clark. Clark was so tall that picking the ball up off the ground was wildly inefficient, so Heisman invented the center snap as an easy way to get the ball in Clark’s hands. Heisman also innovated the use of pulling guards for running plays and the infamous hidden-ball trick.

Any Other Shenanigans on Heisman’s Resume?

You bet. When Heisman found a way to gain an edge, he jumped on it no matter how ridiculous it seemed. When Heisman was coaching at Clemson in 1902, his team traveled to Atlanta for a game against Georgia Tech. Although Heisman was known for being a rather gruff disciplinarian, the Clemson team immediately started partying upon their arrival.

When Georgia Tech’s players and fans heard that the entire Clemson squad had spent the night before the game carousing, they prepared to coast to an easy win. When the game started, though, Clemson roared out of the gate en route to a 44-5 stomping.

How did Clemson crush Tech when by all rights they should have been ridiculously hungover? The “team” that everyone had seen partying the night before wasn’t really Heisman’s Clemson squad at all. He had sent his junior varsity players to Atlanta the night before to serve as drunken decoys, then quietly slipped his varsity team in on a morning train right before the game.

What Kind of Coach Was He?

Heisman worked as an actor in community stock theater during the summer – he consistently received rotten reviews – and allegedly spoke in a brusque, yet bizarrely ostentatious manner. Georgia Tech’s website relates a story of one of Heisman’s speeches he would break out on the first day of practice while describing a football: "What is this? It is a prolate spheroid, an elongated sphere - in which the outer leather casing is drawn tightly over a somewhat smaller rubber tubing. Better to have died as a small boy than to fumble this football."

How Did His Name Get on the Trophy?

After leaving his head-coaching job at Rice in 1927, Heisman became the athletic director at New York’s Downtown Athletic Club. In 1935 the club began awarding the Downtown Athletic Club Trophy to the nation’s top college football star. (Chicago’s Jay Berwanger won the first trophy.) Heisman died of pneumonia the following fall before the second trophy could be awarded, and the club voted to rename the prize the Heisman Memorial Trophy Award.

Did He Ever Really Throw that Iconic Stiff Arm?

© Bettmann/CORBIS

Possibly, but Heisman didn’t have the ball in his hands all that much. Even though he was a fairly small guy at just 5’8” and 158 pounds, he played as a lineman throughout his college career.

The famous “Heisman pose” is actually based on Ed Smith, a former NYU running back who modeled for the trophy’s sculptor in 1934. Interestingly, Smith went years without knowing that he’d modeled for the famous trophy. His sculptor buddy Frank Eliscu had just needed a football player to model for a project, and Smith volunteered.

Smith figured Eliscu was just doing some little personal sculpture and remained totally oblivious to his spot in football history for the next 48 years until a documentary filmmaker called Smith to interview him about the Heisman in 1982. Smith initially had no idea what the guy was talking about, but he eventually remembered his modeling days. In 1985, the Downtown Athletic Club gave Smith his own copy of the Heisman, and in 1986 he even received recognition on the televised ceremony. He looked at the four finalists – Vinny Testaverde won that year – and quipped, "Whoever wins the award, I feel sorry for you, because you're going to be looking at my ugly face for a long time." [Pictured Above: Auburn's Bo Jackson in 1985.]

What’s a Heisman Trophy Worth on the Open Market?

Quite a bit. A number of Heisman winners have eventually sold their hardware, and the trophies fetch quite a bit of loot. O.J. Simpson got $230,000 for his, and several others have gone for six-figure prices. The most expensive trophy that’s changed hands was Minnesota back Bruce Smith’s 1941 award; it fetched $395,240.

How Did Steve Spurrier Change the Process?

SEC fans are going to be floored by this one, but the Ol’ Ball Coach did something really classy when he won the Heisman in 1966. Instead of taking the trophy for himself, Spurrier gave it to the University of Florida so the school could display it and let the student body enjoy it. Florida’s student government thought Spurrier’s generosity was so classy that they paid for a replica for Spurrier so he’d get to have his own trophy, too. Since then both the school and the player have received copies of the trophy.

So Heisman Must Have Been the World’s Greatest Sportsman, Right?

Well, not really. Heisman was on the victorious side of possibly the most gratuitously run-up score in sports history. In 1916 tiny Cumberland College canceled its football program and disbanded its squad, but it had previously signed a contract to travel to Atlanta to play Heisman’s Georgia Tech team. If Cumberland didn’t show up, they had to pay Georgia Tech a $3,000 penalty, which was quite a bit of cash in 1916.

Rather than forfeiting the money, Cumberland scraped together a team of 16 scrubs and went to take their walloping from Heisman’s boys. For reasons that still aren’t totally clear – some say it was to avenge an earlier baseball loss to Cumberland, while others claim Heisman wanted to make a statement about the absurdity of the old system of using total points scored to determine the national champion – the legendary coach showed Cumberland’s ragtag band no mercy. Tech went up 63-0 in the first quarter, but Heisman kept attacking until the final score was 222-0. There are tons of hilarious stats from the game, but the funniest is Georgia Tech rushing for 1,620 yards while Cumberland only squeaked out negative-96 yards on 27 carries.

This article originally appeared in 2010.

What Is Nougat?

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iStock.com/InaTs

If you've ever had a Snickers, Three Musketeers, or Milky Way bar, you know what nougat tastes like. The sweet, creamy concoction can range in texture from chewy to fluffy, and it is the star ingredient in many popular candy bars. But aside from being delicious, what is nougat exactly?

In its simplest form, nougat is made of two basic ingredients: egg whites and a sweetener, traditionally sugar or honey. The signature texture comes from how it's prepared. Like a meringue, eggs and sugar are whipped together quickly until the mixture is aerated and stiff.

Nougat predates mass-produced candy bars, with the confection originating in the Middle East around the 8th century. It spread to southern Europe and gained widespread popularity in 17th-century France. Nougat is still a common component in many Middle Eastern desserts today, and torrone, a type of nougat containing nuts like almonds and pistachios, is enjoyed in Italy around Christmastime.

As more large candy companies have embraced nougat, its quality has suffered over the years, with corn syrup often standing in for the sweetener. But you don't need to head to the candy aisle of your local supermarket to get your nougat fix. If you have eggs and honey in your kitchen, you can make nougat at home today.

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