Tonsil Issues: When to Seek ENT Help and Infection Risks

Tonsil issues, may I ask?

Hello, Doctor Hong.
Previously, I visited an ENT specialist because I had tonsil stones.
The doctor used a tool to press on it and later seemed to suction it out.
After lunch today, while brushing my teeth, I noticed a white spot near my tonsils that looked like a fish gill.
The cotton swab was too short to reach it, so I used chopsticks and rinsed with mouthwash.
I gently pressed on it, and a small part came out, which had a foul smell.
However, I felt a slight discomfort when the chopsticks touched it, possibly because the tonsils are sensitive.
Later, I noticed a little blood in my saliva, but it stopped after rinsing a few times.
I would like to ask if I need to see an ENT specialist again, even though I currently feel fine.
I still see a bit of white, but I'm afraid to try to remove it myself, worried about bleeding or infection.
I'm unsure if the clinic doctor would be willing to examine my mouth for this issue, and I hesitate to go to a hospital for something minor.

Additionally, the previous doctor told me not to worry too much if I wasn't experiencing discomfort, inflammation, or social issues, suggesting that drinking water, rinsing, talking, and coughing would help it come out on its own.
Lastly, I just found out from my brother that our father has hepatitis B.
Given that I have a small potential wound, could this be a risk for transmission? I primarily use my own chopsticks, and I always clean them and use a heating sterilizer afterward.
Am I at risk of infection? My brother often scares me with these things, but I thought if it were a risk, I would have been in danger when I had bleeding gums while eating before.
I'm not sure about this mode of transmission, so I wanted to ask for your advice.
Thank you, Doctor.
😊

Ni Ni, 20~29 year old female. Ask Date: 2021/07/26

Dr. Hong Yuanbin reply Internal Medicine

Hello, tonsil stones, as your doctor described, do not necessarily require any special treatment if there is no discomfort or inflammation.
Regarding hepatitis B, it is primarily transmitted through vertical transmission and blood.
The risk of infection from bleeding in the mouth, as you mentioned, is low.
Thank you for your question.

Reply Date: 2021/07/26

More Info

When it comes to understanding tonsil issues, particularly in the context of tonsil stones and potential infections, it's essential to recognize when to seek help from an Ear, Nose, and Throat (ENT) specialist. Your experience with tonsil stones, which are calcified deposits that can form in the crevices of the tonsils, is quite common. They can lead to discomfort, bad breath, and sometimes even infections if not managed properly.

From your description, it seems you have successfully removed some of the tonsil stone material, but you also noted some discomfort and a slight amount of blood. This is a critical point to consider. While minor bleeding can occur from the tonsils due to irritation or trauma, it’s important to monitor the situation closely. If the bleeding persists, increases, or is accompanied by significant pain, fever, or swelling, you should definitely seek medical attention.

Regarding the white material you observed, it could be remnants of tonsil stones or possibly a sign of an infection, such as tonsillitis, especially if it has an unpleasant odor. The advice you received from your previous ENT doctor about not worrying too much if there are no symptoms of inflammation or discomfort is generally sound. Tonsil stones can often be managed with good oral hygiene, including regular gargling with salt water and staying hydrated. However, if you feel that the situation is worsening or if you develop new symptoms, it would be prudent to consult an ENT specialist again.

As for your concern about potential transmission of Hepatitis B due to a minor injury in your mouth, it’s important to clarify how Hepatitis B is transmitted. Hepatitis B is primarily spread through contact with infectious body fluids, such as blood, semen, or vaginal secretions. While it is theoretically possible to contract Hepatitis B through a cut or open sore if it comes into contact with infected blood, the risk in your situation seems low, especially since you mentioned that the utensils you used were cleaned and sterilized afterward.
However, if your father has Hepatitis B, it’s wise to be cautious. If you have any open wounds or cuts, it’s best to avoid sharing utensils or engaging in activities that might expose you to his blood. If you have concerns about your exposure or if you start experiencing symptoms such as jaundice, fatigue, or abdominal pain, it would be advisable to get tested for Hepatitis B and discuss your concerns with a healthcare provider.

In summary, while tonsil stones can often be managed at home, any signs of persistent bleeding, significant discomfort, or new symptoms warrant a visit to an ENT specialist. Additionally, while the risk of Hepatitis B transmission in your scenario appears low, it’s always best to err on the side of caution and consult with a healthcare provider if you have concerns about potential exposure. Regular check-ups and open communication with your healthcare provider can help ensure that any issues are addressed promptly and effectively.

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