Who is at the greatest risk for tonsil stones, bad breath?

If you've never heard of tonsil stones before, that doesn't mean you haven't had them. In fact, many people are unaware that they are carrying them around (and some vicious bad breath to boot). It can be a difficult topic for friends and coworkers to broach, so read on to see if you're at a high risk for developing them.

First, what exactly causes tonsil stones, also known as tonsilloliths? These little objects, which are often no larger than a grain of sand, originate when your oral bacteria and the food you eat each stick to - what else - your tonsils.

In a way, tonsil stones are a perfect storm of poor oral hygiene, bad luck and the inability to smell your own halitosis. When you eat a meal, microscopic bits of food stick to your tonsils and adenoids, which are those lumps of tissue on either side of your throat.

Bacteria go to town on this immoveable feast, making a sticky mess called a biofilm. Soon, more food is adhering, more microorganisms are piling on top, and you have a tonsil stone, a small, whitish lump in the back of your throat.

Without the ability to smell this object - which gives off a truly repulsive odor - you can have a tonsillolith for years with knowing it.

So who is at the highest risk for having tonsil stones and, by extension, halitosis?

- Those with cryptic tonsils. While it may sound fabricated, this is an all too real condition. Typically occurring among people who have had a serious throat or sinus infection at least once, this health problem occurs when the glands swell, get wrinkled (like a raisin) and stay that way. All the folds in the tonsil catch food particles and form the ideal breading ground for microbes.

- People who have not had a tonsillectomy and adenoidectomy. Without these glands, it's difficult to get tonsil stones, as you might expect.

- Individuals who have post-nasal drip. This condition allows mucus to slide down the back of the throat, giving microbes nourishment and you bad breath..

- Smokers. Smoke adheres to the throat tissue very well and does your mouth's flora cleanliness no favors.

If you find tonsil stones in your mouth, it's probably time to switch to a specialty breath freshening mouthwash, which can loosen and eliminate tonsilloliths.