“How can I prevent a relapse of my tonsil infection?”

Prevention of tonsillitis can be achieved through meticulous handwashing, the use of hand sanitizers, avoiding touching your nose/mouth/etc, and social distancing - especially around anyone who is ill.

Despite this, some patients are colonized with bacteria in their tonsils and suffer from repeat bouts of tonsillitis. These patients often only find temporary relief with antibiotics and may be best served with removal of the tonsils. However, this decision should be a last resort as there are serious risks associated with tonsillectomy.

Most episodes of tonsillitis are acute so that relapse is not the main concern. This could occur, however, if you were taking an antibiotic for a bacterial infection and didn’t finish the course of the medication. It could also lead to resistant organisms; so always take the full course of medication if it is given. Recurrent tonsil infections may be caused by a persistent strep infection and may need tonsillectomy to stop. If your tonsils are making stones (tonsilloliths) these are often recurrent and other than digital manipulation to remove them, surgery may also be necessary for long-term relief.  

Most of the throat infections may be initiated by a virus which can then activate dormant bacteria in the tonsil crypts. There may be other bacteria causing infections rather than Streptococcal infections are which are treated to reduce potential complications of strep. Good oral hygiene and healthy habits may reduce infection from relapsing.

Avoid those with colds. Gargle frequently with dilute salt water (or baking soda), 1/2 tsp in glass of lukewarm water. Wash hands frequently. If having 3-4 infections/ year, consider tonsillectomy.

Infection relapse can in many cases be prevented by regular gargling with salted water. The idea is that since the tonsils have a rough surface, food can accumulate in the crypts (holes). By gargling, one effectively removes the debris that gets lodged and decreases the risk of inflammation, tonsillolith formation (these white pieces of debris that can occur) and infection. I ask patients to boil 2 tablespoons of idolized salt in 4 cups of water, and bring back to room temperature (do not refrigerate since the salt will crystallize again!). Gargle with that solution after meals - or at least twice a day! Some people are able to brush their tonsils with their toothbrush, that can be great too, but it is almost impossible to many, so not so useful... Hope this can help. All the best!