White Spots on Tonsils (No Pain, Fever or Strep): Causes, STD, Sore Throat?

Many infections in the throat can result in the formation of either white, yellow or red spots and patches.  In most cases, tonsil stones, tonsillitis, oral thrush and other serious infections may lead to similar symptoms.

  • The bumps may be with no pain, no fever or any other symptoms.
  • Some people complain of a sore throat and strep throat

The size of these bumps can vary a lot depending on the cause and progression of the infection, if any. Let’s find out what brings about such a symptom.

What are white spots on tonsils?

Unusual small whitish dots or patches in your throat, on tonsils or around the uvula are in most cases pus cells. But this is not always the case.

When the back of your mouth has solid particles that appear to be yellowish to gray in color, they are normally tonsil stones.

However, in most cases, the dots are an indication of an oral infection that is producing pus cells.

[clickToTweet tweet=”Pus cells accumulate on the tissue surface due to the activity of white blood cells trying to fight bacteria and viruses.” quote=”Pus cells accumulate on the tissue surface due to the activity of white blood cells trying to fight bacteria and viruses.” theme=”style1″]

Meaning

Does it mean poor oral hygiene? Ordinarily, there’s no reason for you to worry or panic because you might have just noticed pus dots at the back of your throat and on tonsils.

In fact, it is normal to have debris on tonsillar crypts for a long time even without noticing it. However, there are times when you should actually worry.

For instance, if you see white dots at the back of your tongue and throat that won’t go away, it could mean an infection, a sexually transmitted disease (STD), allergy or even laryngeal cancer.

If you observe any of these symptoms, you should see a doctor for proper diagnosis and treatment. Below, we have listed the possible causes and symptoms that are related, such as fever, strep throat, cold and difficulty or pain when swallowing to help you clearly find out what your symptoms could be pointing to

Pictures

Below are pictures of similar white spots and patches on tonsils and back of the throat. In some people, as you can see in the photos, they may appear to be small dots or bumps.

In other cases, you will notice large patches that may keep growing to cover the surface in your throat and even cause pain when swallowing.

White spots on tonsils

Causes

Reasons for such symptoms range from less dangerous ones to some that are worrying. For instance, tonsil stones may not be serious if they are the cause. However, cancer and STIs and other infections including herpes, thrush, HIV, and chlamydia can be a source of worry. Here are the common causes.

1. Tonsil stones

Are tonsil stones normal? Yes, if you have white dots on your tonsils that come off or fall off when you try to remove them, they are tonsilloliths.

  • Tonsil stones are white lumps or orbs of debris trapped, hardened and calcified on the tonsil crypts or tonsil pockets.
  • These are mostly dead or destroyed bacteria and other particles accumulating in your throat after being destroyed by the body’s defense mechanism.

According to WebMD, tonsil stones are not harmful in most cases, even though they may cause a nuisance such as bad breath because they smell bad (smelly).

When they are big and visible, you may want to dislodge the stones from your throat by gargling with warm salt water or removing the stones from your throat manually.

2. STD

What STD causes white patches in the throat? HIV, chlamydia, gonorrhea, and herpes have all been known to cause similar symptoms in the mouth. These STDs or viral infections may manifest as pus cells on your tonsils, uvula or surfaces within the mouth.

Chlamydia

Chlamydia is sexually transmitted and people who have oral sex are at a higher risk of showing oral chlamydia symptoms. These include inflamed and swollen tonsils, nausea, pain all over the body, fever, reduced appetite, sore throat and more importantly, white stuff in the mouth.

Gonorrhea

According to the University of Illinois at Urbana, (see sources), gonorrhea manifests itself with symptoms in the oral cavity.

The symptoms may show a lot faster if transmitted through oral sex. The reason for the yellow and white patches in the throat is that the viral infection has exudate (white or yellowish patches) that settle in your oral cavity.

Herpes Simplex Virus (HSV)

Oral herpes can also show symptoms such as oral sores or mouth sores, itching mouth, swollen gums, swollen uvula and lymph nodes and most importantly, grayish or whitish coating on tonsils.

The plaque is likely to start covering tonsils if left untreated or after antibiotics or penicillin treatment.

HIV

Another STD that is known to cause white plaque or yellowish coating on tongue and throat is HIV. The white bumps in the mouth may be accompanied by red inflamed tonsils at the back of the throat.

Esophageal patches may come from opportunistic infections and fungal lesions such as candidiasis.

Candidiasis can also be seen in babies or children at 3 years and below if they are infected. If you see these symptoms in them, see a doctor for proper treatment, which usually includes an anti-fungal prescription.

3. Oral thrush

Oral thrush shows its symptoms in many ways around the mouth or oral cavity. It develops suddenly and can be recurring if not treated soon enough.

Signs include raised lesions of creamy patches in the throat, on tonsils, uvula and even on the tongue and inner cheeks. The back of the throat may also be affected.

4. Cancer

Do you have one white spot on tonsil? If you experience swelling on one side of tonsils in your neck – either left or right with white spots on it, usually recurring, you could be having laryngeal cancer of the tonsils.

Other symptoms include a constant sore throat, pain on the one side with one white spot on the tonsil, ear pain or earaches and sometimes a noticeable lump in your throat.

In some patients, saliva may have blood spots and the mouth will have a constant bad breath, pain in the neck but no pain during swallowing.

Swollen tonsils and any of these symptoms should be properly diagnosed and treatment started immediately because lymphoma or such cancer is a life-threatening disease.

5. Tonsillitis – viral and bacterial

Tonsillitis is a throat infection due to bacterial and viral attacks. Your tonsils will fight the bacteria and viruses and produce white pus.

The creamy pus collects on parts of your throat, including tonsils, uvula and the back of the throat to form white patches.

Other symptoms associated with tonsillitis include headaches, fever and sometimes a stiff neck.

6. Sore throat, flu or cough

Flu, cough and sore throat may show symptoms such as throat pain, difficulty swallowing solid food and liquids.

Swollen glands and progressing hoarseness in your voice can accompany white specks and flecks at the back of your mouth.

7. Allergies

Seasonal allergies can manifest in the oral cavity with a white tongue. Other signs show in the throat, including whitish substances.

For some people, allergies to post-nasal drips can also cause a similar sign. Symptom Checker also lists indoor allergens as a source of white dots on tongue and throat area.

8. Smoking and leukoplakia

Smoking pre-exposes you to cancer of the oral cavity. People who smoke are normally at a higher risk of developing leukoplakia, a precancerous condition whose signs include white patches in the mouth, gums, tongue and even throat.

Smoking and tobacco chewing are highly discouraged if your problem is recurrent. To treat the condition, you should stop smoking and chewing tobacco.

However, in cases of cancer, the patches are scraped off after diagnosis. Freezing and removing the cancerous cells can also help get rid of white patches on tonsils caused by cigarette smoke.

9. Acid reflux

Some people have reported having white stones in their tonsil holes especially when their symptoms of acid reflux worsen.

According to Dr. A.K. Srivastava on Healthcare Magic, “post nasal drip and chronic GERD are also irritating the pharynx for developing leukoplakia.”

However, in other cases, fungal infections are likely to cause the white bumps at the back of the tongue and in the throat that may appear as those caused by acid reflux.

10. Mononucleosis (mono)

Also called mono, this is a viral infection that is contagious, and has signs such as white bumps on the throat, swelling of tonsils and lymph nodes, as well as severe fatigue and dizziness.

Since it is contagious, it is important to prevent it by avoiding sharing utensils, kissing and general exchange of fluids with an infected person.

There’s no pain

When the coating in your throat comes with no pain,  it could mean a viral infection or even a malignant growth. While it can mean that there is nothing to worry about, developing bacteria and viruses can, later on, cause pain, inflammation, stiff neck and even severe headaches.

In most cases, painless spots on tonsils are just an indication of accumulated mucus or pus over a long period of time. Gargling with warm salt water can help get rid of them quickly. If however, they persist, seek medical attention.

No fever

Did you know that you can have tonsillitis with no fever? Also, tonsil stones can occur in your throat with no other symptoms, no fever, no headaches and tests for bacterial and viral infections coming back negative.

According to Dr. Martin Raff of HealthTap, patients who complain of seeing their tonsils covered in a white substance but have no fever or a rise in temperature are likely to be having tonsillar stone deposits. These are yellowish, whitish or grayish deposits on tonsillar arches or crypts.

These are not life-threatening and are relatively normal for most people, only that they are not aware of it. Tonsil stones can be removed by dislodging them manually, or by gargling with diluted hydrogen peroxide, salt water or just warm water.

It is not strep

What should you do when it is not strep or you have a negative strep test? Can you have white spots on tonsils and not have strep throat?

A rapid strep test is done by swabbing the back of your throat with a cotton swab. The swab is then tested for streptococcus bacteria. If the test is negative, then your symptoms are not caused by strep throat.

The small patches are likely to be caused by something else and your healthcare provider will do a different test to see the kind of bacteria that is likely to cause the problem before treatment is administered.

Large spots and swollen tonsils

Swollen tonsils are a sign of inflammation and infection. Also called enlarged tonsils, that keep getting bigger and worse may be an indication of lymphocyte activities fighting off infections.

The infections can spread to the ears and cause earaches, itching in the ears and sometimes white coating on the tonsils.

If it is the white bumps on your tonsils that keep growing without pain or any other symptoms, it could be a sign of a benign cancerous growth in your throat. You should see a doctor immediately. The same should be done if you have hard dots in your throat.

How to get rid of white spots on tonsils

The cause must be identified first before a treatment is applied. Treating most of the diseases pointed out to show symptoms with whitish plaque on your throat above will remove the dots.

Sometimes, the white stuff will go away on their own. If they do not, treatments and home remedies can help. Try these natural remedies and medical treatments.

Remove tonsil stones

If caused by tonsil stones, dislodging the stones can be done at home. Use a cotton swab, a water pick or q-tip to remove the white stones in your throat.

While trying to remove them, be careful not to injure the tissue in your throat as this can cause bleeding and even an infection.

  1. Stand before a mirror.
  2. Open your mouth and use a cotton swab or water pick to dislodge tonsil stones.
  3. Gargle with salt water and spit out to get rid of white dots on your throat.

Gargling with salt water

Inflamed tonsils can be healed using salt water. Warm salt water can remove the patches with just one or two gargles. Here’s how to get rid of white plaque in the throat by gargling.

 

  1. Make a mixture of salt and warm water to make a slightly salty solution. Ensure the mixture is not too hot because it can scald your mouth and cause you blisters on the tongue or even cause swollen taste buds.
  2. Take the warm salt solution in your mouth and lean your head back. Open your mouth and try to make a continuous “g” sound. That is gargling with the back of your throat.
  3. This way, water will swish around your tonsils and remove the white stuff on the throat.
  4. Spit out the liquid and the debris.

Salty water has antibacterial, antiviral and antifungal properties and will help you eliminate any infections in the mouth and throat that cause white lines on tonsils.

Honey tea remedy

Honey has strong antibacterial properties. Making honey tea and sipping it all day can help clear out infections in the throat naturally and get rid of the symptoms. If not tea, you can keep sipping warm fluids all day long in order to bathe the throat and clear out infections.

Other beverages recommended include chicken broth, warm water, and generally warm noncaffeinated drinks. Try to avoid taking dairy products such as yogurt because they can increase mucus production, cause a runny nose and worsen the condition.

Treatment

If it is not a serious infection, the signs should clear out on their own. However, if the symptoms are severe and are compounded by ear infections, drainage, metallic taste in the mouth and even low-grade fever or high fever, conventional treatment should be used.

See a doctor for treatment and avoid non-prescription, over-the-counter medications. The following are the treatments commonly applied.

Antibiotics, penicillin or amoxicillin: Tonsillitis that is caused by bacteria is normally treated using antibiotics such as penicillin. An alternative medication is erythromycin, but usually, if the patient is allergic to penicillin.

Tonsillectomy or surgical removal: Surgical removal of tonsils is only recommended if the problem keeps recurring.

Swollen tonsils can hurt when swallowing and even breathing. Your doctor is well placed to advice you on whether removal of the tissue and glands will be the most appropriate course of action. Surgery takes about two weeks to heal.

Antifungal medications: Your doctor will prescribe anti-fungal medication if the white bumps on tonsils are caused by a fungal infection such as candida.

Additional information

Other than the natural home remedies and treatments mentioned above, you could also take some measures to reduce the occurrence white patches in your mouth. Here are further tips to help with the healing.

  • Avoid eating spicy foods and drinking hot beverages. Raw vegetables and acidic foods can also aggravate the condition and even affect your tongue.
  • If there is inflammation, swelling, and pain, use painkillers such as ibuprofen.
  • If your throat feels tickled or irritated, humidify your house to avoid irritation from dryness.
  • For reducing fever bouts, drink enough water. It also helps fight infections in your throat that may cause yellow tongue and white patches on tonsils turning yellow faster.

In conclusion, crypts above, around, behind, below and beside tonsils can accumulate a lot of viruses, bacteria, and debris from the oral cavity. These structures help fight infections in your body by preventing their ingestion.

When harmless, a whitish coating can still cause bad breath and such discomfort. Removing them will help you enjoy fresh breath. Some mouthwashes such as TheraBreath are sometimes recommended as a remedy for bad breath from such a coating or stones in the throat.

Sometimes I get questions like ‘Is pus on tonsils an STD sign?‘ While largely not, some infections like the ones we have discussed above may cause pus cells and sores in the mouth. If the spots are turning black, it is important to seek the advice of a medical practitioner who will do a thorough diagnosis and prescribe the appropriate treatment.

Sources and references

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