Everything You Need to Know About Tonsil Stones

Medically Reviewed By Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP
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Tonsil stones, or tonsilloliths, are collections of bacteria and debris that form within the crevices of the tonsils. Some tonsil stones are too small to see, while others develop deep in the tonsillar tissue. When they are on the surface and visible, they look like white or pale yellow bumps on the tonsil.

It can be common for people with tonsil stones to not even notice that they have them, especially if they do not cause any pain. Although they rarely cause serious health issues, they do give an unpleasant smell to the mouth.

This article explains what tonsil stones are. It also covers the symptoms, causes, and treatment options associated with them.

What are tonsil stones?

Your tonsils are lymph glands on either side of the back of the throat. Tonsils fight infections that enter through the mouth. They are sponge-like tissues that act as filters in the month, helping the body fight infections with cells called lymphocytes by sifting bacteria and viruses from the mouth and throat.

Since these sponge-like glands have pits and crevices, food particles, mucus, and dead cells from the oral cavity can collect in the nooks. At first, the clump of debris is soft. With time, however, it can calcify and harden into a stone-like lesion called a tonsil stone.

Tonsil stones are easy to remove and can often dislodge naturally if you cough.

The main symptom tends to be bad breath, or halitosis. Other symptoms include being able to feel them and pain or difficulty when swallowing.

What causes tonsil stones?

Usually, a buildup of debris causes tonsil stones. They are simply collections of debris that have calcified and hardened in the crevices of the tonsils, or the tonsil crypts.

Tonsil stones tend to be harmless, but their repeated presence can point to more serious health issues, such as tonsillitis, poor oral hygiene, or infections. That said, some people have tonsils that are more cryptic than others, and stones can occur even in the absence of infection and with good oral hygiene.

Most tonsil stones are small. They can grow to large sizes without treatment, though this is rare.

Who gets them?

Anyone can get tonsil stones, but those with large tonsils are usually more prone to developing them. People with chronic tonsil infections are also more prone to developing tonsil stones.

Learn more about tonsillitis here.

What are the symptoms of tonsil stones?

Small stones may not cause any other symptoms besides the presence of the stone itself. When symptoms occur, bad breath is a common one.

Although small stones are fairly common, large stones that require treatment are rare. When you can see a tonsil stone, it is usually white or pale yellow.

Other tonsil stone symptoms can include:

Bacteria in the tonsil stones cause these symptoms.

It is important to seek medical care to have tonsil stones removed if they cause discomfort or if you get them regularly.

What do they look like?

Medical image of someone with open mouth showing tonsil stones
Chaiwat Wongsangam/Shutterstock

Tonsil stones may be visible on the tonsils as hard,

almond-white deposits of oral debris.

Tonsil stones occur when bacteria and other debris collect in the irregular surface of the tonsils. Tonsils catch bacteria and viruses in the mouth and throat. However, they can also trap bits of food, mucus, and dead cells.

When the collection first forms, it is usually soft. If it remains, it can calcify and harden into a stone-like bump.

When to contact a doctor

You should contact a doctor for the following reasons:

  • You have symptoms such as bad breath or a sore throat, but you cannot see a tonsil stone.
  • You have symptoms that cause discomfort, such as a sore throat, irritation, or pain.
  • Your throat feels swollen to the point of causing breathing difficulties.

If you do experience a swollen throat while finding it hard to breathe, seek immediate medical care.

Having bad breath and a sore throat with recurrent stones is also a reason to contact a doctor, especially if home remedies such as gargling salt water do not work.

How can you treat tonsil stones?

Tonsil stones can cause discomfort, but they are mostly harmless. The main symptom is bad breath, so people tend to get them removed for that reason.

Various treatments exist for tonsil stones, ranging from medical procedures to home remedies.

Medical treatments and what to expect

  • Surgical removal of the stones: Surgery can remove the stones, but it is uncommon to undergo surgery unless the stones are very large. There may be a risk of complications and bleeding after the removal of the stones.
  • Laser tonsil cryptolysis: Lasers can remove the crypts where tonsil stones are usually located.
  • Antibiotics: Taking medications that lower the amount of bacteria in your mouth helps reduce recurring tonsil stones. However, it does not treat the underlying cause of tonsil stones. Also, these medications should not be used unless there is a bacterial infection.
  • Tonsillectomy: For severe cases of recurring tonsil stones, tonsillectomy is also an option. This refers to the removal of the tonsils.
  • Coblation cryptolysis: This involves using radiofrequency currents and lower temperatures to dissect the tonsils. It can be less painful than tonsillectomy. However, it is not a common practice.

Learn more about tonsillectomy here.

Home remedies

You should always seek medical care for the removal of tonsil stones, as attempting to remove them yourself can lead to complications such as infections or bleeding.

Home remedies to help manage the discomfort of tonsil stones can include:

  • gargling salt water
  • maintaining good oral hygiene by regularly brushing the teeth
  • drinking water after eating to flush away any food
  • using mouthwash
  • not smoking
  • using a water flosser

Tonsil stones are not dangerous, but they can lead to chronic tonsillitis. Contact a healthcare professional if tonsil stones are bothersome or recur frequently.

What is tonsil stone removal surgery?

Although tonsil stone removal surgery is rare, some cases of tonsil stones do require it. This involves going under anesthesia and having the stones removed manually.

There is usually a limited amount of pain during recovery.

What are the risk factors for tonsil stones?

Tonsil stones can develop in anyone, though people with large or cryptic tonsils are more likely to experience them.

Reducing your risk of tonsil stones

The best way to reduce the risk of getting tonsil stones is to keep debris from lodging in your tonsils and to practice good oral hygiene. This relies on:

  • brushing and flossing your teeth after every meal
  • drinking water after eating anything
  • gargling with an antiseptic mouthwash or saltwater solution

Smoking may also contribute to tonsil stone development, so quitting and avoiding secondhand smoke is beneficial.

If you get recurrent tonsil stones, tonsillectomy is the most effective way to prevent them.

How do doctors diagnose tonsil stones?

Doctors can usually diagnose tonsil stones by examining your throat. Tonsil stones that are deep and not visible may show up on an X-ray.

To diagnose tonsil stones, your doctor may ask you several questions related to your symptoms, such as:

  • Describe your symptoms. Are you having chronic bad breath, throat irritation, or difficulty swallowing?
  • How long have you had these symptoms?
  • Have you seen any white or yellowish bumps on your tonsils?
  • What, if anything, seems to make your symptoms better or worse?
  • Are you experiencing any other symptoms, such as fever or headaches?
  • Have you ever had tonsillitis? If so, how many times?

Once your healthcare professional understands the cause, they can recommend an appropriate treatment.

What are the potential complications of tonsil stones?

In most cases, tonsil stones are harmless and do not cause complications. However, they can affect your quality of life if bad breath causes embarrassment or if other symptoms are bothersome.

Summary

Tonsil stones are small collections of bacteria and other oral debris, such as food, that gather in the crevices of the tonsils.

They usually look like white or pale yellow bumps on the tonsils, and they can cause minor discomfort. The main symptom of tonsil stones is bad breath.

If you have any symptoms that bother you, contact a healthcare professional regarding the removal of the tonsil stones.

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Medical Reviewer: Nicole Leigh Aaronson, MD, MBA, CPE, FACS, FAAP
Last Review Date: 2022 Mar 28
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