Tonsil Stones: Causes, Symptoms, Removal, Treatment

Good oral hygiene can prevent debris from getting trapped in your tonsils

Tonsil stones, also known as tonsilloliths , are clumps or lumps that form when debris becomes trapped in pockets in the tonsils—the mounds of tissue in the back of the throat. A tonsil with a tonsil stone may look like it has a crack with a small, pebble-like mass wedged inside it. Sulphur Dyes Color

Tonsil Stones: Causes, Symptoms, Removal, Treatment

While tonsilloliths are generally harmless, they may occasionally cause discomfort such as a sore throat, feeling like there is something stuck in the throat, dry mouth, and bad breath (halitosis ).

This article explains tonsil stone symptoms and causes. It offers information about how people with tonsil stones (sometimes called cryptic tonsils) are treated, some steps you can try to remove tonsil stones at home, and when it may be time to see a healthcare provider.

Tonsil stones range from white to yellow in color and are often (but not always) visible, sometimes looking like pus. You also may feel or see that your tonsils are swollen.

Other symptoms of tonsil stones may include:

The bad breath associated with tonsil stones can be severe because a common bacteria that contributes to the formation of tonsil stones produces sulfur. Disturbing or removing a tonsil stone can sometimes release this putrid odor.

This video has been medically reviewed by Benjamin F. Asher, MD.

Tonsil stones develop when particles such as food, dead skin cells, and bacteria get trapped in tonsil tissue. Over time, this debris calcifies and hardens into rock-hard tissue that resembles stones.

Chronic inflammation can cause the formation of crypts (crack-like pockets) and tissue fibrosis (thickening and scarring), making it easier for stones to form. They're more common in older people than in teens and children.

There may be a greater risk of tonsil stones in people experiencing frequent ear, throat, and sinus infections associated with inflammation. Other contributing factors may include:

Tonsil stones are often seen in people who experience frequent bouts of tonsillitis, which can occur due to other, potentially serious infections.

Tonsil stones may require professional care, though there are a few steps you can take to try to remove them yourself (and prevent them from forming).

However, if you're not sure you have tonsil stones, it's important to see a healthcare provider for your symptoms. They can determine whether you have tonsil stones or, in some cases, if a more serious condition is causing ear pain or difficulty swallowing.

Tonsil stones can be removed at home in most cases. There are a few things you can try to remove tonsil stones:

Once the stone is out, gargling with salt water will help to remove any bacteria. Water irrigators (water picks) have been shown to be helpful in removing a portion of the tonsil stones, but the removal is often incomplete and still results in symptoms.

Trying to remove tonsil stones on your own may lead to the stones actually becoming pushed further into the tissue, causing more discomfort and problems.

You should not try to remove tonsil stones with sharp objects, because you could accidentally damage tonsillar tissue. The tonsils are also in close proximity to major blood vessels.

Ear, nose, and throat experts (otolaryngologists ) report an uptick in people, especially teens, who try to identify tonsil stones on their own and then share videos of their removal on social media. They warn that do-it-yourself "TikTok tonsils" treatment can lead to significant injuries and otherwise unnecessary surgeries.

If the tonsil stone is large or you've tried to remove a tonsil stone without success, a healthcare provider can extract it. They also can accurately diagnose the problem, especially when you have symptoms of a tonsil stone but don't see the cause.

A healthcare provider may use irrigation to flush the stone out with water, or try a tool called a curette. An antibiotic also may be prescribed to treat infection associated with the tonsil stones.

Sometimes, other procedures are necessary. They include techniques called temperature-controlled radiofrequency (TC-RF) tonsil ablation and CO(2) laser cryptolysis . These treatments rely on probes inserted into the tonsil tissue, delivering energy via the radio or laser technique, while a person is under local anesthesia.

Rarely, a tonsillectomy is needed. While a tonsillectomy would subsequently remove any tonsil stones, surgical removal of the tonsils is not generally a compelling enough reason for this surgery. Your physician can review the benefits and risks associated with a tonsillectomy for tonsil stone removal.

Tonsil stones form because of bacteria and debris that collect on the tonsils, so limiting exposure can help to prevent them.

Good oral hygiene can help. If you've had tonsil stones, you may be able to avoid recurrence through an oral hygiene routine that includes daily warm saline mouth rinses. Mouthwashes, especially alcohol-free types, may also be good for tonsil stones.

Smoking may contribute to tonsil stone formation, so quitting may reduce the risk along with boosting an overall improvement in your health.

Your body is able to remove tonsil stones naturally, so they may go away on their own. However, tonsil stones that continue to grow can cause discomfort. They can also change position, interfering with the respiratory tract, or cause symptoms that signal a more serious condition. Contact your healthcare provider if you are concerned.

Tonsil stones are caused by bacteria and debris in your airway that become trapped in the tonsil tissue. Over time, the debris hardens and the stones may cause symptoms, including bad breath, difficulty swallowing, and ear or throat pain.

Tonsil stones are highly treatable and may even go away on their own. While there are home remedies you can try, a healthcare provider can best diagnose and treat the condition. In rare cases, treatment may require removal of the tonsils.

Good oral hygiene can help to prevent tonsil stones from forming. If you smoke, consider quitting, as smoking may be a factor that increases your risk of tonsil stones.

Usually no. Those who have had a tonsillectomy don't typically get tonsil stones even if some of their tonsil tissue grows back.

However, some people report that they still get stones even after a tonsillectomy. This could happen if not all the tonsil tissue is removed, stones form in crevices in scar tissue that develop after surgery, or stones grow in other similar tissues like the adenoids.

Yes. Tonsil stones may be removed by a dentist, oral surgeon, or an otolaryngologist (ear, nose, and throat specialist).

Yes. Tonsil stones are not harmful. If they become dislodged, you may swallow them without even knowing it.

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By Kristin Hayes, RN Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.

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Tonsil Stones: Causes, Symptoms, Removal, Treatment

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