Tonsil Stones (Tonsilloliths)? What are They and How to Get Rid of Them

Updated: 9/21/23

If you’re someone who has ever experienced bad breath, sore throat, or difficulty swallowing, you may have heard of tonsil stones. Tonsil stones, also known as tonsilloliths, are small calcium deposits that accumulate in the crevices and grooves of your tonsils over time. While they are not necessarily harmful, they can be a nuisance and cause discomfort. In this blog post, we will delve into what tonsil stones are, their symptoms, what causes them, and how you can get rid of them.

What are Tonsil Stones?

Tonsil stones are small, white, calcified deposits that form in the crevices of the tonsils. It is also called tonsilloliths. Tonsil stones are a result of the accumulation of bacteria, mucus, dead cells, and food particles that get stuck on the tonsils. Though they are not dangerous, they can cause unpleasant symptoms such as sore throat, chronic bad breath, difficulty swallowing, and ear pain.

When someone mentions stones that form in the body, most of the time people will think about the kidneys. However, kidneys are not the only organs that can form stones. Sometimes patients develop hard, painful stones in the tonsils as well, a condition called tonsilloliths. There are three types of tonsils in the back of the throat and they serve as a part of the body’s immune and lymphatic systems. According to the American Academy of Otolaryngology, the tonsils are the body’s first line of defense.

Tonsilloliths occur when debris gets trapped in pockets in the tonsils. Mucus, food, bacteria, dead cells and other debris may collect in the crypts or grooves on the tonsils. The debris hardens over time to form tonsil stones. Some patients may develop only one tonsil stone, while others may have several smaller formations. Potential causes may include poor dental hygiene and chronic tonsillitis (inflamed tonsils).

Sometimes a patient may have a tonsil stone without knowing it. They are typically harmless, but sometimes they may cause discomfort and other noticeable symptoms, even if they are small and hard to see. Patients may have a sore throat, bad breath, difficulties swallowing, swelling in the tonsils, ear pain and yellow or white debris on the tonsils. There are many ways to prevent tonsilloliths, including staying hydrated, practicing good oral hygiene, gargling with salt water and avoiding smoking.

Are Tonsil Stones Normal?

Tonsil stones are not uncommon, but that doesn’t necessarily make them normal. Many medical professionals suggest that having tonsil stones is not a cause for concern unless they are causing symptoms such as pain or discomfort. It’s also important to note that some people may be more prone to developing tonsil stones than others, so frequency of occurrence may vary from person to person.

Are Tonsil Stones Contagious?

The good news is that tonsil stones are not contagious. They aren’t caused by exposure to viruses or bacteria, nor can they be spread between individuals. However, it’s important to note that the bacteria that contribute to tonsil stone formation can be contagious. Therefore, practicing good oral hygiene habits like brushing and flossing regularly can help prevent the buildup of bacteria that lead to tonsil stones.

How do Tonsil Stones Form?

Tonsil stones form when food particles, bacteria, dead cells, and mucus accumulate in the crevices of your tonsils. Over time, these materials calcify and harden, forming tonsil stones. People who have large tonsils, chronic inflammation, poor dental hygiene, or a history of tonsillitis are more likely to develop tonsil stones. In addition, those who suffer from allergies, sinus issues, or post-nasal drip may be at higher risk of developing tonsil stones.

Other Conditions that Affect the Throat

There are other health conditions that can cause similar symptoms as tonsilloliths, but do not necessarily involve tonsil stones. It’s important to visit a physician for an accurate diagnosis and to confirm the cause.

Tonsillitis

Tonsillitis is inflammation in the tonsils and sometimes the adenoids, usually as a result of a viral infection. It is usually caused by a viral infection, such as the common cold or flu. It can also be caused by bacteria, such as streptococcus, which is known as strep throat. Tonsillitis is highly contagious and can easily spread from person to person through close contact or the sharing of objects, such as utensils or towels. The tonsils look red and swollen and the patient may have a fever and difficulty swallowing.

Strep Throat

Strep throat is a common bacterial infection that can affect anyone, regardless of age or gender. Characterized by a sore throat, fever, and swollen glands, it is a condition that can be both painful and uncomfortable. If left untreated, it can lead to more severe complications and even result in hospitalization. Unlike tonsillitis, strep throat usually results from a bacteria group, specifically A Streptococcus. The bacteria lives in the nose and throat and spread through coughing or sneezing. It causes a very sore throat, fever, swollen tonsils and sometimes patients may also contract scarlet fever.

Tonsil Cancer

Cancer is one of the most feared diseases in the world. Tonsil cancer, also known as oropharyngeal cancer, is a type of cancer that affects the tonsil, which is a small organ located in the back of the throat. Although rare, tonsil cancer can have serious consequences if not diagnosed and treated in its early stages.

The primary cause of tonsil cancer is the human papillomavirus (HPV). HPV is a sexually transmitted virus that targets the mucosal lining of the throat. Smokers and users of alcohol are also at higher risk for developing tonsil cancer. Scientists have also linked poor oral hygiene and a high intake of processed meat to increased risk of tonsil cancer.

Most of the time, tonsil cancer affects the tonsils on the sides of the throat. Usually the tumor is made up of squamous cell, but some cases are lymphomas. The cancer causes a sore to develop in the back of the throat that does not heal. Other symptoms include blood in the mouth, bad breath, a persistent sore throat, one swollen tonsil and difficulty swallowing, chewing and talking.

Risk Factors for Tonsil Stones 

Anyone can develop tonsil stones. However, teenagers are more likely to develop the condition. It is also more common in individuals with chronic tonsil inflammation and repeated cases of tonsillitis, as well as people with large tonsils.

Chronic Sinusitis

High levels of mucus production may also contribute to tonsil stone formation. Excessive mucus can accumulate and trap food particles and bacteria in the tonsil pockets, leading to the formation of tonsil stones. Chronic allergies, sinus infections, and other respiratory conditions can increase mucus production in the body. So, if you’re experiencing excessive mucus in the throat, nose, or mouth, then seeing a doctor is recommended.

Repeated cases of sinusitis may infect the tonsils. The tonsils contribute to the immune system, so when they do not function correctly, the body cannot trap bacteria and viruses. When a patient has sinus problems, it can cause post-nasal drip and bacteria can drip into the throat.

The bacteria then settles into tonsillar crypts, producing thick excess mucus. The crypts become the focus point for the infection because they trap more mucus and collect more bacteria.

Tonsillitis

Repeated bouts of tonsillitis can also cause tonsil stones. Inflammation in the tonsils makes them more vulnerable to bacterial infections because the body cannot rid itself from harmful debris that collect and harden on the swollen tonsils, creating stones.

People with large tonsils are more likely to develop tonsil stones. The larger the tonsils, the more area there is for food particles, bacteria, and other debris to get stuck and form a stone. Enlarged tonsils have pockets and crevices that are ideal for trapping debris and promoting the growth of bacteria. Meanwhile, people with smaller tonsils rarely have this problem.

Poor Dental Hygiene

Poor oral hygiene is one of the primary risk factors for tonsil stones. When you don’t brush and floss your teeth regularly, harmful bacteria will thrive in your mouth. These bacteria can produce sulfur compounds, which can cause a foul odor in your breath and contribute to the formation of tonsil stones. Therefore, it’s essential to maintain good oral hygiene to prevent tonsil stones from occurring.

People who fail to brush or floss their teeth properly or regularly are highly vulnerable to tonsil stones. When people do not wash their mouths frequently or thoroughly, food particles and debris enter the throat, collect on the surface of the tonsils and cause tonsil stones.

Poor Diet

Having a poor diet can increase your risk of tonsil stones (x). Eating foods that are high in sugar, such as candy, soda, and sweets, can promote bacteria growth in the mouth. Moreover, consuming alcohol can also lead to tonsil stones. These substances can dry out your mouth and cause the tissues inside the mouth to break down more quickly, leading to the formation of tonsil stones.

Smoking and Vaping

A smoking habit causes damage in the mouth by reducing its ability to clean itself, which leaves the tonsils susceptible to bacterial infection and inflammation. Smoking is one of the leading causes of tonsil stones. The chemicals found in cigarette smoke can irritate and inflame the tonsils, causing the formation of stones. Additionally, smoking can cause dryness in the mouth, which reduces the production of saliva, an essential component in keeping the mouth clean. Therefore, smokers are more likely to develop tonsil stones than non-smokers. The longer you smoke, the higher the risk of tonsil stones.

Although vaping has been marketed as a safer alternative to smoking, it still carries some risks. E-cigarettes contain nicotine, which is an addictive chemical that can irritate the tonsils and cause them to produce more mucus. The thick mucus can accumulate and harden, leading to tonsil stones. Moreover, vaping can also cause dryness in the mouth, which, as mentioned earlier, can contribute to tonsil stone formation.

People who smoke and vape have an even higher risk of tonsil stones since they are exposed to double the amount of harmful chemicals. The combination of smoking and vaping can cause more severe inflammation in the tonsils, leading to an increased likelihood of stones. Furthermore, smoking and vaping can increase the production of mucus and reduce saliva production, both of which are key contributors to the formation of tonsil stones.

Tonsil Stones Symptoms

Some of the symptoms that are commonly associated with tonsil stones include difficulty swallowing, a metallic taste in the mouth, bad breath, sore throat, swollen tonsils, earaches, and coughing. If you experience any of these symptoms, it is best to seek medical help.

Many people with tonsil stones do not experience any noticeable symptoms at all, especially if the stones are small. Even when tonsil stones are larger, sometimes patients only discover them by accident on CT scans or X-rays. However, some larger stones may cause multiple noticeable symptoms.

Sore Throat

Sometimes, tonsil stones cause pain and discomfort in the back of the throat where debris gets trapped. Patients report that tonsilloliths feel as if there is something stuck in the throat. However, sometimes the patient may have tonsilloliths in conjunction with tonsillitis. In these cases, it can be hard to determine if the pain is a result of the tonsil stones or tonsillitis.

Swelling

Once the debris collects in the throat, it hardens and tonsil stones are formed. The stones may cause irritation in the throat and cause them to swell.

Growths on the Throat

Although the symptoms of tonsilloliths are similar to tonsillitis, there is one major difference. Patients with tonsil stones develop white or yellow growths on the tonsils. Sometimes the growths are small enough where the patient cannot even see them or they don’t cause enough irritation to raise concern.

Bad Breath

One of the most significant symptoms of tonsil stones is foul breath. These stones harbor bacteria and food particles that produce an odor that can lead to bad breath, also known as halitosis. If you cannot get rid of your bad breath even after regular brushing, flossing, and using mouthwash, your tonsil stones may be the culprits. You might also notice a strange metallic taste in your mouth.

This is one of the prime indicators that a patient has tonsil stones. They act as a home for bacteria, which release sulfides that give off an unpleasant smell. One study determined that 75 percent of its subjects with tonsilloliths had high levels of volatile sulfur compounds in their breath. These sulfur compounds are responsible for bad breath. According to other studies, tonsil stones may also be responsible for halitosis, which research links to around 3 percent of cases of bad breath.

Ear Pain and Feeling of a Foreign Object

Tonsil stones can also cause discomfort ranging from ear pain to a feeling like something is stuck in your throat. The sensation of an object lodged in the throat can be irritating and distracting, especially if left untreated.

The ears and tonsils share the same nerve. So when tonsil stones develop, they put pressure on this nerve, which can cause pain and irritation in the ear. Research suggests that ear pain may have a connection to tonsilloliths.

Other Symptoms

In addition, patients may have difficulties or feel pain swallowing food or drinks, depending on the size of the stones. The patient may also choke as they try to swallow because the stones limit food passage. It may also affect the patient’s ability to taste. It may cause a metallic aftertaste in the mouth that results from the debris mixing and decomposing in the throat.

Can Tonsil Stones Cause Bad Breath?

Yes, tonsil stones are known to cause bad breath. The bacteria that accumulate in the tonsil stones release a foul odor, which can lead to chronic bad breath. People with tonsil stones typically experience an unpleasant taste in their mouth, as well as a feeling of irritation or discomfort.

Symptoms of Tonsil Stones

Complications from Tonsil Stones

Tonsil stones do not cause any serious health complications, even though they can cause pain or discomfort. However, tonsilloliths may cause dental problems. According to studies, the stones are similar to dental plaque, which can cause cavities and gum disease.

When to See a Doctor

Even though they are harmless, sometimes a medical professional is the best option. It is best to visit a doctor if the patient cannot remove the stone at home themselves, if they have symptoms of tonsilloliths but cannot see any stones or if they manage to remove the stone but feel pain afterward. If the tonsils are red, swollen or painful, the condition may require medical treatment.

Tonsil Stones Treatment

Usually tonsil stones do not require any medical treatment and patients can treat the condition themselves at home.

Home Remedies

Gargling vigorously with salt water may help dislodge the stones and ease throat discomfort. It can also help them detach from the tonsils. Some individuals discover that they have tonsil stones once they expel one from coughing. Coughing intentionally may help loosen the stones.

Try loosening the stone with a cotton swab. Press down on the tissue around it and push forward toward the front of the mouth, but don’t push too hard. Tonsils have soft and gentle tissues, so don’t use anything pointed or sharp to avoid infections, bleeding or any other damage to the throat.

Drinking plenty of water can help flush out the tonsil pockets and prevent the accumulation of bacteria and debris. It is recommended that you drink at least 8-10 glasses of water per day. You can also include herbal teas and drinks with lemon juice to help keep your throat hydrated.

Another simple yet effective remedy for tonsil stones is the use of a tongue scraper. Tongue scrapers are designed to remove bacteria and debris from the surface of the tongue, which helps to prevent tonsil stone formation. Gently scrape your tongue from back to front daily to reduce the chances of tonsil stones forming. This simple technique can also help to freshen your breath.

Medical Treatment

If the above home remedies fail to cure your tonsil stones, you may need to take antibiotics. Antibiotics are used to control and treat bacterial infections that may be causing the tonsil stones. However, antibiotics should only be taken under the advice of a trusted healthcare provider. Overuse of antibiotics can lead to antibiotic resistance and cause a host of other issues.

Patients with large, frequently recurring tonsil stones may require surgical removal if they cannot remove the growths themselves. If the stone or the symptoms do not go away after a few weeks, consult a doctor.

Tonsillectomy

A tonsillectomy is a surgical procedure that completely removes the tonsils. Doctors recommend it to patients with severe, chronic cases of tonsilloliths with significant pain, infection or bad breath. However, a tonsillectomy has some potential risks attached to it: bleeding, infection and even life-threatening reactions to anesthesia, in rare cases.

Laser Tonsil Cryptolysis

Laser resurfacing is another conventional treatment. The surgeon reshapes the crypts that collect the tonsil stones, reducing them using laser cryptolysis.

Coblation Cryptolysis

Coblation cryptolysis is another treatment option. It uses radio waves and salt solution that remove the crypts. It reduces the crypts, but without the high temperature, so it is less risky than laser treatment.

Preventing Tonsil Stones

Practicing consistent, proactive oral hygiene is imperative when it comes to preventing tonsil stones. It keeps away undigested food particles and other debris that can get trapped in the throat. Staying hydrated also helps prevent and remove tonsil stones. Bacteria can easily grow in a dry mouth that produces little saliva.

Who Can Remove Tonsil Stones

Ear, Nose, and Throat (ENT) specialists are medical doctors who specialize in diagnosing and treating conditions related to the ears, nose, throat, and neck. They are trained to handle tonsil stones safely and effectively. An ENT doctor may use a special tool to extract them without causing any discomfort. If you are experiencing recurring tonsil stones, you should consult an ENT specialist who can evaluate your condition and suggest appropriate treatment options.

Tonsil Stone is Stuck. What Do I Do?

If you’re struggling with tonsil stones, one home remedy you can try is gargling with saltwater. Saltwater can help loosen and remove tonsil stones. Mix one teaspoon of salt in eight ounces of warm water and gargle for 30 seconds before spitting the water out. Another home remedy is using a cotton swab or your finger to gently press on the tonsil stone until it comes loose. Be careful not to push too hard, as this can cause bleeding.

If home remedies don’t work, your doctor may recommend tonsillectomy, which is the surgical removal of the tonsils. However, this is typically reserved for individuals with severe tonsil stone problems or other ongoing issues. In most cases, tonsil stones can be easily treated at home. One way to prevent tonsil stones from forming is by maintaining good oral hygiene habits. Brush your teeth twice a day, floss once a day, and use a mouthwash daily. Be sure to schedule regular dental appointments to stay on top of any potential oral health issues

Supplements for Tonsil Stones

Supplements are another method that may help eliminate tonsilloliths. Certain varieties can help boost the immune system so that the body can fight off bacteria and prevent it from collecting in the tonsils. Talk to your doctor to see which supplements are right for you and be sure to maintain a healthy diet to support your overall health and wellbeing. With the right approach, your tonsil stone woes can be a thing of the past.

Grapefruit Seed

This tropical citrus fruit is known for its bitter and sweet taste. But grapefruit seeds are also rich in antioxidants and a natural antibacterial that can suppress bacteria growth. As a dietary supplement, take 500 to 1,000 mg of grapefruit seed extract powder up to three times a day, or following a doctor’s instructions.

Magnesium

Magnesium is a mineral that is essential for muscle and nerve function, but it also helps to maintain overall health and wellbeing. It can also help prevent tonsil stones by regulating the pH levels in your mouth, which can prevent the growth of the bacteria that cause them. You can find magnesium in foods like spinach, almonds, and avocados or by taking a supplement.

Vitamin D

Vitamin D is essential for bone health and helps our bodies absorb calcium. But did you know that it may also help fight off the bacteria that cause tonsil stones? Vitamin D can be found in some foods, like fatty fish and mushrooms, but supplementation may be necessary in areas with low sunlight

Vitamin E

Popular in cosmetic products for its ability to improve skin health, Vitamin E is an effective antioxidant that can reduce free radical damage in the body. As a dietary supplement, the recommended dosage for Vitamin E powder is 350 mg with food and water. Consult with a doctor before adding Vitamin E to your supplement regimen. 

Vitamin C

This vitamin is a powerful antioxidant and immune booster. Vitamin C can help the body fight off damaging bacteria that may cause tonsil stones. For this supplement, take 1,000 mg (1/4 tsp) of Vitamin C powder daily. Consult with a doctor to confirm safety and dosage. 

Zinc

As the second most abundant mineral in the body, zinc has several benefits on the body, including boosting the immune system to fight off infections. The recommended serving for zinc gluconate powder is between 225 mg and 450 mg per day. Do not exceed 450 mg under any circumstances and seek medical advice before taking this supplement. 

Echinacea

This is a traditional herb with a long history of treating different medical conditions. Echinacea is effective to strengthen the immune system and fight off infections. The suggested serving for echinacea extract powder is 450 mg once or twice a day, or as directed by a physician.

Licorice Root

Licorice root is not only a sweetener for drinks and candies, it is also a powerful remedy for sore throat and cough. It helps kill bacteria in the mouth that cause tooth decay. As a dietary supplement, take 600 mg of licorice root extract daily, unless a physician recommends a different dosage.

Garlic

Chewing raw garlic can help kill the bacteria that cause infection in the tonsil stones. It may prevent the bacteria from increasing, as well as decrease unwanted symptoms. One of its active components, allicin, has beneficial and powerful antimicrobial abilities (x, x). As a dietary supplement, take 650 mg of garlic extract powder twice a day with meals, or following a physician’s instructions. 

The Bottom Line

Tonsil stones form when debris collects in the tonsils, such as food particles and bacteria. Over time, the debris hardens and forms into small bumps. They are generally harmless. Some patients have them without even realizing it. 

Tonsil stones might not be life-threatening, but they sure can be bothersome and unpleasant. Knowing the symptoms of them can help you diagnose and treat them quickly. If you experience persistent bad breath, sore throat, swollen tonsils, difficulty swallowing, or any discomfort in your throat, it is best to get checked by a doctor. Treatment options, such as antibiotics or surgical removal, can help alleviate the symptoms and restore your throat’s health. Remember, maintaining oral hygiene, including regular brushing, gargling, and flossing, can also help prevent the formation of tonsil stones.

Medical treatment for tonsil stones is usually not necessary. Patients can usually treat the condition themselves with home remedies, including gargling salt water or using a cotton swab to gently push the stone out of the mouth. If a patient cannot remove it themselves, they may need medical treatment. The only way to permanently get rid of them is to completely remove the tonsils with a tonsillectomy. There are also a variety of supplements that can help eliminate tonsil stones and fight the bacteria that causes them. 

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease

Author: Robin B.