The tonsils are masses of lymph tissue in the back of the throat. Tonsil stones (also called tonsilloliths or tonsil calculi) are clusters of calcifications, or stones, that develop in the tonsil’s craters (crypts) that are formed from a buildup of food, bacteria, cells, and mucus.
What Are Symptoms of Tonsil Stones?
Tonsil stones are hard, white or yellowish colored formations on the tonsils. Tonsil stones often do not cause symptoms. When symptoms occur, they include:
- Persistent bad breath (halitosis)
- White or yellow formations on the tonsil
- Sore throat
- Tonsil swelling
- Difficulty swallowing
- Feeling of an object being stuck in the back of the throat/choking feeling
- Ear pain
- Cough
- Chronic tonsil infection/inflammation
Small stones are common and are often swallowed without patients having symptoms or knowing they exist. Large stones are rare.
What Is the Treatment for Tonsil Stones?
Tonsil stones are usually not dangerous, and don’t always need to be removed, but they can cause bad breath, the sensation of an object being stuck in the back of the throat, or difficulty swallowing. In these cases, patients may want to get rid of them.
Tonsil stones often dissolve on their own, are coughed up, or are swallowed and no treatment is needed.
If tonsil stones do not go away on their own, treatments include:
- Medications used to treat tonsil stones may include
- Antibiotics to treat infection
- Antihistamines to treat sinus problems or allergies
- Laser treatment (laser tonsil cryptolysis): a noninvasive treatment used to minimize or remove tonsil crypts where tonsil stones can become lodged
- Coblation cryptolysis: a treatment that uses radio waves to change a salt solution into charged ions that can cut through tissue to reduce tonsillar crypts and get rid of tonsil stones
- Tonsillectomy: surgical removal of the tonsils, usually a last resort but the only cure for the condition
Removing tonsil stones at home is generally not recommended because tonsils are delicate tissues and bleeding and infection may occur if stones are not carefully removed. If tonsil stones are painful, large, or you are having difficulty breathing, see a doctor.
Tonsil Stones (Tonsilloliths)
Written by Hilary Parker
Medically Reviewed by Jennifer Robinson, MD on November 19, 2021
In this Article
- What Are Tonsil Stones?
- Tonsil Stone Causes
- Tonsil Stone Symptoms
- Tonsil Stone Diagnosis
- Tonsil Stone Treatment and Removal
- Tonsil Stone Home Remedies
- Tonsil Stone Complications
- Tonsil Stone Prevention
Tonsil stones, or tonsilloliths, are hard, sometimes painful bits of bacteria and debris that get stuck in nooks on your tonsils. Your tonsils are gland-like structures in the back of your throat. You have one on each side. Tonsils are made of tissue with lymphocytes, cells that prevent and fight infections. Many experts think your tonsils play a role in your immune system and are meant to work like nets, trapping bacteria and viruses that come in through your throat.What Are Tonsil Stones?
But your tonsils don’t always do their job well. For some people, they’re more trouble than help. Research suggests that people who have their tonsils removed are no more likely to get bacterial or viral infections than people with who keep their tonsils.
Tonsil Stone Causes
Your tonsils are filled with nooks and crannies where bacteria and other things, including dead cells and mucus, can get trapped. When this happens, the debris can bond together.
Tonsil stones form when this debris hardens, or calcifies. This tends to happen most often in people who have long-term inflammation in their tonsils or repeated cases of tonsillitis.
Many people have small tonsilloliths, but it’s rare to have a large tonsil stone.
Tonsil Stone Symptoms
Small tonsil stones may not cause any symptoms that you’d notice. Even when they’re large, some tonsil stones are found only after X-rays or CT scans. Symptoms include:
- Bad breath. A main sign of a tonsil stone is severely bad breath, or halitosis, that comes along with a tonsil infection. One study of patients with a form of long-term tonsillitis checked their breath for things called volatile sulfur compounds, which can mean bad breath. The researchers found that 75% of the people who had unusually high amounts of these compounds also had tonsil stones.
- Sore throat. When you get a tonsil stone and tonsillitis together, it can be hard to figure out which is causing pain in your throat. The tonsil stone itself might give you pain or discomfort.
- Cough. A stone might irritate your throat and make you cough.
- White debris. You might be able to see a tonsil stone in the back of your throat as a lump of solid white material.
- Trouble swallowing. Depending on the location or size of the tonsil stone, it may be hard or painful to swallow food or liquids.
- Ear pain. Tonsil stones can develop anywhere in your tonsil. Because of shared nerve pathways, you might feel pain in your ear, even though the stone itself isn’t touching your ear.
- Tonsil swelling. When debris hardens and a tonsil stone forms, inflammation, infection, and the tonsil stone itself may make your tonsil swell.
Your doctor can usually diagnose tonsil stones with a physical exam. If they’re hidden in the folds of your tonsils, you might need imaging tests, such as CT or MRI scans, to spot them. Many tonsil stones, especially those that don’t have symptoms, don’t need special treatment. It depends on their size and whether they might cause you trouble. Treatments include: For smaller stones, you can try: Large tonsil stones can cause swollen tonsils and give you trouble swallowing. Tonsil stones can also sometimes trigger infections.Tonsil Stone Diagnosis
Tonsil Stone Treatment and Removal
Tonsil Stone Home Remedies
Tonsil Stone Complications
Tonsil Stone Prevention
People who have long-term tonsillitis are more likely to get tonsil stones. The only way to prevent them is to remove your tonsils.
Good dental habits can help prevent tonsil stones. Brush and floss your teeth regularly to remove bacteria and keep things from getting stuck in your tonsils. Gargling after eating can also prevent food buildup.
SOURCES: American Academy of Otolaryngology: "Tonsils and Adenoids." Ansai, T and Takehara, T. British Dental Journal, Mar 2005; vol 198: pp 263-264. Australian Department of Health: “Tonsil stones.” UPMC: “What Are Tonsil Stones (Tonsilloliths)? Tonsil Stone Symptoms and Treatment.” Ear, Nose and Throat Journal: “Coblation Cryptolysis to Treat Tonsil Stones: A Retrospective Case Series.”Show Sources
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