Tonsil Stones: Removal, Treatment, Causes, Symptoms & Smell

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• Introduction
  • What are tonsil stones?
• Causes/Risk Factors
  • What causes tonsil stones? What are the risk factors for tonsil stones?
• Symptoms
  • What are tonsil stones symptoms?
• Doctors Who Treat
  • What specialists diagnose and treat tonsil stones?
• Diagnosis
  • How are tonsil stones diagnosed?
• Treatment
  • What are the treatments for tonsil stones?
• Home Remedies
  • How do you get rid of tonsil stones at home?
• Prognosis
  • Do tonsil stones go away?
• Complications
  • What are the complications of tonsil stones?
• Prevention
  • How to prevent tonsil stones
• FAQs
  • Frequently asked questions

What are tonsil stones?

Tonsil stones can form when food, mucus, and bacteria get stuck in the craters of the tonsils.

The tonsils are lymph nodes located at the back of the throat. Tonsil stones (also called tonsilloliths or tonsil calculi) are small clusters of calcifications or stones that form in the craters (crypts) of the tonsils. Tonsil stones are hard and appear as white or yellowish formations on the tonsils. They usually smell bad (and make your breath smell bad) due to the presence of bacteria.

What causes tonsil stones? What are the risk factors for tonsil stones?

Several factors can cause or contribute to the formation of tonsil stones:

• Substances such as food, dead cells, mucus, and bacteria may get stuck in the nooks and crannies of the tonsils.
• The body's immune system, which sees these as foreign invaders, sends white blood cells to the area to fight infection. When the white blood cells are done, they leave small calcifications behind.
• Usually, these small stones are swallowed, but sometimes they get stuck in the tonsillar crypts and continue to grow into tonsil stones. Small stones are common; large stones are rare.

Risk factors for developing tonsil stones include:

• Chronic or recurring tonsillitis (inflammation of the tonsils)
• Large tonsils
• Chronic sinus problems
• Poor dental hygiene
• Smoking
• Certain medications that make your mouth dry (antihistamines, decongestants, and others)

What are tonsil stones symptoms?

In many cases, tonsil stones do not cause any symptoms. When symptoms do occur, they may include:

• Persistent bad breath (halitosis)
• White or yellow formations on the tonsil
• Sore throat
• Difficulty swallowing
• Ear pain
• Swollen tonsils
• The sensation of a foreign object lodged in the back of the throat/choking feeling
• Cough
• Chronic tonsil inflammation/infection

What specialists diagnose and treat tonsil stones?

Most of the time your primary care provider will be able to diagnose and treat the condition. If symptoms of tonsil stones are severe, you may see an ear, nose, and throat (ENT) specialist, also called an otolaryngologist.

How are tonsil stones diagnosed?

Tonsil stones can frequently be seen in the back of the throat. They typically appear as white or yellowish spots on or around the tonsils that may range in size from a grain of rice to a pea.

For stones that cannot be visualized, an MRI or CT scan can help make a definitive diagnosis.

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What are the treatments for tonsil stones?

Tonsil stone treatment is not always needed. Stones frequently either dissolve on their own or are coughed up.

How to get rid of tonsil stones

For stones that do not go away on their own, there are several types of treatments:

• Medications:
  • Antibiotics to help reduce bacteria
  • Antihistamines to reduce mucus from sinus problems or allergies
• Laser treatment (laser tonsil cryptolysis): A noninvasive treatment that helps minimize or remove the tonsil pockets (crypts) where the tonsil stones are lodged
• Coblation cryptolysis: Radio waves are used to change a salt solution into charged ions that can cut through the tissue to reduce crypts on the tonsils and eliminate tonsil stones
• Tonsillectomy: Removal of the tonsils, usually the last resort but the only way to definitively eliminate tonsil stones and prevent new ones from forming

How do you get rid of tonsil stones at home?

Manual tonsil stone removal at home is generally not recommended. Tonsils are delicate tissues, and removing them on your own may cause bleeding and infection.

Home remedies to get rid of tonsil stones include:

• Saltwater gargle: This may help dislodge tonsil stones and get rid of the odor and bad breath they cause.
• Coughing: Can you cough up tonsil stones? Tonsil stones are often coughed up inadvertently. In some cases, a hard cough may help dislodge them.
• Oral irrigation: Oral irrigators can sometimes be used to gently shoot water into the back of the mouth in an attempt to dislodge the tonsil stones. Follow instructions and use caution because it is possible to injure the tonsils if it is not done gently.

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Do tonsil stones go away?

What happens if you leave tonsil stones untreated? Tonsil stones, also known as tonsilloliths, often go away on their own. If they are causing pain, bothering you, or keep coming back, there are several noninvasive and invasive methods to remove them (see above paragraph).

How long do tonsil stones last?

The length of time tonsil stones last varies and depends on several factors.

• Tonsil stones may dislodge or dissolve on their own in a short time.
• Tonsil stones may last for weeks if bacteria continue to grow on the tonsils due to tonsil stones deep in the throat.
• If tonsil stones are ignored and left in place without lifestyle changes, they may last for years.
• The only surefire way to cure tonsil stones and prevent any recurrence is to have the tonsils removed (tonsillectomy).

What are the complications of tonsil stones?

Most tonsil stones are not serious, but sometimes they can affect your quality of life, including causing bad breath. If they are continually painful or bothersome, you should reach out to your medical professional.

How to prevent tonsil stones

There are several ways to prevent tonsil stones, such as the following:

• Maintain good oral hygiene: Brush and floss regularly; consider using a tongue scraper to remove bacteria.
• Gargle regularly with mouthwash or saltwater solution.
• Drink plenty of water.
• Quit smoking.
• Avoid excess alcohol.
• Reduce the consumption of carbonated beverages such as sodas.
• Treat sinus infections or allergy symptoms promptly.
• Limit the intake of dairy products.

Frequently asked questions

• Does mouthwash help tonsil stones? Yes, using mouthwash regularly can help reduce the formation of tonsil stones by decreasing bacteria and removing debris from the mouth. However, it may not completely prevent the formation of tonsil stones.
• How do you make deep tonsil stones fall out? To make deep tonsil stones fall out, gently apply pressure on the tonsils with a cotton swab, gargle with salt water, or use a water pick to flush tonsil stones out. If they persist, consult your health care provider for removal.
• What happens if a tonsil stone won't come out? Usually, tonsil stones are harmless; however, in some cases tonsil stones may cause bad breath, pain and swelling, making it difficult to swallow. Tonsil infection may occur in severe cases, necessitating immediate medical attention.

Medically Reviewed on 8/23/2024 References American Academy of Otolaryngology. Tonsils and Adenoids. 2019. October 2019. <https://www.enthealth.org/conditions/tonsils-and-adenoids/> Bickle, Ian and Maxime St-Amant. Tonsillolith. 2019. October 2019. <https://radiopaedia.org/articles/tonsillolith-1> Busaba, Nicholas and Shira Doron. Tonsillectomy in adults: Indications. Sept. 24, 2019. October 2019. <https://www.uptodate.com/contents/tonsillectomy-in-adults-indications?search=tonsilloliths&source=search_result&selectedTitle=2~3&usage_type=default&display_rank=2> Tonsilstoness.com. Tonsil Stones Guide. 2019. October 2019. <https://www.tonsilstoness.com/> Prevalence and Imaging Characteristics of Detectable Tonsilloliths on 482 Pairs of Consecutive CT and Panoramic Radiograph. https://www.medscape.com/viewarticle/813869_2 Fauroux MA, Mas C, Tramini P, Torres JH. Prevalence of palatine tonsilloliths: a retrospective study on 150 consecutive CT examinations. Dentomaxillofac Radiol. 2013;42(7):20120429. Keck Medicine of USC: "What Are Tonsil Stones?" Health Direct: "Tonsil stones." My Health Alberta: "Tonsil Stones: Care Instructions." Jefferson Dental & Orthodontics: "Tonsil Stones: Causes, Symptoms, Treatment & Prevention." Cleveland Clinic: "Tonsil Stones Might Be Causing Your Bad Breath." All about tonsil stones. Mayo Clinic Health System. Accessed July 31, 2024. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/all-about-tonsil-stones Tonsil Stones. Cleveland Clinic. Accessed July 31, 2024. https://my.clevelandclinic.org/health/diseases/21505-tonsil-stones

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