What you should know about tonsil stones

Tonsil stones form when debris, such as food, dead cells, bacteria, and other substances, becomes trapped on the tonsils.

The debris hardens as calcium builds up around it, forming tonsil stones. These stones are also called “tonsil calculi” or “tonsilloliths.” They are usually visible as white or yellowish lumps.

Extraction

Tonsil stones are generally easy to extract; some people remove them when coughing. Gargling with salty water may also dislodge them.

People with tonsil stones may be able to loosen them by gently pressing on the surrounding tissue with a cotton swab. However, the throat tissues are delicate, so to avoid injury, a person with tonsil stones should be careful not to push too hard.

A water flosser can flush out tonsil stones cleanly without introducing bacteria to the mouth and tonsils. Some people will water floss after meals or daily to prevent debris from accumulating and prevent tonsil stones.

As tonsils are made of lymphoid tissue, they can have crypts, holes in their surface. Debris may build up on these surfaces before often being swallowed or washed away by saliva.

Tonsil stones develop when bacteria and other debris get trapped in tiny crevices on the tonsils.

Most tonsil stones are small, and a person is unlikely to experience symptoms. However, potential symptoms include:

• halitosis, or bad breath (tonsil stones provide a home for anaerobic bacteria, which produce foul-smelling sulfides)
• a sense that something is caught in the back of the mouth or throat
• an irritating cough
• a bad taste in the mouth
• swollen and inflamed tonsils

Tonsil stones can look like small white or yellow flecks at the back of the throat. A large stone may be visible. Some are large enough to jut out of the tonsils, resembling tiny rocks trapped in the mouth.

Similar conditions

Other conditions that can mimic the symptoms of tonsil stones include:

• tonsillitis
• strep throat
• gum disease and tooth decay:
• tonsil cancer
• oropharyngeal squamous cell carcinoma

An otolaryngologist, or ear, nose, and throat doctor, can treat most tonsil and throat conditions.

In rare cases a doctor may recommend surgery to remove tonsil stones that cannot be extracted by other means.

In most cases, the first-line surgery in the United States to prevent tonsil stones from recurring is a tonsillectomy, the surgical removal of the tonsils. A tonsillectomy is safe, but it can cause throat pain for several days after the procedure. Like all surgeries, tonsillectomy carries some risks.

If a person is not eligible for a tonsillectomy, a doctor may suggest treating tonsil stones with laser resurfacing.However, this is not a common practice.

A paper published in the American Journal of Otolaryngology explains that this process, called coblation cryptolysis, smoothes the surface of the tonsils, reducing the number of crevices in which tonsil stones can grow.

Tonsil stones are usually harmless. However, they may cause discomfort and impact a person’s ability to swallow.

In some instances, the presence of tonsil stones may increase the risk of infections in the throat and mouth.

Practicing good oral hygiene, including frequent brushing and flossing, may reduce the risk of tonsil stones. Irrigating the tonsils and mouth with a water flosser may also help by washing away debris and bacteria.

Tonsil stones are small, hard lumps that form in crevices on the surface of the tonsils. They are usually harmless, although they can cause bad breath.

Many people can dislodge them with a cotton swab or by gargling. However, to help prevent harmful bacteria from entering the mouth, people should always use clean cotton swabs.

A doctor may recommend surgery if a person cannot remove their tonsil stones at home.