Tonsil Stones: Causes, Removal & Prevention
Tonsil stones are accumulations of bacteria and debris in the crypts of some people's tonsils.
Credit: Mayo Clinic

While tonsil stones may seem like a bad medical hoax, they can be a real problem. Tonsil stones, also known as tonsilloliths or tonsilliths, are benign accumulations of bacteria and debris in the crypts of some people's tonsils. Though this problem may cause discomfort, it is not dangerous and is usually easily treatable. 

The tonsils are part of a protection system that keeps foreign objects from slipping into the lungs. They are also a lymph node that filters for bacteria and viruses while producing white blood cells and antibodies, according to the Mayo Clinic. Objects such as food, dirt and other particles can get stuck in the groves on the surface of the tonsils. The grooves, called crypts, also collect old cells and bacteria. 

The body's white blood cells proceed to attack the foreign objects stuck in the tonsils. When the white blood cells are finished, hard particles remain on the tonsils. Most people simply swallow what is left behind and never know that it was there in the first place. If the particles are lodged into the crypts, though, the particles will continue to grow. These growing objects are tonsil stones, which are also called tonsil calculi.

According to Dr. Alan Greene's website, tonsil stones are most common in teens and those with large tonsils.  Those with poor dental hygiene may also experience tonsil stones.

Typically, tonsil stones can be seen as white, yellow or grey nodes on the tonsils. This isn't always the case, though. Many tonsil stones aren't visible because they are burrowed down inside of the tonsil, said Dr. Ileana Showalter, an otolaryngologist at Mercy Medical Center in Baltimore, Maryland.

Some people have no symptoms when afflicted with tonsil stones. Those who do have symptoms often report redness or irritation of the tonsils. There are several other symptoms that can be related to tonsil stones, with bad breath being one of the most obvious. According to the Mayo Clinic, bacteria grow on the stones, which produces a foul odor. 

People with throat stones can also feel like they have something stuck in their throats, according to Dr. Erich P. Voigt, an associate professor of otolaryngology at NYU-Langone Medical Center. Other symptoms can include chronic, mild sore throat and reoccurring tonsillitis.

One of most common treatments to cure tonsil stones is simply scraping them off with a toothbrush. If that doesn't work, there are several other at-home options. "Gargling with salt water can help dislodge them. Using a cotton swab to express them from the little small cavities that are visible is another option," said Showalter. A water flossing device can also be used to power wash the debris out of the tonsils. 

Sometimes the tonsil stones are so deeply embedded that they cannot be removed at home. In this case, an ear, nose and throat specialist can often remove the stones. If a person gets tonsil stones often, then the patient and doctor may discuss removing the tonsils.

"A last resort cure of this problem is tonsillectomy. However this surgery carries risks of anesthesia, pain, and bleeding, as well as other risks, thus a decision of this type must be balanced by a risk/benefit discussion," said Voigt. 

Preventing the formation of tonsil stones is as simple as good dental hygiene. The Mayo Clinic suggests brushing teeth and tongue after meals, at bedtime and first thing in the morning. Flossing teeth daily can also help by cleaning out bacteria. Voigt also suggested gargling daily suing commercial gargles, or a homemade solution of hydrogen peroxide and water. The Mayo Clinic advises against using a mouthwash that contains alcohol.

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