Tonsil stones, or 'tonsilloliths', are small lumps of hardened material that can form in the tonsils. They can cause bad breath and are more common in adults than in children. The stones are usually small and it is rare to have a large tonsil stone.
Tonsil stones are not harmful and may not need to be treated, but surgical options are available if they become a problem.
What are the symptoms of tonsil stones?
Tonsil stones commonly cause bad breath. They can also cause an irritable cough, earache, sore throat or a foul taste in your mouth.
If you have tonsil stones, you might find it hard to swallow. It might feel like there's something stuck at the back of your throat. You might be able to see small patches of white on your tonsils.
Tonsil stones can also trigger infections and can be difficult to treat with antibiotics.
Tonsil stones don't always cause symptoms. Sometimes, they are found on a scan or x-ray or during a dental examination.
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What causes tonsil stones?
Tonsil stones are formed by debris that can build up in the tonsils. The tonsils are glands found at the back of your throat that help protect you against infection. The glands contain folds known as tonsillar crypts. Most tonsil stones are small, just 1mm to 2mm across. In some cases, however, they can be up to 1cm across.
If your tonsillar crypts are enlarged, minerals like calcium can become trapped and harden or calcify into stones. Bacteria or fungi that cause tonsillitis can also cause tonsil stones to form.
How are tonsil stones diagnosed?
If you think you might have tonsil stones, your doctor will talk to you and examine you. The stones might or might not be visible and a scan might help to find them if they are not obvious.
If the stones are dislodged and examined, they will usually smell foul.
How are tonsil stones treated?
While you can manage the symptoms of tonsil stones, such as bad breath, there is no specific treatment for them. Good oral hygiene is important. This includes gargling with warm salt water and brushing your teeth regularly.
During vigorous gargling, the tonsil stones may become detached. Some people choose to dislodge them with a dental pick or swab. Be gentle if you decide to do this.
Removing tonsil stones
You might decide you want the tonsil stones surgically removed. This option is best discussed with your doctor, who can refer you to an ear, nose and throat (ENT) specialist. The specialist will examine your tonsil stones and provide advice on the best course of action.
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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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