Tonsil Stones

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What are tonsil stones?

Tonsil stones are a collection of bacteria and debris that form within the crypts (pits and crevices) of the tonsils. The tonsils are lymph glands on either side of the back of the throat. They are sponge-like, soft balls of tissue that act as filters. They help the body fight infections by sifting bacteria and viruses from the mouth and throat. Like a sponge, the tonsils have pits and crevices. Debris can collect in these nooks, such as food particles, mucus, and dead cells from the oral cavity. At first, the clump of debris is soft. With time, it can calcify and harden into a stone-like lesion. Tonsilloliths, tonsilliths and tonsil calculi are other terms for tonsil stones.

Some tonsil stones are too small to see. Others develop deep in the tonsillar tissue. When they are on the surface and visible, they look like white or pale yellow bumps on the tonsil. Small stones may not cause any other symptoms. When symptoms occur, bad breath—or halitosis—is the most common symptom. Other tonsil stone symptoms include throat irritation and red inflamed tonsils. Bacteria in the tonsil stones can cause these symptoms.

Small tonsil stones are common and usually harmless. Anyone can get tonsil stones. The risk of developing stones increases when you have large tonsils or recurrent tonsillitis.

Most tonsil stones do not require treatment. However, they can be annoying if they cause discomfort and embarrassing if they cause bad breath. There are several home remedies that may help dislodge the stone, including gargling salt water. In rare cases, a large stone that is causing problematic symptoms may require medical treatment. Options may include antibiotics, laser therapy, tonsil stones removal, or removal of the tonsils.

Tonsil stones are not dangerous, but they can lead to chronic tonsillitis. See your doctor if tonsil stones are bothersome or recur frequently.

What are the symptoms of tonsil stones?

Tonsil stones may or may not cause symptoms. Small stones may be unnoticeable. Larger ones may be visible and are more likely to cause problems. While small stones are fairly common, large stones that require treatment are rare. When you can see a tonsil stone, it is white or pale yellow in appearance.

Common symptoms of tonsil stones

Common tonsil stone symptoms include:

  • Chronic bad breath or bad taste in the mouth due to bacteria collecting in the stone
  • Swollen or infected tonsils

If you have tonsil stones that cause discomfort, see your doctor to find out about your treatment options. You should also consult your doctor if you get tonsil stones frequently.

What do tonsil stones look like?

Tonsil stones may be visible on the tonsils as almond-white, hard deposits of oral debris from the mouth.

Closeup shot of open mouth showing large tonsil stone.

tonsil stone (tonsillolith) on the palm isolated on white background
Isolated large tonsil stone held in the palm.

What causes tonsil stones?

Tonsil stones occur when bacteria and other debris collect in the irregular surface of the tonsils. The tonsils are designed to catch bacteria and viruses in the mouth and throat. But they can also trap bits of food, mucus, and dead cells. When the collection first forms, it is usually soft. If it remains, it can calcify and harden into a stone-like bump.

What are the risk factors for tonsil stones?

Tonsil stones develop in anyone. They affect about as many males as females and occur most commonly in people 20 to 60 years of age. People with large tonsils or who get recurrent cases of tonsillitis are more likely to have tonsil stones.

Reducing your risk of tonsil stones

The best way to reduce the risk of getting tonsil stones is to keep debris from lodging in your tonsils. This relies on intensifying your oral hygiene routine including:

  • Brushing and flossing after every meal
  • Drinking water after eating anything
  • Gargling with an antiseptic mouthwash or salt water solution

Smoking may also contribute to tonsil stone development, so quitting will be beneficial. If you get recurrent tonsil stones, tonsillectomy is the most effective way to prevent them.

How do doctors diagnose tonsil stones?

Doctors can usually diagnose tonsil stones by examining your throat. Tonsil stones that are deep and not visible may show up on an X-ray.

To diagnose tonsil stones, your doctor may ask you several questions related to your symptoms, such as:

  • How long have you noticed these symptoms?
  • Have you seen white or yellowish bumps on your tonsils?
  • What, if anything, seems to make your symptoms better or worse?
  • Are you experiencing any other symptoms, such as fever or headache?
  • Have you ever had tonsillitis? How many times?

What are the treatments for tonsil stones?

Tonsil stones treatment may or may not be necessary. Small stones that do not cause symptoms generally do not require treatment. Most cases fall under this category. When symptoms are bothersome, your doctor may recommend treatment including:

  • Surgical removal of the tonsil stone in severe cases
  • Tonsillectomy when tonsil stones recur often or frequently result in tonsillitis
  • Tonsil cryptolysis, which is an alternative to tonsillectomy (surgical removal) that involves using a laser (laser tonsil cryptolysis) or wand (coblation tonsil cryptolysis) to scar the tonsil crypts—the nooks and crannies of the tonsils. The scar tissue fills up the nooks and crannies, which helps prevent tonsil stones from forming. Some ear, nose and throat specialists may use coblation for partial or full tonsil removal as well.

Home remedies for tonsil stones

Medical treatment for tonsil stones is rarely necessary. In most cases, you can manage tonsil stones at home using these strategies:

  • Flush the area with a water pick device
  • Gargle with antiseptic mouthwash or a salt water solution to dislodge the stone
  • Gently scrape the stone off the tonsil using a toothbrush or cotton swab

It usually is not a problem to remove the stone yourself if it dislodges easily. Gargling with salt water after removal can help flush away remaining bacteria. If a tonsil stone seems stuck or you are having difficulty moving it, do not force it. See your doctor instead.

What are the potential complications of tonsil stones?

In most cases, tonsil stones are harmless and do not cause complications. However, they can affect your quality of life if bad breath causes embarrassment or other symptoms are bothersome. Rarely, tonsil stones can lead to chronic inflammation of the tonsils or recurrent tonsillitis.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 May 4
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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