Tonsil Stones

What are tonsil stones?

Tonsil stones are small lumps of calcified (hardened) material that form in your tonsils’ nooks and crannies. They consist of hardened minerals (like calcium), food debris and bacteria or fungi. They’re rarely harmful, but they can cause bad breath, sore throat, earache and other symptoms. The medical term for tonsil stones is “tonsilloliths.”

Tonsil stones look like tiny white or yellow pebbles on your tonsils. You might have one, or you might have several. They’re usually small, but it’s possible to get large ones.

You can usually remove tonsil stones at home. Rarely, you might need surgery — especially if they keep coming back.

Symptoms of tonsil stones

The most common tonsil stone symptom is bad breath (halitosis). Other symptoms could include:

• Bad taste in your mouth.
• Sore throat.
• Cough.
• Earache.
• Difficulty swallowing.
• Feeling like there’s something stuck in your throat.

Tonsil stone causes

Tonsil stones form when debris becomes trapped in folds called tonsillar crypts, and then calcifies. You’re more likely to develop enlarged tonsillar crypts if you get frequent tonsil infections.

Risk factors

Anyone can get tonsil stones, but you’re more likely to get them if you:

• Get tonsillitis (frequent tonsil infections).
• Have enlarged tonsillar crypts (folds).
• Have dehydration.
• Are a teenager.

Complications

Tonsil stones are usually harmless. But large or chronic ones can cause swelling and make it difficult to swallow. In some cases, tonsil stones can trigger other types of infections.

How doctors diagnose tonsil stones

To diagnose tonsil stones, your healthcare provider may:

• Do a physical exam, looking inside your mouth and throat.
• Take an imaging scan if they can’t see the stones easily.
• Dislodge the stones using a dental pick.

Sometimes, providers discover tonsil stones by coincidence. For instance, your dentist might find them during an exam.

How are tonsil stones treated?

In many cases, you can remove tonsil stones at home. Here are some things you can try:

• Gargle with warm saltwater.
• Cough vigorously to try and dislodge the stones.
• Use a water pick to flush tonsil stones out.
• Use a cotton swab to gently push the tonsil stones out.

If you’re unable to remove them at home, your provider can do tonsil stone removal during an office visit.

You may not need to do anything if tonsil stones don’t bother you. In fact, tonsil stones often fall out on their own eventually and the underlying cause goes away. But if you get them frequently, or if they cause uncomfortable symptoms, your provider can recommend other treatments.

Medications

You can take over-the-counter (OTC) pain relievers to ease any discomfort. If you have an infection, your provider might prescribe antibiotics. But antibiotics aren’t a long-term solution. If tonsil stones cause symptoms or keep coming back, you might need to explore surgical options.

Surgery

Depending on your symptoms, your provider may recommend tonsillectomy (surgery to remove your tonsils).

Can tonsil stones be prevented?

You can’t always prevent tonsil stones. But there are things you can do to reduce your risk:

• Brush and floss regularly. Make sure to brush your tongue, too.
• Quit smoking. Ask your healthcare provider for helpful resources.
• Gargle with salt water after eating.
• Stay hydrated.

When should I see my healthcare provider?

Talk to your provider if:

• At-home remedies aren’t working as they should.
• Tonsil stones keep coming back or are bothering you.
• You want to discuss other treatment options.

What questions should I ask my healthcare provider?

If you have tonsil stones, you might want to ask your provider:

• How can I get rid of tonsil stones at home?
• What can I do to improve my symptoms?
• What should I do if tonsil stones come back?
• Will I need surgery?

Is it normal to get tonsil stones?

Tonsil stones are common, and they rarely cause serious health issues. Many people have tonsil stones and don’t know it. You can treat them at home most of the time. If tonsil stones keep coming back, you and your healthcare provider can discuss a more permanent solution.

Do tonsil stones go away on their own?

Yes, in many cases tonsil stones fall out on their own. You can help this process along by gargling with warm saltwater.

What happens if you swallow a tonsil stone?

It’s OK to swallow tonsil stones. They won’t hurt you. Tonsil stones commonly loosen and fall out on their own, so you may have already swallowed one or two without knowing it.

Are tonsil stones contagious?

No, tonsil stones aren’t contagious. You can’t pass them on to other people.

Why do I keep getting tonsil stones?

If you get tonsil stones repeatedly, you probably have enlarged tonsillar crypts. Tonsillar crypts are folds that form and grow larger after each tonsil infection. If you have tonsillitis frequently, then you’re more likely to get tonsil stones.

A note from Cleveland Clinic

Tonsil stones generally aren’t harmful. But they can become a major annoyance if you get them often. It’s OK to try and remove them at home. But if home remedies don’t work, it’s time to call your healthcare provider. They can recommend ways to prevent them and tell you whether you need surgery.