Tonsil stones or tonsilloliths are hard and even painful in some cases. These are formed with bits of bacteria and debris that get stuck in the nooks of your tonsils.

Tonsils are gland-like structures in the back of your throat and you have one on each side of your neck.

These are made of tissues with lymphocytes, the cells that prevent and fight infections.

According to many experts, tonsils play a crucial role in your immune system and work like nets.

These nets trap bacteria and viruses that come in through your throat.

However, it does not mean that they always work well. For some, they can be a lot of trouble.

Moreover, research suggests that people who get their tonsils removed are more prone to bacterial and viral attacks than those who keep their tonsils.

Causes of Tonsil Stones

Tonsils in your neck are made of crevices, tunnels, and pits, called tonsil crypts.

When different types of debris like dead cells, mucus, saliva, and food particles are trapped in these pockets and build up, the bacteria and fungi feed in them and can cause a distinct odor.

Over time, this debris hardens and forms tonsil stones.

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In some cases, people can have one tonsil stone while in others, there may be many smaller formations.

Potential causes of tonsils are as follows:

  • If you do not take care of your dental hygiene, the debris and bacteria accumulate in your mouth, and over time it forms stones
  • large tonsils due to the accumulation of debris, bacteria, and food particles
  • long-term and persistent sinus issues.
  • inflammation in the tonsil or chronic tonsillitis, it can form pus pockets in the tonsils and has bacteria in it. Over time, they can be foul-smelling stones formation.
  • it can also be due to an ear nose and throat infections

Learn more about different ways to maintain dental hygiene and healthy teeth.

Signs and Symptoms of Tonsil Stones

In case you have small tonsil stones, they may not contain any signs and symptoms, even in large form, they are only found after an X-ray or CT scan.

Signs and Symptoms include:

Bad Breath: One of the major signs of tonsils is bad breath.

Bad breath is due to tonsil infection and usually, sulfur is the main compound found.

In one study, people with chronic tonsil infection had volatile sulfur in usually high amounts.

Sore Throat: If you have tonsil stones and tonsillitis at the same time, it is often hard to figure out the cause of pain.

The tonsil stone itself might give you pain and discomfort in some cases.

tonsil stones 2

Cough: In some cases, it can irritate your throat and make you cough.

Tonsil Swelling:  When the debris becomes har, and tonsil stones form, inflammation, infection, and the tonsil stone itself can cause swelling.

White Debris: You might be able to see the tonsil stone at the back of your throat in the form of a white lump.

Ear Pain: These stones can develop in any part of your tonsil, and because your nerves share the same pathway, they can cause pain in your ear.

In such cases, many doctors advise diagnosis or treatment to look into the nooks and crannies.

Diagnosis of Tonsil Stones

In most case, tonsil stones do not cause any signs and symptoms and often goes unnoticed.

However, they often cause symptoms like coughing, sore throat, bad breath, etc.

Your doctor will be able to medical advice diagnosis includes a physical exam as they can cause swelling and inflammation in your tonsils.

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While this selling can also be due to sore throat or strep throat, to confirm the diagnosis, your doctor will order other tests as well.

These tests include image tests like X-ray and CT scans.

Treatment Options

Most tonsils or tonsilloliths are harmless, however, many people choose to remove them because they can cause bad breath or even discomfort.

The treatment options can range from certain home remedies to medical procedures.

Moreover, it also depends on the size and the pain or discomfort they might be causing.

Let’s discuss these options as follows:

Gargling and Coughing

When you gargle vigorously with saltwater it can help to relieve discomfort in your throat and can also help dislodge them.

Moreover, salt water can also help to change your mouth chemistry and get rid of bad odor from your mouth.


For this remedy, mix 1/2 teaspoons of salt in 8 ounces of warm water and gargle.

In some cases, you may also discover a tonsil stone when you cough one out.

Thus, when you cough energetically, it can help loosen the stones.

Manual Removal of Stones

Removing tonsil stones all by yourself is often not recommended by the doctor as your tonsil tissues are soft and delicate.

Moreover, do not try to remove them with a toothbrush as it can be risky can lead to other complications.

These complications include bleeding and infection in either your throat, tonsils, or your mouth.

However, if you must try, then gently using a pick or cotton swab is a better choice.

In some cases, your doctor may recommend a minor surgery if the stones are particularly large and causing persistent symptoms.

Large Tonsil Cryptolysis

This is one of the most common and effective tonsil stone removal treatments.

Cryptolysis is the removal of tonsil crypts or fissures, cracks, or holes in your tonsils.

Before starting this procedure, your doctor will administer local anesthesia.


During this procedure, our doctor will evaporate away from the holes, cracks, crevices, and crypts where food and debris trap and form stones, along with hard food lumps are squeezed within the tonsils.

Moreover, your doctor will use a laser to eliminate the crypts in your tonsils. During the procedure pain and discomfort are minimal and anesthesia wears off after some time.

Coblation Cryptolysis

This treatment involves the use of radiofrequency waves that excites the electrolytes in a conductive medium like a saline solution or a get to create a plasma.

This plasma results in tissue breakdown and dissolution of the stone while causing minimum damage to the surrounding tissues of tonsils.

Lasers often cause heat or burning sensations, however, this treatment, helps to reduce the tonsil crypts without those burning sensations.


This is the surgical removal of the tonsils, at the back of your throat.

Moreover, your doctor will recommend this surgery if you have infection and inflammation of the tonsils and it occurs more frequently.

It is also necessary if you have breathing problems and others related to enlarged tonsils, however, it is very rare.

During this procedure, your doctor will administer general anesthesia and use a scalpel, laser, or coblation device.

They will cut out the tonsils with a blade or laser to remove or destroy the tissues and stop bleeding.

Antibiotics for Tonsil Stones

Antibiotics can help to manage and treat tonsil stones in some cases.

To lower the bacteria count in your mouth that leads to the development and growth of the tonsil stones, your doctor may recommend certain antibiotics to stop it.

However, one pitfall of using antibiotics is that they will not treat the underlying cause of stones and they will cause other side effects.

Moreover, you can not use antibiotics for a long period of time, which means that they will return eventually.  when you stop using antibiotics.

Other Conditions Affecting Tonsils

Certain conditions can cause pain in or near your tonsils, however, your doctor can help to determine the cause.

Some conditions that overlap with the symptoms of tonsils are as follows:

Tonsillitis: If your tonsils are red and have swelling, then they can make swallowing difficult.

Moreover, there may be an infection in your tonsils and often comes with fever.

Gum Disease and Tooth Decay: Pain in the teeth, and gums can move to your jaws and even your throat.

If you do not get treatment, it can spread throughout the mouth and even to other parts of your body causing other complications.

other conditions

Strep Throat: It is one of the types of tonsillitis that can cause pain in your throat and even at the back of your mouth.

Strep throat can also cause fever.

Tonsil Cancer: Also known as Tonsil Lymphoma, it can cause a sore at the back of your mouth which does not heal.

Signs and symptoms include pain in your ear, throat, and difficulty swallowing, and even blood in your mouth.

An ENT doctor or otolaryngologist can help treat tonsils and throat conditions.


Complications of tonsil stones are often rare, however, they are possible.

Moreover, one of the most serious complications that can result from these stones is a deep infection also known as Abscess.

In some cases, tonsil stones can even damage and disrupt normal tissues of the tonsil and can lead to swelling, inflammation, and infection.

In such cases, you will have to undergo surgery to stop the infection, inflammation, and swelling.

They can also become a breeding ground for bacteria.

One study has found that tonsil stones are similar to the dental plaque that causes cavities and gum disease.

Learn more about Tooth Abscess.

Preventive Measure

People who have tonsil stones can recur on regular basis, however, the following preventive measure can help to prevent tonsil stones:

preventive measures

Most people often confuse tonsil stones as contagious, however, they are not.

They consist of material biofilm which is the combination of bacteria and fungi interacting with your mouth’s chemistry.

This mixture attaches itself to a moist surface, and in the case of tonsil stones, it can become hard and form stones.

Final Thoughts

Tonsil stones are common in many people and the signs and symptoms can range from mild to severe and can even result in serious complications.

In case you have recurring tonsil stones, then you need to practice good oral and dental hygiene and make sure to drink plenty of water.

Moreover, if they cause pain or discomfort, talk to your doctor as they can help you determine the best treatment option and prevent them in the future.