Rejuvenation Dentistry logo Rejuvenation Dentistry logo

Tonsil Stones: Symptoms, Causes, and Treatment Options

Tonsil stones are small lumps that develop on your tonsils, the fleshy pads that line the back of the throat. Also called tonsil calculi or tonsilloliths, these yellow or white stones may appear as small as a grain of rice or as big as an olive. They can lead to bad breath, throat pain, and trouble swallowing. Nearly 6% of adults experience tonsil stones at some point. Many people who get them don’t realize they have them. Adults who’ve had tonsillitis are more likely to experience other tonsil issues, such as tonsil stones. If you’re concerned about tonsil stones or other oral health issues, schedule an appointment with Rejuvenation Dentistry, where we take a science-backed biological approach to integrative treatment.

What Are Tonsil Stones?

Tonsil stones are calcifications that form on the tonsils, the fleshy pads that line the back of the throat. Also called tonsil calculi or tonsilloliths, these yellow or white stones may appear as tiny as a grain of rice or as big as an olive. Your tonsils are a part of your immune system at the back of your throat. They filter bacteria and viruses that enter your mouth. Your tonsils have folds and crypts (crevices) where different substances can build up and form tonsil stones. Tonsil stones may be so mild as to go unnoticed until you have difficulties swallowing or severe bad breath. Tonsil stones smell because of anaerobic bacteria, which create sulfides that produce a putrid smell.

Common Symptoms

The most commonly reported symptoms of tonsil stones include:

  • Visible yellow or white pebbles on one or both sides of the tonsils
  • Chronic bad breath (halitosis)
  • Bad taste in your mouth
  • Difficulty swallowing
  • Feeling like you always need to swallow
  • Pain when swallowing
  • Swollen tonsils
  • Sore throat
  • Persistent cough
  • Ear pain

Untreated tonsil stones may lead to bacterial infections, including throat infections.

Background media
man smiling with blue glasses

Causes and Risk Factors

You may have tonsil stones because of your previous cases of tonsillitis, poor dental hygiene, too much calcium, or significant hormonal changes. Dehydration and a lack of lymphatic drainage can also be root issues, and tonsilloliths are signs of stagnancy from the lymph nodes.

The potential causes of tonsil stones include:

  • Chronic tonsillitis (inflammation of the tonsils)
  • Poor oral hygiene
  • Chronic mouth breathing (waking or sleeping)
  • Food particles lodged in your tonsillar crypts
  • Hormonal changes (such as during pregnancy or menopause)
  • Too much calcium intake without enough vitamins K2 and D3 to transport calcium through your bloodstream to its proper location in your teeth and bones
  • Imbalanced oral microbiome

Enlarged tonsils are an additional risk factor for tonsil stones, which are most common in:

  • The male gender
  • Anyone under the age of 40
  • Those of Hispanic or Caucasian ethnicity
  • Anyone who has a history of frequent tonsil infections or sinus infections

At-Home Remedies

Promoting a healthier oral environment and balancing the microbiome is also important. Proper hydration, partnered with good oral hygiene, is a key way to achieve this homeostasis.

Treatments for tonsil stones include saltwater gargles and antibiotics. In severe cases, where at-home remedies are not working, it is suggested that you see your oral health specialist and see if they suggest a tonsil stone removal surgery.

To safely get rid of tonsil stones at home, try these home remedies:

  • Gargle warm saltwater; saltwater is the most reliable home remedy.
  • Gargle diluted apple cider vinegar; the acidic vinegar should break down the tonsil stones.
  • Use a water flosser to dislodge the calcified stone. Spray water carefully at your tonsils for tonsil stone removal. Without proper caution, you may risk damaging your tonsils or causing an infection.
  • Gently dislodge tonsil stones with a cotton swab. You have to be very careful that you don’t gag yourself or scratch your delicate tonsils. However, this can also run the risk of causing damage to your tonsils.
  • Making yourself cough can dislodge tonsil stones. You may have to cough hard, so have some warm tea on standby to loosen up.

When to See a Healthcare Professional

You should see a healthcare provider to diagnose persistent tonsil stones or in case of an emergency.

Seek medical advice immediately if you experience any of the following emergency symptoms:

  • Blood in your saliva
  • Serious problems swallowing, speaking, or breathing
  • Pain, swelling, or lumps in your mouth or neck — especially if it’s persistent
  • Pus discharge or bleeding from your tonsils
  • Inability to tolerate eating or drinking foods that contain citric acid (lemons, oranges, grapefruit, etc.)

In non-emergencies, your healthcare provider can diagnose tonsil stones, also. While many cases of tonsil stones will clear up on their own, seek medical care if your symptoms persist for longer than 3 weeks.

Banner media

Diagnoses

To diagnose tonsil stones, your dentist or doctor may do the following:

  • Look inside your mouth and at the back of your throat to identify the stones.
  • Do a CT scan, X-ray, or MRI if they can’t easily identify the stones with just their eyesight

Your provider may refer you to a doctor of otolaryngology (ear, nose, and throat doctor) for treatment or to confirm the diagnosis.

Your dentist may notice the stones during your twice-yearly checkup. This is just one of many reasons you should see your dentist at least once, preferably twice, a year.

greyscale of procedural tools

Medical and Dental Treatments

If your tonsil stones don’t resolve within 1-3 weeks, it’s time to seek treatment from your ENT, dentist, or healthcare provider. Here are the most common treatments of tonsil stones after home remedies don’t work:

  • Antibiotic drugs: Antibiotics can reduce the symptoms of tonsil stones caused by bacterial buildup. However, they should not be overused to avoid antibiotic resistance or disrupting your oral and gut microbiomes.
  • Anti-inflammatory drugs: Over-the-counter and prescription anti-inflammatories (ibuprofen) may reduce swelling of the tonsils. This treatment reduces discomfort and makes tonsil stones easier to dislodge.
  • Laser tonsil cryptolysis: This outpatient procedure uses a laser to eliminate deep tonsil crypts that contribute to tonsil stone formation. Expect to miss only 1-2 days of work during recovery from laser tonsil cryptolysis.
  • Coblation cryptolysis: Coblation uses radio waves to destroy tonsil crevices without heat. Only introduced in 2012, coblation cryptolysis’s main benefit is the lack of a “burning sensation” on the mouth, face, or eyes.
  • Tonsillotomy: This tonsil surgery removes the palatine tonsils, where tonsil stones occur. Also known as a partial tonsillectomy, this surgery requires general anesthesia. However, a tonsillotomy is less invasive and easier to recover from than a complete tonsillectomy.
  • Tonsillectomy: A full tonsillectomy is the most drastic surgical option for tonsil stones. This tonsil surgery removes all three types of tonsils (palatine, pharyngeal, and lingual). Recovery time may be 10-14 days.

Surgery for tonsil stones should be performed only as a last resort after other options have been exhausted. Surgery is invasive and comes with unavoidable risks and side effects.

How To Prevent Tonsil Stones

The best ways to prevent tonsil stones include:

  • Brush your teeth twice a day with a soft-bristled toothbrush to get rid of bacteria that may contribute to tonsil stones.

  • Rinse your mouth after eating sugary, acidic, or processed food and drink. Food particles can get lodged in your tonsil crevices, but food particles stuck in your teeth can also promote bacteria proliferation.

  • Avoid alcohol-based or antibacterial mouthwash, which disrupts the oral microbiome and dries out your mouth. Paradoxically, alcohol-based mouthwashes can lead to more bacterial growth in your oral cavity and tonsils.

  • Use natural toothpaste like Revitin.

  • Floss in between your teeth every day.

  • Use dental probiotics. These probiotics consisting of beneficial bacteria that balance your oral microbiome and contribute to good oral hygiene.

  • Scrape your tongue every day to get rid of excess bacteria. Just be sure not to harm your tongue by scraping too hard.

  • Eat a healthy diet rich in nutrient-dense foods and low in processed foods. Sugary foods contribute to bacterial proliferation in your oral microbiome. Make sure you’re drinking plenty of water throughout the day, too.

  • Use mouth tape when you go to bed, especially if you’re experiencing sleep apnea, chronic snoring, or even teeth grinding, which may be associated with mouth breathing at night. Mouth tape promotes nasal breathing, which is good for both your cardiovascular and tonsil health.

  • Talk to your dentist about the DNA appliance, particularly if you have sleep apnea.
  • Don’t overuse alcohol; it can dry out your mouth and mess with your oral microbiome, promoting the growth of harmful bacteria.
  • Visit your dentist twice a year. Your dentist can identify early signs of tonsil stones and other oral conditions.
Banner media

Getting to the Root of Your Dental Health Issues

If you’re experiencing recurrent oral wellness issues like tonsil stones, chronic halitosis, and bacterial mouth or throat infections, you need to get to the root cause.

Rejuvenation Dentistry is a biological dentistry clinic that identifies the underlying causes of oral health problems. That way, we can treat the root cause of your condition, not just the symptoms. Schedule an appointment with us today! Virtual consultations are also available for expert advice around personalized, wellness-focused treatments. 

Logo media

Frequently Asked Questions

How long do tonsil stones last?

Are tonsil stones contagious?

Can tonsil stones lead to complications if left untreated?

How long do tonsil stones last?

Tonsil stones can last anywhere from a few days to a few years. An average case of tonsil stones resolves itself within 1-3 weeks. Larger stones might linger on your tonsils for years unless treated by a healthcare professional.

Are tonsil stones contagious?

No, tonsil stones are not contagious. Unfortunately, you can pass bacteria buildup from your oral microbiome (including your tonsils) to another person via kissing or sharing utensils.

Sharing harmful bacteria may contribute to the reason why tonsil stones form, other bacterial infections, or an imbalanced oral microbiome.

If you want to learn more about your oral microbiome and how it connects to your whole-body health, read Dr. Gerry Curatola’s book, The Mouth-Body Connection.

Can tonsil stones lead to complications if left untreated?

Untreated tonsil stones can lead to bacterial infections and difficulty swallowing, but do not generally cause significant health complications.

Sources

  1. Aragoneses, J. M., Suárez, A., Aragoneses, J., Brugal, V. A., & Fernández-Domínguez, M. (2020). Prevalence of palatine tonsilloliths in Dominican patients of varying social classes treated in university clinics. Scientific reports, 10(1), 1-7. Full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC6997381/

  2. Van Ballegooijen, A. J., Pilz, S., Tomaschitz, A., Grübler, M. R., & Verheyen, N. (2017). The synergistic interplay between vitamins D and K for bone and cardiovascular health: a narrative review. International journal of endocrinology, 2017. Full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC5613455/

  3. Chang, C. Y., & Thrasher, R. (2012). Coblation cryptolysis to treat tonsil stones: a retrospective case series. Ear, Nose & Throat Journal, 91(6), 238-254. Full text: https://pubmed.ncbi.nlm.nih.gov/22711390/

  4. Hamza, B., Tanner, M., Körner, P., Attin, T., & Wegehaupt, F. J. (2021). Effect of toothbrush bristle stiffness and toothbrushing force on the abrasive dentine wear. International Journal of Dental Hygiene, 19(4), 355-359. Full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC8597153/

  5. Bollen, C. M., & Beikler, T. (2012). Halitosis: the multidisciplinary approach. International journal of oral science, 4(2), 55-63. Full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC3412664/

Header image credit: AsktheDentist.com

Dr. Gerry Curatola is a renowned biologic restorative dentist with more than 40 years of clinical practice experience. He studied neuroscience at Colgate University and attended dental school at the New York University (NYU) College of Dentistry, where he now serves as Adjunct Clinical Associate Professor in the Department of Cariology and Comprehensive Care.

Recent Posts

Look Great.
Feel Great.
 Live Great.

Contact Us
Contact us media Logo media
Accessibility: If you are vision-impaired or have some other impairment covered by the Americans with Disabilities Act or a similar law, and you wish to discuss potential accommodations related to using this website, please contact our Accessibility Manager at (646) 847-3995.
Virtual Consultation Book a Visit Call Rejuvenation Dentistry on the phone at (646) 847-3995