What are tonsil stones?
Tonsil stones, medically known as tonsilloliths, are small, troublesome formations that can develop on your tonsils, causing unpleasant symptoms like bad breath, throat discomfort, and difficulty swallowing. Treating tonsil stones can involve various approaches, such as saltwater gargles, antibiotics, or, in severe instances, surgical removal.
It’s surprising to learn that nearly 6% of adults experience tonsil stones at some point, and a significant number may not even be aware of their presence. Interestingly, adults who have previously dealt with tonsillitis are at a higher risk of encountering other tonsil-related issues, including the formation of tonsil stones.
You might be wondering, “Why do I have tonsil stones?” There are several potential factors contributing to their development, such as a history of tonsillitis, subpar dental hygiene, excessive calcium intake, or significant hormonal fluctuations.
If you find yourself concerned about tonsil stones or other oral health matters, we invite you to schedule an appointment with Rejuvenation Dentistry. At our practice, we specialize in a science-backed biological approach to integrative treatment, ensuring your oral health receives the utmost care and attention. Your well-being is our priority.
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.
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.
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 tonsil stones, 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.
What causes tonsil stones?
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
Risk factors for tonsil stones include:
- Male gender
- Age under 40
- Hispanic or Caucasian ethnicity
- Frequent tonsil infections or sinus infections
How to get rid of tonsil stones at home
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. Make sure not to choke yourself.
- 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.
- Make yourself cough. You may have to cough hard, so have some warm tea on standby.
Do tonsil stones go away on their own? Most cases of tonsil stones go away on their own. However, a small number of cases persist or worsen. If this is the case for you, schedule your appointment today.
When should i see a healthcare provider about my tonsil stones?
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 citrus food or drink
- Blood in your saliva
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.
Diagnosing tonsil stones
To diagnose tonsil stones, your dentist or doctor may do the following:
- Look inside your mouth and 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
- Dislodge the tonsil stones using a dental pick or an oral irrigator
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.
Tonsil stone treatments [at the doctor + dentist]
If your tonsil stones don’t resolve within 1-3 weeks, it’s time to seek treatment from your ENT, dentist, or healthcare provider. If gargling, coughing, and other home remedies don’t work, your provider may recommend antibiotics or surgical removal.
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 due to bacteria buildup. Remember, antibiotics 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. Do not 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.
- Mouth tape while you sleep, 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 not only good for your cardiovascular health but also your tonsil health.
- Talk to your dentist about the DNA appliance, particularly if you have sleep apnea.
- Don’t overuse alcohol. One glass of red wine a day might improve your heart health, but alcohol dries out your mouth and messes 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.
Have recurring dental health issues? Get to the root.
If you’re experiencing recurrent oral wellness issues like tonsil stones, chronic halitosis, and bacterial mouth or throat injections, you need to get to the root cause.
Rejuvenation Dentistry is a biological dentist clinic that identifies 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!
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.
- 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://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997381/
- 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://www.ncbi.nlm.nih.gov/pmc/articles/PMC5613455/
- 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/
- 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://www.ncbi.nlm.nih.gov/pmc/articles/PMC8597153/
- Bollen, C. M., & Beikler, T. (2012). Halitosis: the multidisciplinary approach. International journal of oral science, 4(2), 55-63. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412664/
Header image credit: AsktheDentist.com