What are tonsil stones?

Tonsils can cause all sorts of issues, but what are tonsil stones?  According to Cleveland Clinic, tonsil stones are small, hard lumps that form in the tonsils. Sometimes known as tonsiliths, they are usually yellow or white and come in a range of sizes. The small formations rarely cause major health issues or pain and some people who have tonsil stones may not even realize they have them. 

Maintaining good oral hygiene can help prevent these stones from forming. You can find great tips on how to do this by reading through our pieces on how to to use an electric toothbrush and how to floss your teeth. But if you're here to find exactly how these stones are formed and where they come from, then read on. 

What causes tonsil stones?

Your tonsils are the two small masses of lymphoid tissue on each side of the root of your tongue. They work to clear away infection and keep your bodily fluids balanced. Tonsils have various gaps and folds called tonsillar crypts, which are often where tonsil stones are created.

As tonsils are a part of the immune system, they work to filter bacteria and viruses that enter your mouth via your food and your breath. Food, debris, minerals, and bacteria can get stuck in the tonsillar crypts, gradually calcifying into yellow or white stones. A tonsil stone’s size can range anywhere from a grain of rice to a grape. In a study published in ISRN Dentistry’s 2014 volume, the average size of a tonsil stone across 124 cases was 4mm, with the range being 3-11mm.  According to this study, the largest reported tonsil stone to date was 14.5cm in 1936. 

A person can have one or multiple small tonsil stones at a time. Some of the causes of tonsil stones are:

• Poor dental hygiene 
• Chronic tonsillitis 
• Chronic sinus problems 
• Larger tonsils 

What are the signs of tonsil stones?

While some smaller tonsil stones do not cause any symptoms to occur, some common examples of tonsiliths symptoms include: 

• Coughing 
• Halitosis, or bad breath 
• Having a bad taste in your mouth 
• Spitting up small white stones 
• A sore throat 
• An earache 
• Difficulty swallowing 
• The constant feeling of something stuck in your throat 
• White patches on your tonsils 
• Throat infections that are resistant to antibiotic treatment 

If you have a range of these symptoms, particularly halitosis and spitting up small stones, that can be a good indicator that you are suffering from tonsil stones. 

(Image credit: Getty)

As discussed in the ISRN Dentistry study mentioned above, "Patients with tonsiliths may be asymptomatic and their tonsiliths may be discovered incidentally on pantomographs or other imaging modalities, including CTs and MRIs. Symptomatic patients may present with a wide range of symptoms and signs, including pain, dysphagia, enlarged tender neck glands, a lump in the throat, halitosis, and ear pain. Clinical examination reveals a white or yellowish hard object within the tonsillar crypt."

How to get rid of tonsil stones

What are possible tonsil stone treatments? According to Cleveland Clinic experts, there are a few ways to remove tonsil stones at home, including:

• Gargling: Intense gargling with warm salt water can soothe your throat and help dislodge the tonsil stones. Gargling just after eating can help prevent food from getting caught in the crypts 
• Coughing: Intense coughing could remove or loosen any tonsil stones in your tonsils. 
• Using a toothbrush, cotton swab, or finger: It could be possible to remove the stones with your finger or a toothbrush; we recommend being wary while using this method in case you accidentally make yourself sick or cause pain. 

Some medical interventions and treatments for tonsillitis include: 

• Minor surgery: It is possible to have your stones surgically removed by a healthcare professional if your tonsiliths are particularly large, causing severe pain, or causing recurring tonsil infections.  
• Tonsillectomy: If tonsil stones repeatedly return, your healthcare provider may suggest having a tonsillectomy. This is not always the case but can be considered when the stones cause repeated infections. 
• Laser tonsil cryptolysis: Under local anaesthetic, a medical professional uses a laser to eliminate the crypts that house your tonsil stones. 
• Coblation cryptolysis: Coblation cryptolysis uses radio waves to create charged ions from a salt solution. This reduces tonsil crypts without giving you a burning sensation. 
• Antibiotics: While antibiotics could prevent the number of bacteria in your tonsillar crypts, they do not treat the tonsil stones themselves.  

How can we prevent tonsil stones from appearing? Writing for the Mayo Clinic, Ann Bell, M.D. said: "You can help prevent tonsil stones from forming in the first place by following good oral hygiene. Brush your teeth after meals, at bedtime, and when you get up in the morning. When you brush your teeth, gently brush your tongue, as well. Floss your teeth daily. Regularly use mouthwash that does not have an alcohol base. These techniques can lower the number of bacteria in your mouth, throat, and tonsils that may contribute to the development of tonsil stones." In other words, practicing good oral hygiene could lower the bacteria level in your mouth and minimize the chances of getting tonsil stones.