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Tonsil Stones: Causes, Symptom & Removal Options

Tonsil stones are an inconvenient growth in the back of the throat. Learn how to remove them easily and without dropping too much money.

Last updated on

October 30, 2024

Katharine Hall

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Tonsil Stones: Causes, Symptom & Removal Options

When we think about good oral hygiene, the teeth and gums are usually the first things to come to mind. However, there are many other components of your mouth that all combine to bring you holistic wellness and relief, including your tonsils.

Your tonsils are a first line of defense against foreign invaders, like bacteria and viruses. But they are also susceptible to diseases of their own, like tonsil stones. Learn what tonsil stones are, how they’re caused, and how you can get rid of them easily.

What Are Tonsil Stones?

Tonsil stones are also sometimes called tonsilloliths. These are small, hard lumps that form in the tonsils at the back of the mouth. They’re not usually painful or harmful to your health, but they can cause some seriously bad breath.

Your tonsils are oval-shaped bits at the back of your throat that have folds and gaps that are lovingly called tonsillar crypts. This is where tonsil stones usually form. Your tonsils are useful for filtering out bacteria and viruses to protect against infection, though removing your tonsils does not affect your immune system.

Symptoms of Tonsil Stones

Small tonsil stones might look like white or yellow specks at the back of your mouth. Larger stones are usually a lot easier to see and might even stick out from your tonsils. If you can’t physically see the stones, some other symptoms might allude to a few tonsil stones hiding in your tonsil crypts:

  • Bad breath
  • Throat pain
  • Ear pain
  • Persistent cough
  • Swelling of the tonsils
  • Bad taste in your mouth
  • Difficulty swallowing
  • Feeling something stuck in your throat
  • Throat infections that don’t respond to antibiotics

Sometimes, tonsil stones don’t have any symptoms at all. In some cases, your healthcare provider might only be able to see them on an X-ray or CT scan. 

How Do Tonsil Stones Form?

It’s not entirely known what exactly causes tonsil stones, but they are made of a material called biofilm. This is a collection of microorganisms on a surface, and in your mouth, this biofilm is a combination of bacteria and fungi reacting with your mouth’s chemistry. This mixture prefers to attach to moist spots, like the surface of the tonsils, where it then hardens. 

Factors can contribute to the formation of tonsil stones and put you at a higher risk of receiving them. This includes poor dental hygiene, large tonsils, chronic sinus problems, and chronic tonsillitis (inflammation of the tonsils).

Tonsil Stone Removal Options

Tonsil stones are usually harmless to your health, but they can make your breath smell bad while also making your confidence a little less than stellar. In most cases, they come out at home. However, there are some home remedies:

Gargling

You can dislodge tonsil stones with salt water gargles. Gargling with salt water, as the moving water physically moves the stones out of place.

Gargling with a solution of warm saltwater has major advantages too. For one, it makes your throat feel better and reduces swelling. But it also can kill off bacteria that might cause more tonsil stones to form. You can gargle regularly to help prevent them from forming in the first place.

Coughing

Sometimes, a strong cough can conjure enough force to dislodge tonsil stones. Be sure to do this in a private location and cover your mouth when you do it so that you don’t spread any germs.

Cotton Swab

You can gently dislodge tonsil stones by using a cotton swab to poke them out. Note that this should only be tried if other methods, like coughing and gargling, fail. Asking your healthcare provider first is wise in case you accidentally do more harm than good.

It might be tempting to try to pick out tonsil stones with a toothbrush or your finger, but your tonsils are delicate and can easily be scratched. Additionally, take caution when using a cotton swab to not damage any parts of your mouth.

Surgical Tonsil Stone Removal

If you have tonsil stones that won’t come loose, no matter what, you can visit a specialist in the field of otolaryngology called an Ear, Nose, and Throat Specialist (ENT) for some extra assistance. They can discuss surgical options with you that are more powerful than what you can accomplish with home remedies. 

Surgical removal is usually only necessary if your tonsil stones are abnormally large or are causing co-occurring problems, tonsil infections, and a scratchy throat.

Coblation Cryptolysis

Some people have abnormally hole-filled tonsils that make them more susceptible to tonsil stones. A procedure called a coblation cryptolysis can be performed by a professional that serves to smooth out the crevices that trap debris in the first place.

This procedure is relatively new and has begun to replace tonsil removal in some cases. Since it is performed with a laser, it usually causes less discomfort, and the recovery time is much shorter than a complete tonsil removal.

Water Flosser

Water flossers are not only a great tool for getting debris out from between your teeth and gums, but they’re also great for removing tonsil stones. A stream of powerful water can easily get those stones out from hard-to-reach places that cotton swabs and gargling alone might not be able to do. Plus, you can aim those water streams more directly at the stones to safely and effectively get them out.

Antibiotics

In some circumstances, a doctor might prescribe antibiotics to lower the bacteria counts in your mouth, which plays a major role in the development of tonsil stones in the first place. With that said, biofilm can be resistant to antibiotics, so doctors may only prescribe this in severe circumstances as a last line of defense before tonsil removal.

Should You Get Your Tonsils Removed Because of Tonsil Stones?

Tonsil stones every now and again aren’t grounds for getting your tonsils completely removed. However, if you are susceptible to frequent stones, a provider might recommend a tonsillectomy to have your tonsils taken out.

While your tonsils can help catch bacteria and viruses, it doesn’t affect your immune system if you get them taken out. Many children have their tonsils removed if they frequently experience sore throats, strep throat, or other infections of the tonsils.

The recovery process for tonsil removal can be challenging, and it can take several weeks for the pain to subside. Have plenty of soft foods, like broth, smoothies, ice cream, and pudding, on hand if you decide to get your tonsils removed.

Cost of Tonsil Removal

While tonsil removal is an enticing procedure for many people hoping to get some relief from their tonsil stones or tonsillitis, it comes at a cost. Tonsillectomies are a pricey procedure, ranging anywhere from $1,500 to $3,500 out of pocket.

Insurance might cover part or all of the cost of a tonsillectomy if you have frequent infections of the tonsils, but since tonsil stones don’t actually affect your physical well-being, insurers may be reluctant to cover the cost of tonsil removal for most people.

How To Prevent Tonsil Stones

One of the best ways to treat tonsil stones is to prevent them from coming up in the first place. There are a few habits that you can employ (or stop) in order to try to lessen your risk of growing some.

One of the main reasons that people experience tonsil stones is because of poor oral hygiene. Be sure to brush and floss on a regular basis, including the front and back of your tongue. Your tongue is home to most of the bacteria in your mouth, so keeping it clean can prevent the build-up of tonsil stones.

Smoking cigarettes and other items can also increase your risk of developing tonsil stones. Quitting smoking will also improve aspects of your life outside of your oral health while also reducing your risk of oral cancers.

You can also prevent tonsil stones by gargling with salt water after eating, as this cleans out any debris in your tonsil crypts that might otherwise lead to tonsil stones. Finally, stay hydrated and drink plenty of water to make it harder for tonsil stones to stick to your mouth’s surface.

Tonsil Stones vs. Strep Throat

While strep throat and tonsil stones are both caused by a bacterial infection, the symptoms are much different. Strep is caused by a bacteria called Streptococcus and can cause a whole-body infection outside of just a sore throat, including fever, sores on the roof of the mouth, and swollen lymph nodes.

Tonsil stones rarely cause a sore throat and usually cause some mild discomfort and swelling. Additionally, tonsil stones probably won’t cause a fever or other major symptoms. You’ll also notice a strange odor coming from the tonsil stones that you probably won’t have with strep.

Why Do Tonsil Stones Smell So Bad?

The defining characteristic of tonsil stones is their foul scent which can also put a horrible taste in your mouth – literally and figuratively. The stones are smelly both inside and outside of your mouth. But why?

The short answer is that tonsil stones are made up of bacteria, and bacteria smell pretty gnarly. They’re composed of layer after layer of living microbes that thrive in dark, wet environments. So naturally, those stones take on a bit of a smell.

You can use mouthwash to help mask the scent, but the only true way to completely eradicate the smell is to remove those tonsil stones from your mouth in the first place.

The Dental Care You Need

Tonsil stones are growths that form in the back of the mouth inside of crevices in the tonsils. They are composed of bacteria, mainly, and while they don’t pose a risk to your health, they can cause bad breath and make the back of your mouth look a little speckled and strange.

In minor cases, you can remove tonsil stones at home by gargling, using a cotton swab, or using a water pick. If you need some extra assistance, dentists might be able to perform surgeries or prescribe medication to get your tonsil stones out as quickly as possible.

You can even get your tonsils removed to avoid tonsil stones in the first place, but this can be a pricey procedure, especially if your insurance has poor coverage. Check with your insurance provider to confirm coverage.

Sources:

Tonsil Stones (Tonsillolith): Causes, Symptoms, Removal & Treatment | Cleveland Clinic

Coblation cryptolysis to treat tonsil stones: a retrospective case series | NCBI

Tonsillectomy | Mayo Clinic

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