Tonsil Stones (Tonsillolith)

Your tonsils are gland-like structures in the back of your throat made of tissue that contains lymphocytes — cells in your body that prevent and fight infections. It is believed that the tonsils play a role in the immune system and are meant to function like nets, trapping incoming bacteria and virus particles that are passing through your throat.

Sometimes the crevices and pockets in your tonsils get filled with bacteria, food debris, dead cells, mucus, and other materials that can get trapped. These materials can eventually build up and calcify.

Tonsil stones, or tonsoliths, are formed when this trapped debris hardens, or calcifies. This tends to occur most often in people who suffer from chronic inflammation in their tonsils or repeated bouts of tonsillitis

What Are the Symptoms of Tonsil Stones?

Many small tonsil stones do not cause any noticeable symptoms. Even when they are large, some tonsil stones are only discovered incidentally on X-rays or CT scans. Some larger tonsoliths, however, may have multiple symptoms:

• Bad breath . One of the prime indicators of a tonsil stone is exceedingly bad breath, or halitosis, that accompanies a tonsil infection. One study of patients with a form of chronic tonsillitis used a special test to see if volatile sulfur compounds were contained in the subjects’ breath. The presence of these foul-smelling compounds provides objective evidence of bad breath. The researchers found that 75% of the people who had abnormally high concentrations of these compounds also had tonsil stones. Other researchers have suggested that tonsil stones be considered in situations when the cause of bad breath is in question.


• Sore throat . When a tonsil stone and tonsillitis occur together, it can be difficult to determine whether the pain in your throat is caused by your infection or the tonsil stone. The presence of a tonsil stone itself, though, may cause you to feel pain or discomfort in the area where it is lodged.


• White debris. Some tonsil stones are visible in the back of the throat as a lump of solid white material. This is not always the case. Often they are hidden in the folds of the tonsils. In these instances, they may only be detectable with the help of non-invasive scanning techniques, such as CT scans or magnetic resonance imaging.


• Difficulty swallowing. Depending on the location or size of the tonsil stone, it may be difficult or painful to swallow foods or liquids.


• Ear pain. Tonsil stones can develop anywhere in the tonsil. Because of shared nerve pathways, they may cause a person to feel referred pain in the ear, even though the stone itself is not touching the ear.


• Tonsil swelling. When collected debris hardens and a tonsil stone forms, inflammation from infection (if present) and the tonsil stone itself may cause a tonsil to swell or become larger.

How Are Tonsil Stones Treated?

The appropriate treatment for a tonsil stone depends on the size of the tonsoliths and its potential to cause discomfort or harm. Various options include:

• No treatment. Many tonsil stones, especially ones that have no symptoms, require no special treatment.


• At-home removal. Some people choose to dislodge tonsil stones at home with the use of picks or swabs.


• Salt water gargles. Gargling with warm, salty water may help alleviate the discomfort of tonsillitis, which often accompanies tonsil stones.


• Antibiotics. Various antibiotics can be used to treat tonsil stones. While they may be helpful for some people, they cannot correct the basic problem that is causing tonsoliths. Also, antibiotics can have side effects.


• Surgical removal. When tonsil stones are exceedingly large and symptomatic, it may be necessary for a surgeon to remove them.

Can Tonsil Stones Be Prevented?

There are certain things you can do to prevent tonsil stones from developing in the first place or coming back once they get removed. Some of these things include:

• Removing bacteria that builds up at the back of your tongue once you get done brushing your teeth. The best way to do this is to utilize a tongue scraper each night before you go to bed each night.


• Brush your teeth regularly so that you can get rid of food debris that get trapped in between your teeth. Brush your teeth and tongue at least 2 times everyday.


• Combine 1 tablespoons of salt and 1 cup of water and gargle it. Gargling salt water will help disinfect your mouth and help remove bacteria that could cause tonsil stones. Do this a few times everyday.


• Increasing your water intake is a good way to prevent this problem, as it will help keep your mouth moisturized. Stay away from sugared drinks, likes sodas, and a diet high in simple sugars because they are known to contribute to the development of tonsil stones.


• Try to stop smoking and drinking alcohol as much. Drinks with alcohol in it can leave your mouth dry, which isn’t good if you often experience tonsil stones. Smoking won’t help your situation either.