Ways to prevent tonsil stones

What are Tonsil Stones and How to Get Rid of Them, Explained by an ENT

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Tonsil stones are smelly white or yellow lumps of variable size that form inside the tonsils. Tonsil stones are usually small in size. The smallest are only a millimeter in diameter, while the largest can be over a centimeter.

Tonsil stones can be quite hard and calcified, like a stone, or soft and compressible, like plasticine.

People who suffer from recurrent tonsillitis often develop tonsil stones as a complication.

The repeated swelling in the tonsils leads to the formation of cracks, gaps, or holes in the tonsillar crypts (folds in the tonsils) which accumulate food debris and calcium deposits over time resulting in the formation of tonsil stones.

Anyone, from children to the elderly, can develop this problem.

In most cases, tonsil stones are not large or harmful enough to warrant surgical intervention. (1)

Do tonsil stones cause bad breath?

Tonsil stones are strongly related to bad breath as they are made up of food, some of which could have been swallowed weeks previously.

This food sits in the tonsils and slowly rots, as it would if you left it out of the fridge, especially at body temperature. Rotting enables putrefying bacteria to multiply, and many of these emit foul smells.

The result is bad breath.

Although there is no proven link at this time, it has been observed that the successful treatment of chronic tonsil stones often leads to an improvement of other symptoms, particularly chronic bowel problems and other stomach issues.

Some patients with certain variants of chronic fatigue syndrome also reported an improvement in their condition after the resolution of tonsil stones, although this may be more related to the reduction of chronic inflammatory tonsillitis.

Why are children more prone to tonsil stones?

Children who suffer frequent episodes of tonsillitis often form tonsil stones.

However, the tonsils shrink back on their own by the time the child reaches the age of 10. Consequently, the tonsillar crypts (holes and folds) that caused the stones disappear, and no treatment is required.

Can an underlying medical condition cause tonsil stones?

Tonsil stones are not caused by any other medical condition other than having cracks or holes in your tonsils.

However, these cracks and holes usually develop in the wake of severe or recurrent tonsillitis. This condition is often associated with glandular fever, which generally affects teenagers.

In these cases, the prolonged or repeated swelling of the tonsils leads to the formation of tonsil stones.

Is it advisable to swallow tonsil stones?

Tonsil stones form when food is compressed into the side of the throat when chewing and swallowing.

In some people, cracks and holes appear in the tonsils, often after tonsillitis. Chewed food disappears down these cracks or holes and becomes compressed at the bottom.

Eventually, it becomes too big for the size of the crack/hole and fall out, sometimes while speaking. Tonsil stones are essentially safe to swallow as they are made up of food that you have swallowed.

Can a tonsil stone dissolve by itself?

Tonsil stones can disintegrate as they sit in the holes and cracks of the tonsils. They can then ooze out as a thick whitish fluid, which is usually swallowed.

This breakdown can sometimes occur in the midst of an operation to remove tonsil stones.

How can we avoid tonsil stones?

Tonsil stones cannot really be avoided if you have tonsillar crypts (holes and folds) where food can get lodged in. Realistically, the only options are to either put up with them or to have them surgically treated, such as through laser tonsil reduction.

Can a person suffer from tonsil stones multiple times?

Tonsil stones are often multiple and recurrent. Once you have cracks and holes in the tonsils, food is continually trapped and forms into tonsil stones.

Should tonsil stones be treated?

Tonsil stones that can be easily and effectively controlled by measures such as water jet irrigation can be treated in an entirely conservative manner as long as the treatment is not causing bleeding or recurrent tonsillitis.

However, most tonsil stone problems are difficult and time consuming to control. Eventually, the sufferer will need to see an ear, nose, and throat surgeon with an interest in this area, preferably with long-standing expertise in carbon dioxide laser surgery.

Surgical treatment should eradicate all associated symptoms, including recurrent tonsillitis, bad breath, and bad taste.

How to get relief from tonsil stones?

Current medical practice

Remember that tonsil stones are much more common than you think.

People shy away from discussing this problem as they are embarrassed by it. Because nobody talks about the problem, those suffering from it mistakenly assume that it is a rare condition, which further adds to the misplaced stigma.

The true incidence is not known but is thought to be over 10% of the adult population who have or have previously suffered from tonsil stones.

Unfortunately, tonsil stones are not widely recognized by general practitioners as a genuine health concern that requires formal treatment.

In most cases, the primary physician will ask the patient to gargle with salt water as a remedy.

It is only in very rare cases that patients are referred to the local ear, nose, and throat service. Even then, tonsillectomy for any indication other than cancer is usually not recommended as it is felt to be of limited clinical effectiveness. (2)

Thus, sufferers of tonsil stones are often not treated despite having marked and quite debilitating symptoms.

Short-term remedies for tonsil stones

The long-term answer for tonsil stones is to either wait for the tonsils to shrink back, if the sufferer is below 8 years old, or to have them surgically treated, either by complete removal of the tonsils or, better still, significant reduction of the tonsils so that the cracks and holes where food is trapped are gone.

However, there are short-term techniques to remove tonsil stones that sufferers often do in the morning after brushing their teeth. These include water jets and use of cotton buds or purpose-made small picks.

These techniques only remove the superficial stones but can certainly be very helpful. Some sufferers do this twice a day for years.

The downside of these techniques is that they can damage your tonsils and cause bleeding or, worse, set off tonsillitis.

What is the best remedy to cure tonsil stones permanently?

There is no doubt that the best way to cure tonsil stones is to remove the cracks and holes in the tonsils that cause the stones to form.

This means some form of tonsil removal, whether complete removal under general anesthesia (“traditional” tonsillectomy) or partial removal, often using carbon dioxide laser under local anesthesia. The latter procedure is widely recognized as being much less painful and dangerous than the other techniques.

Do tonsil stones cause tonsillitis?

Tonsil stones almost certainly do trigger tonsillitis (infection of the tonsils) all on their own. This is because the natural rotting process of the organic food that tonsil stones are made of causes local inflammation (soreness) in the cracks and holes where tonsil stones form.

This, in turn, leads to swelling of the lining of the tonsils deep in the crypts. Subsequently, the natural defensive wall of the tonsils weakens, allowing in viruses and bacteria that multiply to cause tonsillitis.

Can tonsil stones be a sign of throat cancer?

Tonsil stones themselves are not a sign of cancer.

However, white patches in the mouth can be the first sign of mouth or throat cancer. Hence, always get your throat and mouth checked if you think you have white patches.

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    The most annoying thing about tonsil stones is not that they cause bad breath, sore throats or trouble swallowing. It is that they keep coming back. Just when you think you’ve removed them for good, another one pops out to surprise you.

    It’s a very frustrating cycle and is one that never seems to stop – if you treat them incorrectly that is.

    In order to prevent tonsil stone regrowth for good, there are a few more things you’re going to need to do apart from just removing them. This is often why people experience recurring tonsil stones and have no idea why they keep growing.

    In this article, I’m going to show you a process for treating the infection which I think is most effective. Just follow what I say and I’m sure it’ll work for you!

    Step 1 – Removal

    Okay, so this step is no different from what you normally do. You aren’t going to get rid of them if they just sit there in your tonsils so you must remove them. The way you do this doesn’t really matter, as long as they come out and you don’t hurt yourself in the process then that’s fine.

    However, I thought I’d list a couple of my favorite methods below just in case you’d prefer them.

    Cotton Bud

    This one’s pretty common.

    Because of its thin and narrow dimensions, the cotton bud makes it really easy to reach the back of your throat without gagging. It also makes finding your tonsil stones much easier as well as it can fit into the crypts of your tonsils easily

    Just make sure to wet the end of bud when doing so and to use a mirror and flashlight.

    Dental Irrigation Syringe

    These you’ve probably seen in the dentist – they’re just little syringes that you can use to squirt at your tonsil stones. The pressure they exert should be enough to push most tonsil stones out so it’ll work for most people.

    They have a narrow, bent tip so they’ll also be able to fit inside the crypts of your tonsils. Which should help with the stones that are stuck deeper within the tonsil.

    Water Flosser

    You may have seen these advertised on TV saying that they help you clean out the small pockets around the bottom of your teeth and gums. Which is true they definitely do that, but they can also be used to knock out tonsil stones.

    The stream of water that they produce is quite powerful so it will be helpful to those with stones stuck deep in the tonsils. The above methods will struggle to deal with stones such as these so if you’re in this situation then you’ll want to get yourself a water flosser.

    Just be careful when using one, they can be pretty powerful and could cause some damage to your tonsils and gums.

    Step 2 – Detoxing

    Tonsil stones are formed when debris gathers within the crypts of the tonsils and when there is bacteria available to feed on them. Therefore, in order to prevent the stones from growing back, we need to clean out the tonsils of both of these things and to do so regularly.

    There a few options available here. You can use a salt water solution, an apple cider vinegar solution or a commercial anti-bacterial mouthwash. They all work and clean your tonsils out of bacteria so it’s up to you which you choose.

    I would say if you’re having trouble with sore throats and swollen tonsils, to go with the apple cider vinegar. It has anti-inflammatory properties as well as antibacterial and antifungal so it should help you a great deal with this.

    Step 3 – Prevention

    Now this is the hard part – keeping the tonsil stones away. The process is actually really simple and easy to do, it’s just that you’re going to need to do it every day.

    In order to prevent tonsil stone growth you’re going to need to keep your tonsils clean of debris and bacteria, like I said above. And to do this you have to maintain good oral health. That means brushing and flossing at least 3 times per day (morning, midday & before bed) and gargling an antibacterial solution about twice a day (any of the ones I mentioned above).

    Sticking to a good routine like this is the most effective way to prevent any oral infection and is no different for tonsil stones. It may be difficult at first but just persevere and I’m sure you’ll be able to do it!

    Final Words

    Now that you know how to get rid of your tonsil stones for good, I hope you take what you’ve learned and apply it to your everyday. Only by doing that will your experience and relief from this frustrating and stressful infection.

    Why You Keep Getting Tonsil Stones and How to Prevent Them

    When Your Doctor Might Recommend Surgery to Prevent Tonsil Stones

    The most effective way to permanently prevent tonsil stones from forming is to get a tonsillectomy, or surgical removal of the tonsils. “Tonsillectomy is a very painful procedure, and it can involve at least two weeks of moderate or severe pain,” says Thatcher. “There is also a risk of bleeding.” (1,2)

    Another procedure is laser tonsil cryptolysis, in which a laser is used to remove the tonsil crypts and resurface the troublesome areas. (4) A newer surgical option is coblation cryptolysis, a procedure that uses lower temperatures and utilizes radio frequency and saline to smooth out crevices in the tonsils, Thatcher says. (5)

    As with any surgery, these procedures are not without risks. That’s why many people opt to take measures to prevent tonsil stones from forming and deal with tonsil stones when they crop up rather than go under the knife (or laser or radio waves).

    But some people may be so bothered by tonsil stones symptoms, like bad breath or persistent and frequent stones, that they may opt for surgery, Thatcher says. Some people may cough up irksome stones every couple of days. (1,2) And for others it’s how the stones and symptoms affect their career or social life. If your job requires you to interact with people frequently, for example, or if you’re a dentist who needs to be in close proximity to patients, chronic bad breath can be problematic, says Thatcher.

    RELATED: What’s Causing Your Bad Breath?

    In some cases, frequent tonsil stones may increase your risk of tonsillitis, or infection of the tonsils, says Setlur. (1)

    When deciding whether or not to choose tonsillectomy to prevent tonsil stones, the key, says Thatcher, is to understand the risks and go over your options with your doctor. “Discuss the benefits and complications,” says Thatcher. “It’s very personal. Weigh and balance how deeply it affects your life.”

    RELATED: Everything You Should Know About Home and Other Remedies for Tonsil Stones

    Do Tonsil Stones Ever Go Away?

    Tonsil stones will not go away on their own and can cause a number of problems if left untreated. If your child has tonsil stones, it is important to remove them as soon as possible.

    Learn more about tonsil stones, including the causes, how to prevent them, and how to remove them.

    Tonsil Stones: Causes and Symptoms

    Tonsil stones form in the small pockets or folds of the tonsils. Food, mucus, bacteria, and dead cells can collect in these pockets and harden into small white or yellow stones. They usually form in people who have large tonsils with lots of folds and pockets.

    Once your child develops tonsil stones, a number of problems can occur.

    Common symptoms of tonsil stones include:

    • Unusually bad breath
    • Sore throat not caused by illness
    • A metallic taste in the mouth
    • Excessive coughing
    • Difficulty swallowing
    • Swollen tonsils
    • Ear pain

    Tonsil Stones: Prevention and Treatment

    The best way to handle tonsil stones is to prevent them from forming in the first place. Like many problems in the mouth, some tonsil stones can be avoided with good dental habits and a change in diet.

    Steps you can take to prevent tonsil stones include:

    • Brushing and flossing twice a day—Removing food particles in the teeth and preventing plaque from forming will help keep tonsil stones from forming.
    • Drinking plenty of water to keep the mouth moist—A dry mouth is bacteria’s favorite place to live and that bacteria can cause tonsil stones.
    • Gargling with watered-down grapefruit seed extract—Doing this a few times a day will help kill bacteria that can cause tonsil stones.
    • Treating post-nasal drip with sinus or nasal drops that kill bacteria and reduce mucus—Avoid sinus or nasal drops that contain alcohol, sodium laurel sulfate, and saccharine because these can dry out the mouth.
    • Brushing or scraping the tongue with a tongue scraper after brushing teeth—This will help cut down on bacteria collecting on the tongue and spreading to the tonsils.
    • Gargling with salt water after eating—This helps prevent food particles, mucus and bacteria from collecting in the tonsils.
    • Having the tonsils surgically removed—If your child continues to get tonsil stones that will not go away, speak with a dentist about having your child’s tonsils removed.

    How to Remove Tonsil Stones

    If your child already has tonsil stones, they can be removed by:

    • Gargling with watered-down grapefruit seed extract to help loosen tonsil stones
    • Gently lifting out tonsil stones using a cotton swab or the end of a toothbrush (Be careful not to use anything sharp that can poke the back of the throat.)
    • Having a dentist surgically remove large tonsil stones that can not be removed any other way

    Find a Kool Smiles Near You

    Your local Kool Smiles dentist is happy to treat your child’s tonsil stones and recommend ways to prevent them from forming. Find a Kool Smiles near you to book your child’s appointment today.



    Tonsil Stone Removal: http://tonsilstoneremoval.org

    Tonsil Stone Removal: http://tonsilstoneremoval.org/how-to-prevent-tonsil-stones-without-surgery

    WebMD: http://www.webmd.com/oral-health/guide/tonsil-stones-tonsilloliths-treatment-and-prevention

    Tonsil Stones: Do You Have Them?

    Many people are familiar with the condition of stones forming in the body, such as kidney stones or gall stones, but did you know that stones can also form on your tonsils? Here is what tonsil stones are and how to tell if you have them:

    What Are Tonsil Stones?

    As with other types of stones that appear in the body, tonsil stones are deposits of calcified dead cells and bacteria. Tonsils are lymph nodes intended to block infections from reaching the lungs, and when the white blood cells inside of them leave behind debris while fighting off infections it can build up on the glands over time and form what we see as tonsil stones.

    Tonsil stones form in the grooves on the surface of the tonsil glands themselves and usually appear as hard, white bumps. They can be very small or quite large if left in place for a long time, though this is rare.

    How Do You Know If You Have Tonsil Stones?

    Tonsil stones are most common in people who have chronic inflammation of the tonsil glands or who have poor oral hygiene. If you have swollen tonsils and suffer from bad breath and a sore throat, you may want to see if you have tonsil stones by checking the back of your throat in the mirror.

    How Are Tonsil Stones Treated?

    If you have mild or moderate tonsil stones, no medical treatment is necessary as they can usually be easily removed. Many people gently dislodge them using a toothbrush, cotton swab, or water flosser, followed by gargling with warm salt water to clear away any leftover debris.

    Larger tonsil stones may be more difficult to remove by yourself and may require surgery, particularly if they occur along with tonsillitis. If you have recurring tonsil stones and inflammation of the glands, your doctor may recommend a tonsillectomy to prevent further issues.

    A good oral care regimen is one of the ways to prevent tonsil stones from forming. Don’t forget to brush, floss, and use a good mouthwash daily. High Point Family Dentistry looks forward to helping all of our patients keep their mouths clean and healthy.

    Contact our office to schedule your next appointment!

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    Tonsil stones: Symptoms, prevention, and treatment in the dental setting

    The tonsils offer many nooks and crannies that bacteria can use to thrive. The multiplying bacteria can become trapped, allowing mucous and dead cells to linger and form tonsil stones in the pockets of the tonsils. (1) Tonsil stones, also known as tonsilloliths, are formed when the trapped debris calcifies. The stones can lead to chronic inflammation and discomfort.

    The most common symptom (and often the only symptom patients experience) is halitosis. If the tonsil stones are left untreated, bacteria continue to multiply and increase the inflammation of the tonsillar tissue. Symptoms of a severe throat and discomfort when swallowing are frequently experienced with tonsil stones that have gone undiagnosed and untreated. Additionally, patients can experience ear pain due to the swelling of the tonsils. (1)

    When studying the bacteria causing inflammation of the tonsils, researchers have found both aerobic and anaerobic bacteria. One study reported that “ome of the anaerobic bacteria produce volatile sulfur compounds such as hydrogen sulfide and methyl mercaptan. The volatile sulfur has been implicated in halitosis.” (2)Therefore, patients who are prone to tonsil stones should avoid pastes, rinses, and drinks, such as wines, that contain sulfur.

    Patients that have postnasal drip, allergies, or colds are more prone to the formation of tonsil stones due to the mucus in the back of the throat. Implementing a natural xylitol-containing nasal spray, such as Xlear, two to three times daily can help eliminate the mucus and prevent the progression and formation of tonsil stones.

    The active ingredient of xylitol works to reduce the amount of bacteria by increasing the salivary flow to create a moist environment that is oxygen-rich. (3) The oxygen-rich environment inhibits the bacteria. This can lead to prevention and eliminate the progression of tonsil stones. (3)

    Reducing the amount of bacteria in the oral cavity will help prevent tonsil stones. Dental hygienists can advise patients to have meticulous home care with electric toothbrushes, flossing, and rinsing with sulfate-free products. Avoiding consuming beverages with carbonatation, sulfur, or dairy products will reduce the risk and growth of tonsil stones. (4)

    Removing tonsil stones chairside can be completed with an air/water syringe or a tongue depressor. Gently use the air/water syringe to spray the stones out of the tonsillar folds while using the suction to remove debris. The back of a tongue depressor can also be used to gently push the tissue down around the stone to then elevate the stone up and out.

    Properly screening the patient for abnormalities through a head and neck exam will allow the clinician to identify the presence of tonsillar inflammation and stones. If left untreated, tonsil stones can lead to severe throat and ear pain. Chronic tonsil stones can lead to the removal of the tonsils, which are a vital part of the immune system.

    Editor’s note: Article originally published April 17, 2017; updated February 19, 2019.

    3. Xlear. Xlear Sinus Care. Available at: http://www.xlear.com/xlear-sinus-care/. Accessed March 2, 2017.

    Amber Auger, MPH, RDH, is a hygienist with experience in multiple clinical settings, including facilities abroad. Amber obtained a master’s degree in public health from the University of New England and a bachelor’s in dental hygiene from the University of New Haven. Auger is a key opinion leader for several dental companies, speaker and published author, and can be contacted through her website at amberaugerrdh.com.

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