Do You Have Tonsilloliths?

Treat, Remove and Prevent Tonsils Stones

Tonsils stones are a misunderstood, under-diagnosed oral health problem and a common underlying cause of chronic halitosis. This condition affects approximately seven percent of Americans, yet many people don't know what tonsil stones are, they don't know that they have them, and they don't understand what's causing their persistent bad breath. Read on to learn more about where tonsil stones grow, how they form and how they can be treated and prevented.

What are They?

To learn what tonsil stones are and how they're formed, it's important to understand the physiology of tonsils. Tonsil stones, also called tonsilloliths, are formed by calcified, partially hardened debris that collects in the tonsil crypts. The human mouth has three types of tonsils, the palatine tonsils, the lingual tonsils and the pharyngeal, or adenoids.

The palatine tonsils, which are found on both sides of the mouth near the throat, are the most well known and are frequently associated with tonsillitis and tonsil stones.

Debris also collects in the lingual tonsils, which are located near the back of the throat on the top of the tongue.

The pharyngeal tonsils, also called adenoids, can collect debris too. Adenoid tonsil stones often develop in people with allergies, sinus issues or adenoid cysts. A group of French radiologists found that tonsils stones frequently adhere to adenoid cysts and irritated areas. Tissue irritation and damage makes it easier for debris to adhere to the area and form tonsil stones. This germ-fighting, immunoreactive area is located between the roof of the mouth and the sinuses.

Although the palatine tonsils are most frequently associated with tonsilloliths, debris can collect in other regions too. Certain people struggle with tonsils stones in particular areas.

***Those photos were provided by WikiMedia Commons and Grays Anatomy Textbooks.

How Do They Form?

Tonsil stones are comprised of food, mucus and biological debris. Contrary to belief, tonsil stones are not caused by deformities or physical inadequacies. In most cases, the tonsils are just doing their job. Tonsils act as a first line of defense protecting the body from germs, bacteria and viruses by collecting these particles and helping the body generate antibodies.

Calcified deposits can form in any crevice within the oral cavity, including the throat and roof of the mouth. Due to their unique, germ-filtering anatomy, the tonsils are ideal for collecting foreign debris. The palatine tonsils in particular have many crypts. When examined microscopically, palatine tonsils have a number of finger-like appendages that connect to important lymph glands. Between each appendage is a crypt or gap where tonsil stones develop.

The primary constituent of tonsil stones is collagen, which includes dead skin cells and protein. Once the debris is trapped, bacteria colonies begin growing. These anaerobic bacteria produce odorous compounds, including methyl mercaptan, a substance that produces a garlicky or onion-like smell and hydrogen sulfide, a powerful, odorous compound that smells unfortunately similar to rotten eggs or natural gas. Secondary compounds found in tonsil stones include ammonia and various minerals.


According to a 2007 study conducted by the State University of Campinas in Brazil, tonsil stones were responsible for 75 percent of bad breath cases in patients with chronic tonsillitis. This fact only adds insult to injury for people dealing with exceptionally painful tonsillitis (a condition I have experienced) and bad breath on top of that.

Most people who suffer from tonsil stones don't understand why these smelly concretions develop. The majority of patients with tonsil stones have suffered from other tonsil-related problems. Recurrent tonsillitis, chronic tonsil inflammation, tonsil infections and strep throat make individuals more susceptible to this condition. Frequent infections and chronic inflammation produces swelling that enlarges the tonsil crypts.

Patients with allergies, post-nasal drip and sinus infections are also prone to developing tonsil stones more than other groups. Infections and chronic irritation compromises the protective tissues and makes it easier for tonsil stones to form. Many people haven't experienced sinus issues or tonsillitis, yet they still develop tonsil stones. In some cases, genetics are causative factors. For example, someone with a parent who dealt with tonsil stones is more likely to experience similar problems as an adult. Patients should note that individuals who have had their tonsils removed cannot develop tonsil stones. This problem is found in adults more than children or the elderly.

Signs and Symptoms

Bad breath that is unaffected by brushing, mouthwash, flossing, mints or sprays is a sign of tonsil stones. Dr. Ansai, an associate professor at Japan's Kyushu Dental College in Japan, has studied tonsilloliths and halitosis extensively and believes that tonsil stones are a secondary cause of bad breath after periodontal disease and tongue bacteria.

The most obvious way to identify tonsil stones at home is to view the tonsils in a mirror. Patients with tonsil stones typically notice small white or yellowish specks on one or both sides of the mouth where the tonsils are located.

Many people don’t know they have tonsil stones because they are deeply lodged or are too small to be detected without radiological imaging. Patients typically detect the problem only after tonsil stones are dislodged by coughing.

These calcifications are typically rubbery. Advanced tonsil stones can be much harder and more difficult to remove. If left untreated, tonsil stones can cause secondary infections, swollen lymph glands and fever. Small concretions often grow without causing discomfort or noticeable symptoms. However, others cause discomfort along with uncontrollable halitosis. Here are a few common symptoms that many patients experience:

  • Swollen lymph glands
  • Difficulty swallowing
  • Breathing obstructions
  • Foreign body sensations
  • Unpleasant pleasant flavors
  • A metallic taste
  • Disturbed sleep
  • Snoring
  • Choking
  • Sore throats
  • Coughing fits
  • Tinnitus
  • Vertigo
  • Ear aches

Have you ever had tonsil stones?

  • No I haven not
  • Yes I developed them once
  • Yes I develop and remove them approximately once per year
  • Yes they are a persistence problem that I cannot get rid of
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Removal Methods - Home Remedies and Commercial Products

Whether tonsils stones are causing bad breath or physical discomfort, it's important to treat them before they become larger or lead to exacerbated symptoms. There are a variety of commercial products, home remedies and surgical procedures for removing and managing tonsil stones.

Tonsil Stone Home Remedies

Popular home remedies for treating tonsil stones include gargling salt water regularly, adopting a more rigorous oral health regimen and drinking more water. These simple tips can be used in conjunction with commercial oral health products and at-home removal methods.

In many cases, tonsil stones go away without treatment or they can be removed with light pressure. Tonsilloliths are frequently removed spontaneously through violent coughing. Many sufferers find they can remove their tonsil stones at home with a toothbrush, cotton swab or light water pressure from an oral irrigator. Surgical methods, such as a tonsillectomy or cryptolysis, are used to treat tonsil stones, but these methods are riskier and have drawbacks.

Dr. Zimmer, an otolaryngologist at the University of Cincinnati, cautions his patients against surgical tonsil removal due to complications and severe bleeding. He also recommends that patients try to remove their tonsil stones at home with an irrigation, such as a WaterPik. The doctor advices patients to use light water pressure and continue the treatment up to one month to see if results are achieved.

Products for Treatment

Commercial products target tonsil stones and bacteria at the source. Tonsil stone treatment kits often feature oxygenating ingredients that kill odor-causing bacteria. Basic tonsil stone kits include nasal-sinus drops, oxygenating tablets, oxygenating throat sprays and advanced breath mints fortified with zinc, oxygenating compounds and sugar-free xylitol that work together to kill bacteria. Studies show that odorous compounds in tonsil stones thrive on sucrose and simple sugars, which makes them release enamel-damaging acids.

Tonsil stones require a multi-prong treatment approach. Oxygenating breath mints improve saliva flow while killing anaerobic, odor-causing bacteria.

Throat sprays attack bad breath at the source and allow the active ingredients to be applied to target areas, which are your tonsils and the back of the throat.

Nasal-sinus drops are extremely important because they kill bacteria that grow in the adenoids in the nasal cavity. By inserting oxygenating sinus drops directly into the nostril, medicine is delivered to all target areas, even if they cannot be reached in other ways.

When dealing with persistent problems in delicate areas, patients should avoid products that contain alcohol, sodium lauryl sulfate (SLS), saccharin and benzalkonium chloride. These ingredients are irritants and allergens that can make your situation worse and damage protective tissues.

Effective Prevention

Prevention is the best cure for tonsil stones. Proper brushing, including the cheeks and roof of the mouth, and thorough oral hygiene practices, such as using a tongue scraper, are effective at cleansing the oral cavity and preventing debris from migrating into the tonsil crypts.

Many experts recommend allergy medications for controlling mucus production and reducing post-nasal drip. However, these medications are habit-forming and have undesirable side effects. They are none to cause irritability and anxiousness. Inhaled allergy medications can also irritate the nasal passages.

Many doctors also prescribe antibiotics, but the benefits of such medications are limited. For effective tonsil stone prevention, patients should adopt a holistic approach that treats the cause not only the symptoms. Effective prevention methods include boosting water intake, cleansing the mouth after meals and using an appropriate, alcohol-free mouth rinse.

Five Simple Tips For Managing Tonsil Stones

If you have experienced tonsil stones before, chances are they will develop again. Here are a few simple tips that anyone can follow to prevent and treat tonsil stones.

1. Drink plenty of water to flush away debris and to keep the mouth naturally moist. If necessary, use sugar-free breath mints or lozenges that contain oxygenating ingredients. These products eliminate multiple problems, including odor, dry mouth and low oxygen levels.

2. Use appropriate toothpaste and mouth rinses fortified with oxygenating ingredients. These products are specially formulated to kill odor-causing bacteria by altering the anaerobic environment where they thrive.

3. Complacency breeds problems. Stay on top of the situation by looking in your mouth regularly to see if there are any tonsiloliths forming. By detecting the problem early, tonsil stones are easier to treat and remove.

4. For best results, use oral health products designed specifically for treating tonsil stones. Patients who develop tonsil stones regularly can continue to experience recurrences even after surgery. Bad breath and most other problems can be prevented by using a multi-faceted approach that includes effective, gentle oral hygiene products, penetrating throat sprays, lubricating lozenges and nasal drops.

5. Rinse the mouth after meals and brush the teeth, mouth, cheeks and gums thoroughly. Purchase a tongue scraper, and use it frequently to remove biofilm, dead skin cells and other debris that sticks to the tongue and leads to tonsil stones.

Watts - 2 Large Syringe Oral Irrigators with Tapered Deep Reach Tips for Crowns, Bridges, Oral Pockets and More - 12ml
Watts - 2 Large Syringe Oral Irrigators with Tapered Deep Reach Tips for Crowns, Bridges, Oral Pockets and More - 12ml

Use oral syringes to gently remove tonsil stones. These specially designed syringes direct water into tonsil crypts with greater control that powered systems. These are the exact type of irrigators that my oral surgeon give me after I had my wisdom teeth removed. Use at least once a day for maintenance or after every meal if you're having an active problem.


Final Thoughts

Eliminating tonsil stones and treating the problem at the source are the first steps to controlling unbearable halitosis and irritating concretions. By recognizing and treating the problem, you can lessen the symptoms and remove debris easily. Tonsils stones are a common problem, but it doesn’t need to be one of yours if you establish a proactive prevention strategy and treatment plan. Tonsil stones aren’t a personal fault, and they can be controlled.

I sincerely hope this information can help you identify and treat any problems that you have! Thanks so much for visiting my lens.

Comments 9 comments

Lady Lorelei profile image

Lady Lorelei 4 years ago from Canada

When I was a child I suffered horribly from Tonsilitis and still get tonsil stones on occasions. I have a rare illness that causes muscle weakness so my swallowing processes are slowed down which could be the cause of trapped food particles in the tonsil pits. This is the first time that I have seen tonsil stones discussed. Fantastic information.

anonymous 3 years ago

I used to suffer a lot from tonsil stones, but never had any discomfort or other problems (besides the bad breath). A few weeks ago, I made my diet healthier and started eating mostly organic foods. I didn't have another stone until a few days ago when I went to the Bahamas ad healthy, organic choices were only available at a hefty price. My tonsil stones returned with my unhealthy diet!! Your diet ALSO plays a part in tonsil stones!!! I feel so much better without them there!

Gypzeerose profile image

Gypzeerose 3 years ago

This is fascinating. I am a nurse but I have never heard of this. This is a helpful article to anyone who has troubling bad breath, and it these stones probably don't help the immune fighting functions of the tonsils either. Bookmarked so that more people can get this info.

pcblogger lm profile image

pcblogger lm 3 years ago

great info.. i had tonsilitis when i was young.. was really painful, but since then haven't had any recurrence.

seacabin 2 years ago

First occurrence after a cold 2 months ago. A metallic taste, then a feeling of something like a hair ball stuck in my throat! I coughed and hacked for about 5 days until I looked with a flashlight and saw 2 white spots on my tonsil. Immediately assumed I had throat cancer. Researched white dots on tonsil and discovered tonsil stones. Yep.. that was them! Enlisted a friend with the flashlight and a long cotton swab (after a you tube video how to). After much hacking, probing, gagging.. all shot out. Disgusting and odifious. Always had good dental hygiene but have really stepped it up. Gargling with Therabreath, using their toothpaste.. bought a water pic. Yet today I spotted another on the opposite tonsil. OMG.. guess the ENT DR. is next. I see my dentist next month.. think that appliance they use to suck out saliva will do the trick on this one, if they're up for it. I'll keep looking, gargling, and prodding as much as possible until then. I do think salt water gargle and vinegar gargle will keep them away once you get rid of those nasty things!

QuiltFinger profile image

QuiltFinger 2 years ago from Tennessee Author

@seacabin: Your Message Subject or TitleInteresting. It seems logical that the flu or an irritating chest cold would both the tonsils and immune system almost as much as straight tonsillitis. Thanks for sharing your experience and good luck!

----- Original Message -----

Sarah 17 months ago

I have an autoimmune disorder and I feel they must be connected. Because I have a stronger than normal immune system it would make sense the tonsils which are a part if the immune system would be overactive and collect debris. I like the syringe idea however absolutely nothing is going in my nose.

Michele 13 months ago

You CAN get them after a tonsillectomy. My son had his tonsils removed aged 5 and just now, aged 13, I helped him to remove 2 large tonsil stones.

Lis 12 months ago

Tonsillectomy was very painful to recover from as a 34 year old. I now have more energy than I've had in years! No more night sweats and constant infection. No more hearing problems and awful tonsil stones. Was a good decision to have the surgery. Count on 10 days to recover. Good post by the way. I new it was time when I could hardly chew my food due to ear/jaw/throat pain. This would come in waves and I was able to relieve by removing stones but could never feel 100%.

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