Tonsil Stones (Tonsilloliths)

What Are Tonsil Stones?

Tonsil stones, or tonsilloliths, are hard, sometimes painful bits of bacteria and debris that get stuck in nooks on your tonsils.

Your tonsils are gland-like structures in the back of your throat. You have one on each side. Tonsils are made of tissue with lymphocytes, cells that prevent and fight infections. Many experts think your tonsils play a role in your immune system and are meant to work like nets, trapping bacteria and viruses that come in through your throat.

But your tonsils don’t always do their job well. For some people, they’re more trouble than help. Research suggests that people who have their tonsils removed are no more likely to get bacterial or viral infections than people with who keep their tonsils.

Tonsil Stone Causes

Your tonsils are filled with nooks and crannies where bacteria and other things, including dead cells and mucus, can get trapped. When this happens, the debris can bond together.

Tonsil stones form when this debris hardens, or calcifies. This tends to happen most often in people who have long-term inflammation in their tonsils or repeated cases of tonsillitis.

Many people have small tonsilloliths, but it’s rare to have a large tonsil stone.

Tonsil Stone Symptoms

Small tonsil stones may not cause any symptoms that you’d notice. Even when they’re large, some tonsil stones are found only after X-rays or CT scans. Symptoms include:

• Bad breath. A main sign of a tonsil stone is severely bad breath, or halitosis, that comes along with a tonsil infection. One study of patients with a form of long-term tonsillitis checked their breath for things called volatile sulfur compounds, which can mean bad breath. The researchers found that 75% of the people who had unusually high amounts of these compounds also had tonsil stones.
• Sore throat. When you get a tonsil stone and tonsillitis together, it can be hard to figure out which is causing pain in your throat. The tonsil stone itself might give you pain or discomfort.
• Cough. A stone might irritate your throat and make you cough.
• White debris. You might be able to see a tonsil stone in the back of your throat as a lump of solid white material.
• Trouble swallowing. Depending on the location or size of the tonsil stone, it may be hard or painful to swallow food or liquids.
• Ear pain. Tonsil stones can develop anywhere in your tonsil. Because of shared nerve pathways, you might feel pain in your ear, even though the stone itself isn’t touching your ear.
• Tonsil swelling. When debris hardens and a tonsil stone forms, inflammation, infection, and the tonsil stone itself may make your tonsil swell.

Tonsil Stone Diagnosis

Your doctor can usually diagnose tonsil stones with a physical exam. If they’re hidden in the folds of your tonsils, you might need imaging tests, such as CT or MRI scans, to spot them.

Tonsil Stone Treatment and Removal

Many tonsil stones, especially those that don’t have symptoms, don’t need special treatment. It depends on their size and whether they might cause you trouble.

Treatments include:

• Antibiotics. Medications may help, but they have side effects and can’t fix what’s causing your tonsil stones.
• Surgical removal. If your tonsil stones are unusually large or causing problems, your doctor might remove them.
• Tonsillectomy. If tonsil stones are a long-term problem, you might need to have your tonsils taken out.
• Cryptolysis. This uses a laser or a radiofrequency wand to scar your tonsils, making tonsil stones less likely.

Tonsil Stone Home Remedies

For smaller stones, you can try:

• At-home removal. You might be able to remove tonsil stones by scraping gently with water picks or swabs.
• Saltwater gargles. Gargling with warm, salty water may help ease the pain of tonsillitis and help remove stones.

Tonsil Stone Complications

Large tonsil stones can cause swollen tonsils and give you trouble swallowing. Tonsil stones can also sometimes trigger infections.

Tonsil Stone Prevention

People who have long-term tonsillitis are more likely to get tonsil stones. The only way to prevent them is to remove your tonsils.

Good dental habits can help prevent tonsil stones. Brush and floss your teeth regularly to remove bacteria and keep things from getting stuck in your tonsils. Gargling after eating can also prevent food buildup.

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