Tonsil Stones: What Are They, Causes & To Get Rid of Them

Dr. Gonzalo Ramirez
About the author: Dr. Gonzalo Ramirez
General Practitioner and Psychologist
August 2021

Tonsil stones, also called tonsilloliths, are small white, or yellowish, masses that can appear in the throat, normally on or within the tonsils.

They are caused by the accumulation of food particles, saliva, and mouth cells, and are responsible for bad breath, sore throats and, in some cases, difficulty swallowing.Tonsil stones are more common in adults who frequently have tonsillitis.

Gargling with warm salt water, about two to three times a day, can help remove the tonsil stones and relieve discomfort and bad breath. However, when tonsil stones occur often or appear due to chronic tonsillitis, surgery to remove the tonsils may be needed.

Main symptoms

Tonsil stones are small white or yellow flecks that may appear attached to the tonsils. In addition, other symptoms that may arise include:

  • Pain when swallowing;
  • Bad breath;
  • Sore throat;
  • Difficulty swallowing;
  • Swelling of the tonsils;
  • Ear ache (in some cases);
  • Changes in sense of taste;
  • Snoring;
  • Feeling of something obstructing the throat.

When the above symptoms are present, it is important to see an ear, nose, and throat specialist (otolaryngologist), or a dentist, in order to determine the best line of treatment.

Possible causes

Tonsil stones can be caused by the accumulation of food particles in the tonsils, which promotes the proliferation of microorganisms, leading to tonsil inflammation and the formation of the stones.

Some factors that may increase the likelihood of tonsil stone formation are poor oral hygiene, use of medications that cause dry mouth, or rhinitis and sinusitis. In these situations there is a greater production of mucus, which can also contribute to tonsil stones.

Treatment options

In most cases, tonsil stones do not require any treatment, as they detach themselves naturally from the tonsils, and can be swallowed without even being noticed. However, when there is pain, discomfort, or bad breath due to tonsil stones, certain treatments may be recommended.

Often, tonsil stones can be treated at home, gargling with saline solutions or mouthwashes, or with natural solutions with antibacterial properties. Signs of improvement may take up to 3 days to appear and usually include a decrease in the number of pellets in the throat and a reduction in bad breath.

Below are some ways to treat tonsil stones:

1. Gargle with warm salt water or with mouthwash

To gargle with warm salt water, just mix a cup of warm water with a tablespoon of salt and gargle for about 30 seconds, 2-3 times a day.

As an alternative to salt water, you can gargle with mouthwash. Make sure the mouthwash is alcohol-free, since alcohol can dry out the oral mucosa, which increases the shedding of cells, exacerbating the formation of tonsil stones. If possible, choose oxygenating mouthwashes, these inhibit the development of anaerobic bacteria, which contribute to both the formation of tonsil stones and to bad breath.

2. Removal with a cotton swab

You can also try to remove the tonsil stones with the help of a cotton swab, by gently pressing on the areas of the tonsil where the stones are lodged. Do not exert too much force to avoid damaging the tissue. In the end, it's recommended to gargle with water and salt or with a suitable rinse.

Although it works, this technique is often not recommended by specialists, since if done wrong, it can damage tonsil tissue. Therefore, this technich should not be used in children.

3. Home remedies

Natural remedies for tonsil stones should have antiseptic and anti-inflammatory properties, helping to both prevent the formation of the white flecks and to improve symptoms.

One option is a pomegranate and propolis rinse, which is also a natural antibiotic. To make this rinse, just add 20 grams of pomegranate leaves, or flowers, and 3 drops of propolis to 2 cups of boiling water and let it cool. Gargle for 30 seconds up to 5 times a day.

Another option is to drink or gargle with broadleaf plantain (scientific name Plantago Major L.) tea, as this medicinal plant has anti-inflammatory, antibacterial and astringent properties, helping in the treatment of tonsil stones. To make the tea, just add 10 grams of plantain leaves to 500 mL boiling water and let it steep for about 15 minutes. Then filter and drink about 3 cups of tea a day.

4. Surgery

Surgery is usually the last resort when home remedies are not helping, when there is chronic tonsillitis, when there's a lot of discomfort or when there's bad breath that cannot be treated with other measures.

In these cases, the surgery chosen is a tonsillectomy, which is the removal of both tonsils. The recovery from this surgery is not always easy, as patients can have a sore throat and ear ache for several days. Another option is the use of laser for a partial tonsillectomy, a technique known as tonsil cryptolysis which seals the crevices in the tonsils where particles could accumulate, thus preventing the formation of tonsil stones.

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About the author:
Dr. Gonzalo Ramirez
General Practitioner and Psychologist
Dr. Ramirez possesses a medical degree from the Universidad Popular Autónoma del Estado de Puebla (UPAEP). He also specializes in clinical psychology.