Tonsil Stones: Possible Causes & How to Get Rid of Them

Medical review: Dr. Gonzalo Ramirez
General Practitioner and Psychologist
August 2022
  1. Symptoms
  2. Swallowing tonsil stones
  3. Causes
  4. Treatment

Tonsil stones are small white or yellowish, masses that can appear in the throat. They are normally embedded within the tonsils. 

They are caused by the accumulation of food particles, saliva, and mouth cells. Also known as tonsilloliths, they can cause bad breath, sore throat 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, as well as relieve discomfort and bad breath. However, when tonsil stones occur often or appear due to chronic tonsillitis, surgery removal of the tonsils may be needed.

Main symptoms

Tonsil stones are small white or yellow flecks that may appear embedded in the tonsils. Other symptoms associated with tonsil stones 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 treatment approach.

Can you swallow a tonsil stone?

Studies on tonsil stones show that these are not actually stones, but rather biofilm structures. That means that tonsil stones are made-up of microorganisms that are able to stick to a moist surface and reproduce more cells. Calcification of the outer tonsil stone is what gives it a "harder" or stone-like quality. Swallowing a tonsil stone is safe, as it is consists of natural particles from the mouth and our food that would have been swallowed regardless. 

What causes them

Tonsil stones can be caused by the accumulation of food particles in the tonsils, which promotes the growth of microorganisms. This eventually leads 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 in the nose and throat, 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 by gargling with saline solutions, mouthwashes, or natural solutions with antibacterial properties. It may take up to 3 days for improvement in the stones and bad breath to be noted.

Below are some ways to treat tonsil stones:

1. Salt water gargle or 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 and promotes the formation of tonsil stones. If possible, choose oxygenating mouthwashes, as these prevent the growth of anaerobic bacteria, which contribute to both the formation of tonsil stones and to bad breath.

2. Remove with a cotton swab

You can also try to remove the tonsil stones with a cotton swab by gently pressing on the areas of the tonsil where the stones are lodged. Do not exert too much force as you may risk damaging the tissue. Once removed, you should gargle with water and salt or with a suitable rinse to cleanse the tonsils. 

Although it works, this technique is often not recommended by specialists, as it can damage tonsil tissue if done incorrectly. This technique should particularly not be used in children.

3. Teas for tonsil stones 

Natural remedies for tonsil stones should contain antiseptic and anti-inflammatory properties to prevent the formation of the white flecks and to improve associated 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. Let this infusion cool, then strain and gargle for 30 seconds up to 5 times a day.

Another option is to drink or gargle with broadleaf plantain (scientifically known as 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 and is recommended for the following situations:

  • Home remedies or conservative treatments are not helping
  • Chronic tonsillitis with frequent flare-ups
  • Intolerable discomfort
  • 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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Atualizado por Tua Saude editing team, em August de 2022. Medical review por Dr. Gonzalo Ramirez - General Practitioner and Psychologist, em August de 2022.

References

  • STOODLEY, Paul et al. Tonsillolith: Not Just a Stone but a Living Biofilm. American Academy of Otolaryngology- Head and Neck Surgery. 316-321, 2009
  • MARINHO, Antonio F. Amígdalas e adenóides - da infecção a obstrução. Revista Portuguesa de Otorrinolaringologia e Cirurgia Cérvico-facil. Vol.48(2). 25-32, 2010
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Medical review:
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.