Tonsil Stones 101

What Are Tonsil Stones?

Your tonsils, the two oval-shaped pads in the back of your throat, are like small bumpy mountains with hidden crevices. The crevices, known as tonsillar crypts, sometimes collect food particles, dead cells, mucus and minerals from saliva, including calcium and magnesium. Tonsil stones form when this debris hardens or calcifies, forming little white or yellow clumps that look and feel like pebbles. Tonsil stones are normal and not contagious. 

“It's common to have debris in the tonsillar crypts. It doesn't mean that it's a bad thing, necessarily,” says Dr. Burns. “Your tonsils are part of your immune system. They are built with a lot of nooks, crannies and folds to deliberately trap things, including pathogens, that we're putting in our mouth.” Once trapped in the tonsils, invaders like bacteria or viruses, are sent to your lymph nodes where cells gather to mount an immune response. If extra particles, such as food and mucus, aren’t naturally flushed out of your tonsil crypts, tonsil stones can form.

“Some people make tonsil stones more than others. Some people don't make any,” explains Dr. Burns.

“It's almost like the analogy would be with earwax. Some people make a lot of earwax and to the point that it's so sticky and stuck that a physician has to remove it from the ear canals periodically. Other people make no earwax, so it's just unique to the individual in terms of whether you have this or not.

It's certainly not a medical emergency, but definitely a nuisance sometimes.”

Signs You Might Have Tonsil Stones

Tonsil stones often go unnoticed, but they can cause some unpleasant symptoms:

• Bad breath (halitosis): The trapped particles are like tiny odor factories, leading to bad breath.
• Sore throat or scratchiness: The stones can irritate the surrounding tissue, making your throat feel scratchy or sore. This can also inflame the tonsil.
• Trouble swallowing: Large stones can make swallowing uncomfortable.
• Ear pain: If a tonsil stone is located next to a nerve that leads to your ear, you might feel pain in that ear.
• A white or yellow speck in your tonsils: You can often see a tonsil stone embedded in your tonsil tissue.

Managing Tonsil Stones

The good news? Tonsil stones are usually harmless and often disappear on their own. Here are some ways to manage them:

• Brush and floss: This removes the bacteria from your mouth, reducing the fuel for stone formation. The American Dental Association recommends brushing your teeth with a fluoride toothpaste for at least two minutes, twice a day and flossing once a day. 
• Hydrate: Drinking plenty of water throughout the day keeps your mouth moist and helps flush out debris.
• Gargle: Gargling with warm salt water (dissolve a half a teaspoon of salt into a cup of warm water) or a mild antiseptic mouthwash can loosen and dislodge stones.
• Cough: A good cough can dislodge stones, so don’t be alarmed if you happen to “catch” one. And, if you happen to swallow one, it will not hurt you.

Dr. Burns advises against trying to remove tonsil stones at home by scraping them with your finger, a cotton swab or other tool. He says your tonsils are delicate and prone to bleeding and infection. If your tonsil stones are causing any type of discomfort or are large, contact a medical professional to have them examined.

Learn more about ear, nose and throat conditions.