What are tonsil stones?

Tonsil stones, or 'tonsilloliths', are small lumps of hardened material that can form in the tonsils. They can cause bad breath and are more common in adults than in children. The stones are usually small and it is rare to have a large tonsil stone.

Tonsil stones are not harmful and may not need to be treated, but surgical options are available if they become a problem.

What are the symptoms of tonsil stones?

Tonsil stones commonly cause bad breath. They can also cause an irritable cough, earache, sore throat or a foul taste in your mouth.

If you have tonsil stones, you might find it hard to swallow. It might feel like there's something stuck at the back of your throat. You might be able to see small patches of white on your tonsils.

Tonsil stones can also trigger infections and can be difficult to treat with antibiotics.

Tonsil stones don't always cause symptoms. Sometimes, they are found on a scan or x-ray or during a dental examination.

What causes tonsil stones?

Tonsil stones are formed by debris that can build up in the tonsils. The tonsils are glands found at the back of your throat that help protect you against infection. The glands contain folds known as tonsillar crypts. Most tonsil stones are small, just 1mm to 2mm across. In some cases, however, they can be up to 1cm across.

If your tonsillar crypts are enlarged, minerals like calcium can become trapped and harden or calcify into stones. Bacteria or fungi that cause tonsillitis can also cause tonsil stones to form.

How are tonsil stones diagnosed?

If you think you might have tonsil stones, your doctor will talk to you and examine you. The stones might or might not be visible and a scan might help to find them if they are not obvious.

If the stones are dislodged and examined, they will usually smell foul.

How are tonsil stones treated?

While you can manage the symptoms of tonsil stones, such as bad breath, there is no specific treatment for them. Good oral hygiene is important. This includes gargling with warm salt water and brushing your teeth regularly.

During vigorous gargling, the tonsil stones may become detached. Some people choose to dislodge them with a dental pick or swab. Be gentle if you decide to do this.

Removing tonsil stones

You might decide you want the tonsil stones surgically removed. This option is best discussed with your doctor, who can refer you to an ear, nose and throat (ENT) specialist. The specialist will examine your tonsil stones and provide advice on the best course of action.