What are tonsil stones, and why do they form?
Noticing little white lumps in your tonsils, or feel like you’ve always got something stuck at the back of your throat? It could be that you’ve developed tonsil stones.
Tonsil stones are generally pretty harmless, and fall out on their own. Where they become a problem is when the stones form frequently, or come attached to other symptoms (such as infection).
Let’s look at why tonsil stones form, and what to do about it.
In this article:
What are tonsil stones?
Tonsil stones, aka tonsilloliths, are hard, calcified lumps which can form inside the many nooks and crannies of your tonsils - those fleshy lumps at the back of your throat, around your uvula (the dangly bit).
Usually when tonsil stones form, they’re quite small and not particularly harmful. Though, larger stones can occur and this may necessitate a trip to the dentist to get treatment suggestions.
Learn more: What happens in a dental check-up?
What are tonsil stones made of?
Your tonsils are full of lots of crevices and pits, known as tonsillar crypts (yes that’s really their name!). It’s within these ‘crypts’ that your tonsils catch germs before they enter the body, killing them there and teaching your body’s immune system how to fight them in future.
In some cases, more than just germs can get caught in these crypts. Food debris and dead cells could wind up stuck, and if this debris calcifies over time it forms tonsil stones.
Why is it important to address tonsil stones?
For the most part, it isn’t! Tonsil stones are usually harmless and often go away either on their own, or with simple at-home treatment.
That said, if your tonsil stones are particularly large or they keep coming back, this could either be a sign of a wider issue or cause further complications (such as swelling and difficulty swallowing). It may also lead to infection. In these cases, a trip to see the dentist is in order to diagnose the issue, plan out personalised treatment, and stop the issue before it gets any worse.
What causes tonsil stones?
As noted, tonsil stones typically occur when debris and other build-up gets trapped in the folds of the tonsils and calcifies, forming lumps.
While study is ongoing about the various causes of tonsil stones, medical experts currently believe that people who experience more frequent bouts of tonsillitis are more likely to get tonsil stones due to the damage caused by having recurring inflamed tonsils.
Risk factors leading to the development of tonsil stones
Regular tonsil infections: Repeat instances of tonsillitis may lead to an increased risk of developing tonsil stones.
Enlarged tonsillar crypts: If the folds of your tonsils have become enlarged (due to damage, infection or other factors), this may increase your chances of debris getting trapped.
Not drinking enough water: Dehydration can increase the likelihood that debris and bacteria aren’t washed out of your tonsils, allowing them to build up.
Age: Some sources, like the Australian government’s Healthdirect, suggest tonsil stones are more likely to occur in teenagers.
Smoking: Use of tobacco products can increase the chance of tonsil stones forming by irritating the tonsils, affecting mucus production and causing dehydration.
Learn more: Dental care for teens
How to identify if you have tonsil stones
If your tonsil stones are small enough, you might not even know they’re there. Sometimes they’re embedded deep, not visible on the surface. Other times they might be visible, but still not cause any issues.
However, there are some symptoms you can watch out for and here’s the list:
Common symptoms of tonsil stones
Visible yellow or white lumps in the tonsils.
Sore throat.
Difficulty swallowing.
Cough.
Earache.
Bad breath or bad taste in the mouth.
Red or swollen tonsils.
The feeling like something is in your throat.
Many of these symptoms may also be signs of other issues, like a throat infection, sinus infection or tooth decay. If you’re ever worried, you’re better off going to see a professional than ignoring the problem.
Treating tonsil stones
Will tonsil stones go away on their own?
Sometimes, yes.
It’s quite common for tonsil stones to be so minor that you don’t need to do anything at all, and that you barely notice them. Over time, they simply fall out by themselves.
Where they’re uncomfortable, cause wider issues or keep recurring, that’s when you might seek to intervene.
At-home treatments for tonsil stones
1. Gargling
One of the most common home remedies is simply gargling, usually with a salt water rinse. Here you’d mix about a teaspoon of salt with a cup of warm water and then gargle vigorously with some of the mixture.
Not only might the action of gargling help dislodge your tonsil stones, salt water rinsing is a common remedy for helping to promote healing, ease inflammation and fight bacterial growth.
2. Coughing
If your stones aren’t embedded too deeply then coughing may be enough to knock them out. Give coughing a good go and see if it works for you.
Can I just… pull my tonsil stones out?
Generally you should never try to manually remove your tonsil stones.
Dislodging stones in this way could cause further damage to your tonsils, including bleeding and infection. This may cause you greater problems down the line.
Professional treatments for tonsil stones
In the event that you do need to go to a medical professional for your tonsil stones, your dentist (or GP, if that’s who you choose to see first) may recommend one of a few treatments.
1. Antibiotics
Antibiotics are likely to be high on the list of treatment options for any sign of infection in your mouth. Tackling the underlying cause of your tonsil stones in this way could help ease some of the symptoms, and prevent them from coming back.
2. Tonsil stone removal
While you shouldn’t try to remove tonsil stones yourself, your dentist can. This would usually be a fairly simple procedure which doesn’t require anaesthesia.
3. Coblation cryptolysis
In more extreme instances, for example where damage has occurred to your tonsils leading to the frequent formation of tonsil stones, your dentist may refer you back to your doctor for a procedure called coblation cryptolysis.
This is a type of laser surgery which would essentially smooth out your tonsillar crypts, helping to limit the chance of the stones coming back. That said, it’s a newer surgery and there isn’t as much data available pertaining to its effectiveness. Still, some ear, nose and throat specialists are starting to prefer it to tonsillectomies (the removal of your tonsils). Early studies, like this one, suggest it may be more effective.
4. Tonsillectomy
A tonsillectomy is the surgical removal of your tonsils. You would need to have a pretty extreme case of recurring tonsil stones for a doctor to get to a point where this is the recommended procedure.
Generally, you will be encouraged to try other methods of treatment first before getting to this stage.
How to prevent tonsil stones from coming back
1. Maintain good oral health habits
If tonsil stones are typically the result of a build-up of bacteria and debris, then good oral health habits are one way to keep that build-up from happening.
Brush and floss regularly, including brushing your tongue, to keep the amount of bacteria and food debris in your mouth to a minimum. Try to brush towards the back of your tongue, too.
2. Stay hydrated
Drinking water regularly or otherwise staying hydrated will help keep your mouth well rinsed, and promote the production of saliva - your body’s natural rinsing mechanism.
This is especially important if you’re a smoker.
3. Gargle regularly if you’re worried
For those of you at a higher risk of developing tonsil stones, regular gargling with salt water may help keep your tonsils clean and clear.
Particularly if you have enlarged tonsillar crypts, some people suggest gargling with at least water after every meal. However, even just adding a gargle to your regular evening routine could help.
4. Visit your dentist regularly
One of the best ways to prevent most oral health problems, and intervene if they start to occur, is to visit your dentist regularly. That means at least annually for most people, though if you’re at a higher risk of an issue then you might consider going twice a year.
Tonsil stones FAQ
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Mostly, tonsil stones will go away by themselves. However, you may find you can dislodge them by coughing vigorously, or gargling with a salt water rinse. At no point should you attempt to manually dislodge them as this can damage your tonsils.
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Yes, doctors do still remove tonsils in extreme cases – a procedure known as a tonsillectomy. That said, these days many more treatments exist for issues that used to be solved through the removal of the tonsils, so it’s not as common as it once was.
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Tonsil removal surgery – aka a tonsillectomy – is usually performed under general anaesthetic, so you wouldn’t feel anything during the surgery itself. The surgery would likely take less than an hour, and often patients can go home the same day.
You can generally expect to have a sore or uncomfortable throat for one to two weeks following the procedure.
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Yes, there may be. Studies (like this one) are starting to discover that there may indeed be long-term risks of infection and respiratory disease associated with tonsil removal.
Need an appointment? Come see us
If you’re ever worried about the state of your oral health, including the development of tonsil stones, we’re here for you.
Come see us on Maunu Road, Whāngarei, call us on 09 430 0707, or book an appointment online.