Tonsil stones form when bacteria and debris get stuck in those gaps and harden. Tonsil stones look like white or yellow pebbles on your tonsils. They can cause bad breath, a sore throat, a bad taste in your mouth, and ear pain. Or they may not cause any symptoms.
While tonsil stones are usually a minor irritation, they sometimes lead to infection and discomfort. People can often resolve them at home with strategies such as salt water gargling, coughing, and using a cotton swab or toothbrush. If tonsil stones persist or cause painful symptoms, a person should contact a doctor.
Poor oral hygiene, as well as tobacco use, can increase the likelihood of tonsil stones. But in other individuals, it's the structure of the tonsils themselves that makes them more prone to developing tonsil stones.
Removing tonsil stones at home is generally not recommended because tonsils are delicate tissues and bleeding and infection may occur if stones are not carefully removed.
Tonsil stones usually fall out on their own without treatment. You can try to help dislodge the stones by brushing your teeth regularly and gargling with warm salt water (one teaspoon of salt mixed with eight ounces of water). You do not need antibiotics.
Tonsil stones smell because the bacteria and fungi feed on the mucus, food, and debris that gets stuck in the tonsil pits. The anaerobic bacteria produces foul smelling sulfides giving it that distinct pungent smell. Tonsil stones are also composed of many layers of living microbes.
Because tonsils stones are composed primarily of bacteria, this is known to produce a foul-smelling sulfide. You will notice this both when the stone is in your tonsil and when it is dislodged and visible outside your body.
If you have a history of chronic tonsillitis or other medical conditions that increase your risk of tonsil stones, you may need to take additional steps to prevent them. This can include avoiding certain foods, such as dairy products or sugary snacks, that can contribute to the formation of tonsil stones.
In severe cases, tonsil stones can lead to chronic tonsil inflammation or infection of your tonsils, which is called tonsillitis. Tonsillitis symptoms include severe throat pain, feeling sick, swelling of the tonsils, and sometimes a fever.
Bad breath — Tonsil stones can have a foul odor, making severe bad breath one of the main symptoms. Sore throat or cough — Sometimes, tonsil stones can irritate the throat and cause a sore throat or cough.
How long do tonsil stones last? Tonsil stones may last anywhere from several days to several years. Most tonsil stones clear up in 1-3 weeks on their own. Large stones may remain on the tonsils for many years if not removed by a doctor.
After 2 or 3 days, mucus may change to a white, yellow, or green color. This is normal and does not mean you need an antibiotic. Some symptoms, especially runny or stuffy nose and cough, can last for up to 10 to 14 days. Those symptoms should improve over time.
Removing tonsil stones
In most cases, removing a tonsil stone can be done at home. Using a cotton swab, gently push on the tonsil, behind the stone, to force the stone out. Vigorous coughing and gargling can dislodge stones, as well. Once the stone is out, gargle with salt water, to remove any remaining bacteria.
If you have a history of developing tonsil stones, the best way to get rid of them permanently is to remove your tonsils. Surgery to take out the tonsils is called a tonsillectomy. It is usually done as an outpatient procedure, so you don't have to stay overnight in the hospital.
Anyone can develop tonsil stones, but recurring strep throat (tonsillitis), viral infections or sinus issues, poor oral hygiene, and the shape and size of your tonsils may put you at greater risk for developing them.
The glands contain folds known as tonsillar crypts (folds). If your tonsillar crypts are enlarged, minerals such as calcium can become trapped, and calcify (harden) into stones. Bacteria or fungi that cause tonsillitis can also cause tonsil stones to form.
People with tonsil stones may be able to loosen them by gently pressing on the surrounding tissue with a cotton swab. It is better to push the stone forward by positioning the swab behind the stone. The tonsil stone then falls into the mouth instead of into the throat. People with tonsil stones often pick them out.
Today, however, this once common procedure is no longer a standard operating procedure. Why? Dr. DeMarino says that, “There are fewer tonsillectomies due to skepticism in the medical community over its usefulness in infection control and more stringent guidelines.”
Tonsilloliths or tonsillar concretions occur in up to 10% of the population, frequently due to episodes of tonsillitis. While small concretions in the tonsils are common, true stones are less so. They commonly occur in young adults and are rare in children.
Pushing or Squeezing Out Stones
“There is risk for injury to the tonsil and bleeding,” says Setlur. “There is a risk for vascular injury.” Even using a finger or toothbrush could scratch your tonsils, so if you do try this method of removal, try using a cotton swab.