Tonsil stones: Understand symptoms, causes and at-home removal

Whether they know it or not, studies have shown that nearly 40 percent of people have tonsil stones. But why do tonsil stones form and what can you do about them? The good news is that most tonsil stones can be prevented with some simple hygiene steps and treated successfully at home.

What are tonsil stones?

Tonsil stones are hard, calcified deposits that form on your tonsils, the fleshy pads on both sides of the back of your throat. Tonsil stones —sometimes called throat stones, or tonsillitis in medical terminology— can be large or small, from the size of a grain of sand up to the size of a grape.

Because your tonsils are a vital part of your immune system, helping to filter bacteria that enter the body through the mouth, they’re usually affected by various bacterial or viral infections like a cold, cough or strep throat. However, tonsil stones aren’t considered an infection. Tonsil stones are annoying, but they are rarely harmful.

Tonsil stone symptoms

Tonsil stones may cause an irritating or odd sensation in your throat, but they’re usually not painful. Some common symptoms of tonsil stones include:

• yellowish bumps or dots in the back of the throat
• tonsil redness or swelling
• a tickle, itch or irritation in the back of your mouth or throat
• bad breath
• cough
• trouble swallowing
• throat pain
• ear pain.

How can you tell you have tonsil stones?

You may feel tonsil stones in your throat which may be irritating but usually not painful. You may be able to see tonsil stones in the mirror. If you can’t see them, you may have tonsil stones hidden within folds of tissue.

Sometimes, if they’re infected or sharp, tonsil stones can cause minor bleeding.

What causes tonsil stones?

Tonsil stones are formed when food or debris gets stuck in the mucous membrane that covers your tonsils, or within folds and crevices on the tonsils. Over the course of weeks or months, these deposits harden and become “stones.” 

Some people have deeper crevices and folds, which makes them more likely to get tonsil stones. Also, people who have a history of tonsil inflammation are more likely to develop tonsil stones. For some people, persistent post-nasal drainage in the throat can increase the formation of tonsil stones.

Poor oral hygiene, including not brushing or flossing your teeth regularly, can also contribute to the formation of tonsil stones. 

Do tonsil stones go away on their own?

In many cases, tonsil stones will go away on their own. They can get dislodged naturally by food, drink or even a cough, causing the tonsil stone to fall out and likely disappear into your digestive tract. A swallowed tonsil stone won’t cause any harm.  

How to prevent tonsil stones

The best way to prevent tonsil stones is with good oral hygiene:

• Brush your teeth after every meal, or at least twice a day.
• Floss your teeth at least once a day.
• Brush or scrape your tongue regularly.
• Rinse and gargle regularly with an alcohol-free mouthwash or warm salt water.
• Avoid tobacco products.
• Drink plenty of water, aiming for 8-10 glasses of water daily.

How to treat tonsil stones

In severe cases, tonsil stones can lead to chronic tonsil inflammation, or an infection called tonsillitis, which is why it’s important to see a provider if you experience ongoing issues with tonsil stones or bleeding from your tonsils. 

Best way to remove at home

If tonsil stones don’t dissolve or dislodge naturally, there are a few at-home remedies to get rid of tonsil stones:

• Try gargling with warm salt water.
• Gently press them out with a cotton swab or the back of your toothbrush.
• Wash them out with a low-pressure water irrigator or flosser.
• Gently use an over-the-counter tonsil stone removal kit, which includes tools to dislodge the stones.

Your tonsils are delicate, and you could cause bleeding or damage if you try to remove tonsil stones too aggressively.

When to seek professional care

If your tonsil stones are causing significant pain, swelling or bleeding, you should see your doctor.

If you think you may have tonsil stones—or if your throat is sore and you’re not sure why—an Allina Health ear, nose and throat (ENT) specialist can diagnose the problem and recommend the best treatment for you.

For large or severe tonsil stones, or if you have a history of recurring tonsil stones, you may want to meet with an ear, nose and throat specialist to discuss surgical removal of the tonsils, or a tonsillectomy. As with most procedures, there are risks of a tonsillectomy to discuss, such as pain and bleeding. This is an outpatient procedure, meaning you do not have to stay overnight in a hospital. A tonsillectomy is the best way to definitively resolve tonsil stones.