Why Do People Get Tonsil Stones?

What are tonsil stones?

Tonsil stones are yellow or white deposits that form on your tonsils. People get tonsil stones when mucus, food particles, bacteria and debris build up in tonsil crypts.
Tonsil stones are yellow or white deposits that form on your tonsils. People get tonsil stones when mucus, food particles, bacteria and debris build up in tonsil crypts.

Tonsil stones are small white or yellow deposits that can form on your tonsils. Made of debris and bacteria, these deposits accumulate in the crevices of the tonsils. They start off soft and gradually harden. 

Experts are not sure what causes tonsil stones. Some research indicates that people with large tonsils or those who have had recurrent tonsillitis might be more likely to get them. 

Symptoms of tonsil stones

Tonsil stones are usually easy to see, although they may not be visible in the early stages. If you have certain symptoms, you should see your doctor to be checked for tonsil stones. These symptoms include:   

Bad breath

Bad breath, also called halitosis, is the main symptom of tonsil stones. In one study, researchers tested people’s breath using a machine that measures odorous sulfurous compounds. They found that having one or more tonsil stones makes you 10 times more likely to have halitosis. 

Throat and ear discomfort

Some people say when they have a stone, they feel as if something is stuck in their throat. Tonsil stones can also cause a chronic sore throat or trigger a case of tonsillitis. You could also have trouble swallowing, especially if you have a large stone.

Related problems

Tonsil stones can cause ear pain because the tonsils are located so close to the ear. They can cause a cough or a restriction in the upper airway

Causes of tonsil stones

Everyone has tonsils, unless they have had them removed. Everyone also has food particles, debris, and bacteria in their mouth and throat. So why do some people get tonsil stones, and some people do not? Researchers aren't sure, but they point to these possibilities:

Formation of the tonsils

Large tonsils may catch more debris than smaller ones, but most authorities believe that the relative roughness of the tonsils is a more important risk factor. Everyone has holes and crevices, called "crypts," in their tonsils. The larger the crypts, the more likely they are to hold stones.  

Problems with dental hygiene

Although experts disagree about whether poor dental hygiene causes tonsil stones, they agree that cleaning the mouth is important. Good oral care can reduce bacteria in the mouth and might prevent stones. Experts suggest:

  •  Brushing the teeth in the morning, after meals, and at night
  •  Brushing the tongue along with the teeth
  •  Flossing
  •  Using an alcohol-free mouthwash

Mouth breathing  

People who habitually breathe through the mouth, during the day or at night, may form tonsil stones. Correcting the problem that causes the mouth breathing might reduce stone formation.

Diagnosis of tonsil stones

Usually, your doctor or dentist can diagnose tonsil stones by sight. Doctors can also use scans to find them, although that is seldom necessary. If you are prone to developing stones, you will probably learn to recognize them yourself. 

Treatments for tonsil stones

If you have visible tonsil stones, but they aren't causing any problems, they shouldn't require treatment. If you begin to have symptoms, you can visit your doctor for removal or learn to remove the stones yourself. 

To remove the stones yourself, you can push the stones out with a swab or a water flosser. Water flossers, also known as water jets or oral irrigators, produce a stream of water under low pressure that will often wash out the stone. Vigorous gargling with salt water may also dislodge the stone.

If tonsil stones are a chronic problem, you may have your tonsils removed. A tonsillectomy, the surgical procedure to remove your tonsils, involves some pain and a small risk of bleeding. If you are an older individual or have certain health conditions, your doctor may not recommend a tonsillectomy. 

Cryptolysis is an alternative to removing the tonsils. In this procedure, a laser or wand is used to scar the tonsils, effectively closing most of the crypts. This procedure can be done in an office setting without general anesthesia. The procedure usually results in less pain, fewer complications, and a shorter recovery time than removal of the tonsils. 


American Journal of Otolaryngology: "Laser tonsil cryptolysis: In-office 500 cases review."

British Dental Journal: "Relationship between the presence of tonsilloliths and halitosis in patients with chronic caseous tonsillitis."

Everyday Health: "What Are Tonsil Stones? Symptoms, Causes, Diagnosis, Treatment, and Prevention." Keck Medicine of USC: "What Are Tonsil Stones?"

Mayo Clinic News Network: "Tuesday Q and A: Self-care steps may help prevent tonsil stones from returning."

North Carolina Health Information Exchange: "Water Flosser and Tonsil Stones – Does It Help?"

Texas Children's Hospital: "My child has bad breath: What do I do?"

UPMC Health Beat: "What Are Tonsil Stones (Tonsilloliths)? Tonsil Stone Symptoms and Treatment."