What are Tonsil Stones and What Causes Them?

So you want to know what tonsil stones are, what causes tonsil stones and how to prevent tonsil stones?
In this article, you’ll learn everything you need to know!

Do you ever feel a lump in your throat or have the sensation that something is stuck there? Have you ever noticed pale lumps stuck to your tonsils or coughed-up smelly yellow chunks? Do you struggle with chronic bad breath or a metallic taste in your mouth?

You might have tonsil stones.

What are tonsil stones, what causes tonsil stones, and how do you get rid of tonsil stones?

This comprehensive guide explains everything you need to know about tonsil stones and what causes them.

What are tonsil stones? Illustration of a tonsil stone surrounded by question marks.

What are tonsil stones?

Tonsil stones are soft balls of debris that collect around the folds of tonsils. They can vary in color from pale yellow to gray or brown and are usually less than a centimeter in size. However, there have been records of large tonsil stones.

Tonsil stones are often less than 1cm in size. Illustration of a tonsil stone and a ruler.

What are tonsil stones made of? 

Tonsil stones are made from a build up of a variety of things naturally found in your mouth. This includes bacteria, food debris, minerals, mucus, saliva and dead cells.

Over time, these materials coagulate into soft lumps in the crypts, or pits, of the tonsils. The fact that there are bacteria in tonsil stones classifies them as a living “biofilm” and it’s the sulfur-producing bacteria that give tonsil stones their signature bad odor.

What are the Signs of Tonsil Stones?

As mentioned above, there are several signs that can indicate you have tonsil stones. Here are some symptoms of tonsil stones:

  • Bad breath and/or a bad taste in your mouth (like mothballs)
  • Toothache or ear pain
  • Discomfort swallowing
  • The feeling of getting food stuck in your tonsils
  • Sore tonsils
  • A persistent need to cough to clear your throat because you feel there’s something stuck in there
  • Coughing up smelly yellow chunks
  • Seeing pale flecks (small stones) stuck to your tonsils when you stick your tongue out and examine your throat in a mirror
What are the signs of tonsil stones? Illustration of a woman on a sofa surrounded by question marks.

If you aren’t sure whether you have tonsil stones, visit a dentist, an ear-nose-and-throat specialist, or your regular doctor to find out.

What are the Causes of Tonsil Stones?

What are tonsil stones caused by, and how can you get rid of tonsil stones?

The size and shape of your tonsils are the biggest contributing factors to the development of tonsil stones. In fact, the primary requirement for tonsil stones to form is simply having tonsils in the first place.

Your tonsils are small oval pads of lymphoid tissue located at the sides of your throat just behind your tongue. Tonsils play an important role in your immune system by fighting disease and protecting your body from invading pathogens. These patches of spongy tissue are usually covered with pits and folds that quickly collect bits of the debris that passes through your throat. When the debris mixes with minerals in your saliva, it can harden into lumps on your tonsils.

People with many deep pits on their tonsils may be more susceptible to getting tonsil stones. Likewise, those with poor oral hygiene and lots of plaque on their teeth may be prone to developing tonsil stones because they have more debris in their mouths.

Tonsil stones are more common in people with poor oral hygiene. Illustration showing an open mouth and teeth with plaque buildup.

Who Can Get Tonsil Stones?

Just about anyone with tonsils can get tonsil stones.

More people are struggling with tonsil stones these days because more people have their tonsils. Just a few decades ago, tonsillectomy was the oft-recommended treatment for just about any upper respiratory concern.

Graph showing that the number of tonsillectomies performed in 1998 was 46% lower than in 1967.

Now that doctors know it’s not needed as often as previously thought, more people have been growing up with their tonsils in-tact.

Having no tonsils means not developing tonsil stones. Tonsil tissue is prone to packing debris in those tight spaces, so having tonsils is required to develop tonsil stones. Simply put, you cannot have tonsil stones if you do not have tonsils.

Some people who get tonsil stones will only get them on one side of their throat. Some individuals are also more disposed to tonsil stones if they suffer from frequent cases of tonsillitis, this is because illness means the tonsils get overloaded with cellular debris.

Just how common are tonsil stones?

More common than you may realize! One study evaluated 124 patients who visited the radiology clinic at the University of Iowa and determined that 8.14% of the patients had tonsil stones, also called tonsilloliths.

As this study only examined a little over 100 people, there’s a good possibility that the number of people who have tonsil stones is closer to one in ten, or even more.

Why don’t you hear about tonsil stones more often?

Not everyone who has tonsil stones realizes that they do, or they might be embarrassed to discuss the problem. Some might even be so used to having tonsil stones that they think they’re normal. Additionally, some doctors and dentists may not correctly explain the problem to patients who ask about tonsil stones.

Whatever the case, tonsil stones are a very real health concern that is more common than you might think.

Tonsil stones are generally harmless. They often pop out on their own and you may cough them up or unwittingly swallow them. There’s no need to panic if you do – they won’t make you sick!

Even so, there are some rare complications of tonsil stones that you should be aware of.

Tonsil stones smell. Illustration showing a man holding a smelly tonsil stone.

Tonsil Stone Complications

Unless it grows to an unusually large size, a tonsil stone doesn’t pose a threat to your health. Tonsil stones have only gotten dangerously big in a few rare cases. If you find that a tonsil stone interferes with your breathing or eating, then you will need urgent medical attention.

Otherwise, the biggest complaint with tonsil stones is the way they cause smelly breath. This is because tonsil stones are loaded with sulfur-producing bacteria and rest right there at the gateway of your throat. Each breath you exhale picks up the odor of this “living biofilm.”

One study compared a group of people with normal breath with a group who had bad breath. While only 6% of those with the normal breath presented with tonsil stones, 75% of the study subjects with bad breath had tonsil stones. The findings suggested that tonsil stones increase your risk of having bad breath by ten times.

Graph showing that 75% of people with bad breath had tonsil stones.

On the plus side, you don’t have to worry about “catching” tonsil stones from anyone. They are not contagious. They develop as a result of the unique anatomy and bacterial ecosystem of an individual’s tonsils. Your biggest concern about tonsil stones is most likely their offensive odor, which can have some embarrassing social consequences.

Can You Prevent Tonsil Stones?

Tonsil stones might not be dangerous, but they’re still not pleasant to have.

How do doctors treat tonsil stones? Stones are not tightly attached to your tonsils, so they are easy to remove as long as you use the right tools. Unfortunately, new tonsil stones can begin developing soon after you remove the old ones. This means that if you are prone to developing tonsil stones, you may always struggle with this smelly problem.

How can you prevent tonsil stones, and how can you get rid of tonsil stones?

The only factor you have control over in the tonsil stone formation process is your hygiene. You can limit the amount of debris in your mouth that would otherwise end up turning into tonsil stones.

Good oral hygiene is an important way you can prevent tonsil stones. Brushing and flossing will reduce plaque bacteria on your teeth and gums. Scraping your tongue eliminates odor-causing bacteria. Flushing your tonsils regularly with water and gargling with mouthwash can blast away the debris that precipitates tonsil stone formation.

Can you prevent tonsil stones? Illustration showing a woman in a bathroom holding oral hygiene tools.

 

Frequently Asked Questions

What happens if tonsil stones are left untreated?

Tonsil stones typically aren’t dangerous, as often, they fall out on their own. However, if they are left untreated, there is the possibility that they could keep getting bigger.

The longer you allow tonsil stones to remain, the longer you will have to put up with the uncomfortable side effects, such as bad breath and discomfort.

How common are tonsil stones?

Tonsil stones are incredibly common, more so than you might realize. In fact, it is estimated that around 1 in 10 people could be living with tonsil stones.

Why do tonsil stones smell so bad?

One of the key components of tonsil stones is bacteria. This bacteria produces sulfur, which causes the signature bad smell.

Do I need to see a doctor about tonsil stones?

You should see a doctor, dentist or ear-nose-and-throat specialist if you aren’t sure if you have tonsil stones, or if you have any concerns.

Do you need antibiotics to treat tonsil stones?

No, you do not need antibiotics to treat tonsil stones. If you have any concerns about getting rid of tonsil stones or think you might have an infection, see your doctor.

Can you get tonsil stones if you don’t have tonsils?

No! Without tonsils, you cannot get tonsil stones.

Would you like to learn more about preventing and removing tonsil stones?

Oravix can help. Our team has developed a set of quality tonsil care tools and instructions for how to clean your tonsils that will help you avoid bad breath and other unwelcome side-effects of tonsil stones.

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