Tonsil Stones: Causes and Safe Removal

Tonsil stones (tonsilloliths) are small white or yellow lumps that form in the pockets of the tonsils. They’re harmless in most cases, but they can cause bad breath and an annoying feeling that something’s stuck in your throat.

Imagine brushing your teeth twice a day, yet still having bad breath. Then you cough up a tiny, foul-smelling white lump. Mystery solved. With regular gargling and gentle care, they become far less of a problem.

Why they form

Tonsils have natural crevices called crypts. Food, dead cells, mucus and bacteria can collect there and harden. They’re more common in people with large tonsils or deep crypts, repeated tonsillitis and poor oral hygiene.

Symptoms

• Bad breath that doesn’t improve with brushing
• White or yellow spots on the tonsils
• A feeling of something stuck at the back of the throat
• Mild sore throat or ear pain on swallowing
• A metallic taste

Safe removal and prevention

• Gargle with warm salty water, especially after meals
• Cough firmly; small stones often come loose
• Use a low-pressure water flosser on the gentlest setting
• Brush your teeth and tongue twice a day and floss
• Drink plenty of water

Avoid poking stones with sharp objects, fingernails or cotton buds. Tonsils bleed easily and can become infected.

But when should I see a doctor?

See a doctor if stones are large or painful, you have trouble swallowing, one tonsil is much larger than the other, there’s bleeding, or symptoms persist despite good care. For frequent, troublesome stones, an ear, nose and throat specialist may discuss laser treatment or removing the tonsils.

Sources: Cleveland Clinic (Tonsil stones), American Academy of Otolaryngology-Head and Neck Surgery, NHS (Tonsil stones), American Dental Association.