What are tonsil stones?

Tonsil stones, or tonsilloliths, are hard white or yellow formations that are located on or within the tonsils.

It’s common for people with tonsil stones to not even realize they have them. Tonsil stones aren’t always easy to see and they can range from rice-sized to the size of a large grape. Tonsil stones rarely cause larger health complications. However, sometimes they can grow into larger formations that can cause your tonsils to swell, and they often have an unpleasant odor.

Your tonsils are made up of crevices, tunnels, and pits called tonsil crypts. Different types of debris, such as dead cells, mucus, saliva, and food, can get trapped in these pockets and build up. Bacteria and fungi feed on this buildup and cause a distinct odor.

Over time, the debris hardens into a tonsil stone. Some people may have only one tonsil stone, while others have many smaller formations.

Potential causes of tonsil stones include:

Although some tonsil stones may be difficult to see, they can still cause noticeable symptoms. Symptoms of tonsil stones can include:

Smaller tonsil stones, which are more common than large ones, may not cause any symptoms.

If you have tonsil stones, they may occur on a regular basis. Fortunately, there are steps you can take to prevent them. These steps include:

  • practicing good oral hygiene, including cleaning the bacteria off the back of your tongue when you brush your teeth
  • stopping smoking
  • gargling with salt water
  • drinking plenty of water to stay hydrated

Most tonsilloliths are harmless, but many people want to remove them because they can smell bad or cause discomfort. Treatments range from home remedies to medical procedures.


Gargling vigorously with salt water can ease throat discomfort and may help dislodge tonsil stones. Salt water may also help to change your mouth chemistry. It can also help get rid of the odor tonsil stones can cause. Dissolve 1/2 teaspoon salt in 8 ounces of warm water, and gargle.


You may first discover that you have tonsil stones when you cough one up. Energetic coughing can help loosen stones.

Manual removal

Removing the stones yourself with rigid items like a toothbrush is not recommended. Your tonsils are delicate tissues so it’s important to be gentle. Manually removing tonsil stones can be risky and lead to complications, such as bleeding and infection. If you must try something, gently using a water pick or a cotton swab is a better choice.

Minor surgical procedures may be recommended if stones become particularly large or cause pain or persistent symptoms.

Laser tonsil cryptolysis

During this procedure, a laser is used to eliminate the crypts where tonsil stones lodge. This procedure is often performed using local anesthesia. Discomfort and recovery time are usually minimal.

Coblation cryptolysis

In coblation cryptolysis, no heat is involved. Instead, radio waves transform a salt solution into charged ions. These ions can cut through tissue. As with lasers, coblation cryptolysis reduces tonsil crypts but without the same burning sensation.


A tonsillectomy is the surgical removal of tonsils. This procedure may be done using a scalpel, laser, or coblation device.

Performing this surgery for tonsil stones is controversial. Doctors who recommend tonsillectomy for tonsil stones tend to use it only for severe, chronic cases, and after all other methods have been tried without success.


In some cases, antibiotics can be used to manage tonsil stones. They can be used to lower the bacteria counts that play a crucial role in the development and growth of the tonsil stones.

The downside of antibiotics is that they won’t treat the underlying cause of the stones, and they come with their own potential side effects. They also shouldn’t be used long term, which means the tonsil stones will likely return after you stop using the antibiotics.

While complications from tonsil stones are rare, they are possible. One of the most serious complications that may result from tonsil stones is a deep infection of the tonsil, known as an abscess.

Large tonsil stones can damage and disrupt normal tonsil tissue. This can lead to significant swelling, inflammation, and infection.

Tonsil stones linked to tonsil infections may also require surgery.

No, tonsil stones aren’t contagious. They are made up of a material called biofilm. In the mouth, a biofilm is a combination of your own mouth’s bacteria and fungi interacting with your mouth’s chemistry. This mixture then attaches itself to any moist surface.

In the case of tonsil stones, the material becomes hardened within the tonsils. Another common biofilm in the mouth is plaque. Biofilms also play a role in cavities and gum disease.

Tonsil stones are a common problem. Though they can bring a range of symptoms, tonsil stones rarely result in serious complications.

If you have frequent tonsil stones, be sure to practice good dental hygiene and stay hydrated. If they become a problem or you’re concerned about them, talk to your doctor. Together you can determine the best way to treat your tonsil stones and prevent future ones.