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Tonsils are pieces of tissue in the back of each side of the mouth. They contain lymph nodes and help filter out bacteria and viruses.

Small calcium deposits, called tonsil stones or tonsilloliths, can build up on tonsils. These usually build up around food, dead cells, or mucus that you usually swallow, but can sometimes get caught in small pockets of the tonsils’ mucus membrane coating. This is the same substance that lines the inside of your mouth, nose, and throat.

Tonsil stones are hard in texture and yellow or white in color. They’re usually small — about the size of a grain of rice — but can grow large, up to about the size of a grape. They’re most common in people who have repeated tonsillitis or have large tonsils.

The only way to fully prevent tonsil stones is to have your tonsils surgically removed. This procedure is called a tonsillectomy. It is usually used to treat chronic tonsillitis.

Tonsillectomies are most commonly done in childhood, but can also be done in adults. The surgery is performed under general anesthesia. Side effects usually include a sore throat and trouble swallowing for a few days. Serious side effects are rare.

For those who do not meet the criteria for a tonsillectomy (e.g. seven cases of tonsillitis or strep throat in one year), there are ways to help prevent tonsil stones on your own.

Practice good oral hygiene

This is the best way to prevent tonsil stones from forming. Be sure to brush your teeth and tongue in the morning, before bed, and after every meal. In addition, you should floss every day. This helps keep debris from building up.

Mouthwash

Mouthwash can help flush debris and bacteria out of your mouth and make tonsil stones less likely to form. Using a mouthwash without alcohol is best.

Gargling water

Gargling with warm salt water can help block bacteria or viruses from getting in your tonsils and causing issues. Additionally, it can help ease pain associated with tonsil stones.

Water pick

You can use a water pick to flush out your mouth, and help get rid of debris and bacteria.

Purchase a water pick online.

Small tonsil stones may not cause any symptoms. However, potential symptoms include:

  • bad breath
  • throat irritation or a feeling like something is stuck in your throat
  • white bumps on your tonsils
  • trouble swallowing
  • tonsil redness
  • ear pain (if a tonsil stone is pressing on a nerve)

Many tonsil stone symptoms are similar to tonsillitis. However, tonsillitis also causes fever and headaches.

If your tonsil stones are small, you can try to remove them at home. The best way to do this is to gently scrape them off with a toothbrush or cotton swab. Using a water pick or gargling can also help dislodge the stones.

Most tonsil stones don’t require medical care. If your symptoms are severe, your tonsils are very red, or you have ear pain, see a doctor. These may be signs of tonsillitis, or other, more serious issues. You should also see a doctor if your tonsil stones are very large.

If your tonsil stones keep coming back (are recurrent), you should see a doctor. They will try to find the underlying cause of your recurrent tonsil stones. In this case, a doctor may recommend that you get your tonsils removed.

In most cases, tonsil stones are harmless buildup that will go away on their own or with proper oral hygiene and at-home removal. However, they can be a sign of a more serious problem, such as tonsillitis. If you get tonsil stones often or the stones grow large, make an appointment to get checked out by your healthcare provider.