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Tonsil stones form on the tonsils and may cause a variety of symptoms. They are not generally dangerous, but sometimes cause troublesome effects so knowing how to recognize and prevent them is helpful. 

Tonsils 

Tonsils are made of cells called lymphocytes, and are believed to have a role in the immune system during early childhood. They shrink over time, although without disappearing completely, and by adulthood are no longer thought to help prevent illness. The tonsils are located in the back of the throat in such a way that they trap debris and germs; this sometimes causes inflammation, which can lead to tonsillitis. In severe cases, a tonsillectomy to remove the tonsils is necessary.

Formation of a Tonsil Stone

Sulfur-producing bacteria and debris can become lodged and accumulate on the tonsils. The debris can include mucus from postnasal drip and particles of food. When enough debris has accumulated, it starts to calcify in the small crevices or crypts of the tonsils, forming hard yellow or white formations. While the stones are more common in people who frequently experience tonsillitis, they can form with or without an infection because the debris that makes up a tonsil stone comes from a variety of sources.

Risk Factors

People ages 20 to 40 are more likely to experience stones. The following factors may also increase the likelihood of developing stones on your tonsils: 

  • Dry mouth, particularly due to medication
  • Recurring tonsillitis
  • Postnasal drip
  • Infections
  • Food trapped in the mouth
  • Salivary glands that are overactive
  • Lifestyle factors such as excessive amounts of refined foods, stress, and alcohol consumption
  • Genetic factors related to the size and shape of the tonsils 

Symptoms

Many people experience few or no symptoms after developing stones, and the size and location of stones greatly influences the symptoms they cause. People can cough up small stones that become loose, or the stones may be swallowed without the person realizing what happened. Thankfully, there is no danger in swallowing them. Chronic bad breath that does not respond to toothpaste, mouthwash, and other products may be caused by tonsil stones. Other symptoms include the following:

  • Throat feeling restricted
  • Choking or coughing
  • Difficulty swallowing
  • Sore throat
  • Metallic taste in mouth 
  • Inflammation and swelling of the tonsils
  • Lasting ear pain
  • White spots on the tonsils
  • In rare cases, dizziness 

Diagnosis

The organic nature of the stones and the way they hide in the folds and twists of the tonsils makes them difficult to detect. Stones may be discovered and diagnosed during CT scans or dental x-rays. The stones can be manually removed if they are causing problematic symptoms.

Prevention

Individuals who had their tonsils removed are not likely to develop stones; however, a tonsillectomy is not a practical way to deal with the problem because adults often experience a more difficult recover from the procedure than children. Fortunately, there are steps you can take to minimize your risk of developing stones without having your tonsils removed.

  • Drink water after eating to wash any remaining food particles down the throat
  • Brush twice a day, remembering to brush your tongue
  • Use a sea salt containing mouthwash
  • Clean the nasal passages to reduce postnasal drip
  • Use an oral irrigator to rinse the tonsils weekly, preventing accumulation of debris and bacteria
  • Limit intake of dairy products because they provide protein for the bacteria to grow
  • Refrain from excessive consumption of alcohol which can cause dry mouth

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