Tonsil Stones: Causes, Symptoms, Treatments, and How to Prevent Them

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What Are Tonsil Stones? What Causes Tonsil Stones? And Who Gets Tonsil Stones?

Tonsil stones are growths that can form, harden, and grow on and inside the tonsils, which are the oval-shaped pads of tissue that sit on either side of the back of the mouth. These stones are not a sign of illness or disease and they do not cause other negative outcomes for your health.

But they can cause symptoms such as bad breath and discomfort in the back of the throat. They can also be a nuisance, because they may repeatedly grow back after they’re removed. (1,2)

How and Why Tonsil Stones Form

In some people, the surface of the tonsils is more irregular than smooth, with crevices and pockets that are deep enough to trap food particles, bacteria, saliva, and other debris. “Food, plaque, cellular debris such as skin cells and the lining of the mouth all collect in the pits and crevices,” says Jennifer Setlur, MD, an otolaryngologist at Massachusetts Eye and Ear, in Boston. Over time, these materials become impacted, and eventually they develop into stones. (1,2)

Tonsil stones are usually about gravel-size, but they can also be quite small — sometimes even too tiny to be seen with the naked eye. They can also potentially grow to be even as large as a golf ball or bigger, especially if they go unchecked. They’re usually soft but they can harden, and they are light yellowish or white in color. Unfortunately, they often smell extremely unpleasant because of the bacteria that is a component of tonsil stones. (One of the most commonly noticed symptoms of tonsil stones is bad breath.) (1,2)

RELATED: Drinking Alcohol Increases Mouth Bacteria

Your Tonsils’ Structure Determines Your Risk of Developing Tonsil Stones

There’s a common misconception that having tonsil stones means you have poor oral hygiene. But the fact is that people who brush and are vigilant about oral hygiene can also be prone to developing tonsil stones. What does determine who is and is not prone to developing these growths is usually the presence of crypts on the surface of the tonsils. “It has to do with the structure of tonsils,” says Aaron Thatcher, MD, an assistant professor with the University of Michigan’s Department of Otolaryngology–Head and Neck Surgery in Ann Arbor. The crypts in the tonsils allow material like food and debris to build up and eventually turn into tonsil stones. (1,2)

It should be noted, though, that poor oral hygiene can indeed contribute to the development of tonsil stones, and brushing, flossing, and gargling water in the back of your throat regularly are important ways to help prevent the problem. (1)

An individual’s propensity to develop tonsil stones may change over time, meaning that someone who once regularly got tonsilliths may get them less frequently, or vice versa. That’s because tonsils can develop more crypts as we reach adolescence and into young adulthood, and then become smaller and less prone to tonsil stones as we age, Dr. Setlur explains. (1,2)

Learn More About What Tonsil Stones Are and What Causes Them

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