Most people who get tonsil stones from time to time are already aware they have them, but if you’ve never seen or felt them in your own tonsils, they may be hiding.

© Viacheslav Iacobchuk | Dreamstime.com

Have you ever had the sensation that something’s stuck in the back of your throat and you’re not sure what it could be? You cough a few times and try to clear your throat, but that weird feeling just won’t go away. There’s a possibility it could be a tonsil stone. If you haven’t had one before, you’re pretty lucky. But if you have, you know that they’re uncomfortable, annoying, and pretty stinky.

What are tonsil stones, exactly? Why do we get them? How long do they last? And how do we get rid of them once and for all? Let’s take an (unpleasant) look.

What Are Tonsil Stones?

Also known as tonsilloliths, tonsil stones are harmless lumps of debris that look like small white or yellow pebbles. Tonsil stones form and become caught inside craters in your tonsils, which medical experts refer to as tonsillar crypts. The stones are believed to be made up of bacteria, mucus, food, dead cells, and other substances, and have an unpleasant smell due to the presence of sulfur.

Although all people (who still have their tonsils) have tonsillar crypts, not everyone gets tonsil stones. Why? The answer’s not entirely known, although some attribute it to chronic inflammation or sinus issues. They also seem to be more common in people with a history of tonsillitis and/or with large tonsils.

Symptoms of Tonsil Stones

Most people who get tonsil stones from time to time are already aware they have them, but if you’ve never seen or felt them in your own tonsils, they may be hiding. In fact, there may even be a possibility that stones have dislodged from your tonsils by themselves and you’ve swallowed or rinsed them away without even realizing. The following symptoms may serve as clues:

• Sore throat
• Cough
• Difficulty swallowing
• Bad breath
• The sensation that something is stuck in the back of your throat or mouth
• Pressure and/or pain in your ears
• A metallic taste in your mouth

Tonsil stones can sometimes be hard to remove at home, so visit an ENT if you have a stubborn one. Photo courtesy of © Designua | Dreamstime.com

How to Remove Tonsil Stones

Depending on the size of the tonsil stones and how deep your tonsillar crypts are will determine how easy (or difficult) it will be to remove them yourself at home. Some are large enough that they jut out of your tonsils and become visible. If you can actually see the stones when you open your mouth in front of a mirror, try one of the following tips to remove them:

• Lightly press a cotton swab against the tissue around the stone to coax it out toward the front of your mouth.
• Use a water pick to flush the stone away.
• Vigorously gargle with saltwater or a 50/50 mixture of hydrogen peroxide and water.

If the tonsil stone is being stubborn and causing you discomfort, pay a visit to your ENT, who can remove it safely using special instruments. Using anything pointy or sharp to dig it out yourself can cause bleeding, irritation, or infection, or it can cause the stone to be pushed down further. So be sure to see a professional if necessary.

If you manage to remove a tonsil stone, don’t be alarmed if another one (or two) pops up behind it. Often, the first stone that you see is a small piece of a larger stone that is settled deep inside your tonsillar crypt and is too large to dislodge itself in one piece.

Treatment

While some people get tonsil stones every once in a while, others find it to be a chronic issue. If you have recurrent tonsil stones or chronic tonsillitis with stones, treatment options may include antibiotics, salt water gargles, and removal of your tonsils (tonsillectomy).

Some ENTs may recommend a procedure called coblation tonsil cryptolysis, where a laser is used to reshape the tonsils and close the tonsillar crypts where the stones form. The procedure can be completed under local anesthetic. However, because there’s a chance the stones could grow back, coblation tonsil cryptolysis isn’t a permanent solution.

How to Prevent Tonsil Stones

Perhaps the best way to deal with tonsil stones is to prevent them from forming in the first place. You can do this by practicing good oral hygiene, according to LiveScience.com. Brushing, flossing, and visiting your dentist regularly will prevent bacteria and plaque from building up in your mouth, which can lead to the formation of tonsil stones. And if you use mouthwash, choose one that’s free of alcohol, which can encourage the growth of stones.

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SOURCES

1. Cleveland Clinic

2. UPMC