Tonsil Stones or Tonsilloliths

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Tonsil stones, also known as tonsilloliths, are formed when debris becomes trapped in pockets (sometimes referred to as crypts) in the tonsils. Trapped debris such as dead skin cells, white blood cells, and bacteria, become saturated with saliva and calcifies forming a stone-like ball.

Individuals who have these pockets in their tonsils are said to have cryptic tonsils, fetid tonsils, or chronic caseous tonsillitis. Tonsil stones are generally harmless to your health but may occasionally cause discomfort such as a sore throat, feeling like there is something stuck in your throat, dry mouth, and bad breath (halitosis).

Tonsil Stone Symptoms

You may be looking at a tonsil stone if you cough up something that is small, is hard like a stone, and has a bad odor. Tonsil stones range from white to yellow in color.

In place on your tonsils, if you don't know what they are, they can sometimes look like pus. You may not always be able to see these stones until they are larger in size.

Halitosis associated with tonsil stones is sometimes severe since a common bacteria that contributes to the formation of tonsil stones is known to produce sulfur. Disturbing or removing a tonsil stone can sometimes release this putrid odor.


Chronic inflammation can cause the formation of crypts and fibrosis (thickening and scarring) to occur allowing an ideal location for stones to form. People who have had a tonsillectomy don't typically get tonsil stones even if some of their tonsil tissue grows back.

Age can play a factor in your risk for developing tonsil stones, with children being the least likely to develop them. Teenagers and adults are much more common than children, and it is thought that chronic inflammation from throat or ear infections can put you at higher risk.


Practicing good oral good hygiene with toothpaste and mouthwashes are not enough to get rid of the bad breath associated with tonsil stones or to prevent the development of tonsil stones. The only way to cure the halitosis is to get rid of the tonsil stones.

You should not try to remove tonsil stones with sharp objects, because you could accidentally damage tonsillar tissue and because the tonsils are in close proximity to major blood vessels.

Water irrigators (water picks) have been shown to be helpful in removing a portion of the tonsil stones. However, it is not generally accepted that the stone is completely removed, and you will likely still have any symptoms, like bad breath.

Getting rid of tonsil stones may be achieved via a procedure called CO(2) laser cryptolysis. Rarely, a tonsillectomy is needed.

While a tonsillectomy would subsequently remove any tonsil stones, surgical removal of the tonsils is not generally a compelling enough reason for this surgery. Your physician can review the benefit versus the risks associated with a tonsillectomy for tonsil stone removal.

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3 Sources
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  1. Yellamma Bai K, Vinod Kumar B. Tonsillolith: A polymicrobial biofilmMed J Armed Forces India. 2015;71(Suppl 1):S95‐S98. doi:10.1016/j.mjafi.2011.12.009

  2. Cleveland Clinic. Are troublesome tonsil stones causing your bad breath? Updated March 21, 2016.

  3. Bamgbose BO, Ruprecht A, Hellstein J, Timmons S, Qian F. The prevalence of tonsilloliths and other soft tissue calcifications in patients attending Oral and Maxillofacial Radiology Clinic of the University of Iowa. ISRN Dent. 2014;2014:839635. doi:10.1155/2014/839635