Tonsil Stones

When you first notice your tonsil stones and they’re small, you may be able to remove them with natural remedies. Bacteria and infection are the primary issues behind tonsil stones, so antibacterial and anti-inflammatory treatments may help to remove them.

Everything You Need to Know to Remove and Prevent Tonsil Stones at Home

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Tonsil stones happen when food particles, bacteria, or mucus get trapped in your tonsils. You may be able to remove them by rinsing your mouth with certain solutions or by eating certain foods.

Tonsil stones, also known as tonsilloliths, are calcified masses that can form on your palatine tonsils. There are three types of tonsils:

• palatine – on the sides of your throat
• pharyngeal – at the back of your throat
• lingual – found at the back, or base, of your tongue

What most people call their tonsils are the palatine tonsils, which you can see at the back of your mouth or top of your throat.

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Tonsil stones are caused by food particles, bacteria, and mucus getting trapped in small pockets on your tonsils. The particles and bacteria can get trapped due to improper oral hygiene or the structure of one’s tonsils. When this trapped material builds up, it can cause swelling and soreness. Many people have tonsil stones removed when they become painful. Some complications caused by tonsil stones may include:

• swelling
• feeling of an obstruction at the top of your throat
• foul smell and bad breath from the infection that increases over time
• difficulty breathing if they become big enough to block the airway
• pain when swallowing, eating, or drinking

When you first notice your tonsil stones and they’re small, you may be able to remove them with natural remedies. Bacteria and infection are the primary issues behind tonsil stones, so antibacterial and anti-inflammatory treatments may help to remove them.

• Apple cider vinegar or any vinegar. Dilute with water and gargle. Vinegar is supposed to be able to break down the stones because of its acidic content.
• Garlic.Studies have shown that garlic has antibacterial, antifungal, and antiviral properties. It may combat bacterial growth and infection.
• Cotton swab or finger. If you can see the tonsil stone, you may be able to remove it by gently pressing on the tonsil with a cotton swab. Do this very carefully as it may cause additional infection if done aggressively or if the stone’s larger. Gargle with salt water immediately after you remove a tonsil stone this way. You shouldn’t do this unless the stone is easy to reach and small.
• Coughing. Depending on the size of the stone, coughing could help to dislodge a stone in some cases.
• Essential oils. Some oils have anti-inflammatory or antibacterial properties. Examples are myrrh, thieves oil, and lemongrass. These may be able to help reduce or eliminate your tonsil stones. Dilute the essential oil in a carrier oil and place one or two drops on a toothbrush before brushing the stones. Be sure to follow the directions for each specific oil. Because of the number of bacteria, it’s recommended that you don’t use this toothbrush going forward.
• Salt water.One study shows that rinsing with salt water is an effective treatment of oral wounds.
• Yogurt. Eating yogurt that contains probiotics may be able to counteract the bacteria causing tonsil stones.
• Apples. While not a scientifically proven treatment, it is thought that the acidic content of apples may help combat the bacteria in a tonsil stone.
• Carrots. Chewing carrots helps increase saliva and the production of natural antibacterial processes. This may help reduce or eliminate your tonsil stones.
• Onions.Onions are believed to contain strong antibacterial properties. Including them in your diet may help prevent or eliminate tonsil stones.

Most of these natural remedies may only work on smaller tonsil stones or to help prevent them from occurring.

Many times, when you have tonsil stones, you won’t know it. They may clear up or be removed in the normal course of eating, drinking, and good oral hygiene. However, if they increase in size, you may notice the following symptoms:

• white or yellow flecks at the back of your throat that may grow larger over time
• foul breath
• sore throat
• trouble swallowing
• tonsil swelling
• ear pain

If your tonsil stones are large, causing you excessive pain, or are obstructing your throat or airway, you should seek medical attention. Also, if you’ve tried to remedy the stones at home and they don’t go away or keep coming back, you should see a doctor. Trying to scrape them off with a cotton swab or your finger can sometimes make the infection worse. If this happens, you should seek medical attention.

You should see a doctor if your tonsil stones persist, continue to get larger, or if they’re large. If you’re having difficulty breathing, head to the nearest emergency room. You should also see a doctor immediately if you have a combination of the following symptoms of possible tonsil cancer:

• one tonsil is larger than the other
• bloody saliva
• difficulty swallowing or speaking
• inability to tolerate eating citrus
• neck pain
• swelling or lump in the neck

Good oral hygiene can help prevent tonsil stones. Brush, floss, and rinse regularly. Many times, tonsil stones aren’t noticeable and will dislodge themselves. However, if they’re large enough for you to see, you can try to remove them at home. If these remedies don’t work, or the symptoms make your routine uncomfortable, you should make an appointment to see a doctor.

Last medically reviewed on July 9, 2018

Tonsil Stones

Tonsil stones, also called tonsilloliths, are small lumps that form in your tonsils. The main symptom of tonsil stones is bad breath. Methods for tonsil stone removal at home include using a saltwater gargle or a water pick. If the tonsil stones keep coming back or bothering you, your provider may recommend surgery.

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Overview

What are tonsil stones?

Tonsil stones are small lumps of hard material that form in the tonsils. Tonsil stones can cause bad breath though they’re usually not painful or harmful. They’re also called tonsilliths.

You can usually treat tonsil stones at home. But in some cases, you may need surgery to remove the tonsils.

What are tonsils?

The tonsils are a pair of small, oval-shaped bits of tissue at the back of your throat. They have folds, gaps and crevices called tonsillar crypts.

Tonsils are part of your immune system, which helps protect against infection. Tonsils filter bacteria and viruses that enter your body through your mouth. Removing the tonsils does not affect your immune system.

What do tonsil stones look like?

Tonsil stones look like little white or yellow pebbles on your tonsils. You may have one tonsil stone or many tonsil stones. They’re usually small, though sometimes people can get large tonsil stones.

What’s the difference between tonsil stones and tonsillitis?

Tonsillitis is a tonsil infection. Both conditions can cause bad breath and throat pain. Usually, if you have tonsillitis, you’ll also get red, inflamed tonsils along with a sore throat, fever and headache.

Who’s at risk of tonsil stones?

People who have more tonsillar crypts tend to get more tonsil stones. These are also more commonly found in people who have had a lot of tonsil infections in their life. Tonsilliths tend to happen more often in teens.

How common are tonsil stones?

Tonsil stones are common. Many people get them and may not even know they have them.

Symptoms and Causes

What causes tonsil stones?

Materials and debris can get trapped in the tonsillar crypts. The material can harden or calcify, forming stones. Trapped material could include:

• Minerals such as calcium.
• Food or debris.
• Bacteria or fungi.

What are the symptoms of tonsil stones?

Some tonsil stones don’t cause any symptoms. If you do have symptoms, they may include:

• Bad breath (halitosis).
• Cough.
• Earache.
• Sore throat.
• Bad taste in your mouth.
• Small white or yellow stones that you may spit up.

Other symptoms include:

• Difficulty swallowing.
• Feeling that something’s stuck in your throat.
• Small white patches on your tonsils.
• Throat infections that are hard to treat with antibiotics.

Diagnosis and Tests

How are tonsil stones diagnosed?

To diagnose tonsil stones, your provider may:

• Do a physical exam, looking inside your mouth and throat.
• Perform an imaging scan if they cannot see the stones easily.
• Dislodge the stones using a dental pick.

Sometimes, a healthcare provider happens to notice tonsil stones during an exam. If you don’t have any symptoms, your provider might notice a stone during a scan or X-ray for a different problem. Or your dentist may see them during a dental exam.

Management and Treatment

How are tonsil stones treated?

Usually, treatment aims to manage tonsil stone symptoms. There isn’t a specific treatment method for stones. Make sure to:

• Brush teeth regularly.
• Gargle with warm salt water.

Can I remove the tonsil stones myself?

You can try these at-home methods to get rid of tonsil stones:

• Gargling: Vigorous gargling using salt water has a few advantages. It helps your throat feel better, plus it can dislodge the tonsil stones. It may even get rid of the bad odor. This is particularly helpful when you gargle after eating to prevent food and debris from getting caught in the tonsil crypts.
• Coughing: Some people find that a strong cough can loosen stones and bring them up.
• Using an object: If gargling and coughing don’t dislodge the stones, it’s tempting to use your finger or a toothbrush to get rid of tonsil stones. But you can easily scratch your delicate tonsils. They can get infected. Instead, if you want to use an object, try a cotton swab.

Are medications used to treat tonsil stones?

Your healthcare provider will tell you if you need antibiotics to treat tonsil stones. In most cases, providers don’t use antibiotics. These medicines don’t treat the underlying cause of tonsil stones. But you may need antibiotics if you develop a bacterial infection.

Is there a way to remove tonsil stones surgically?

If tonsil stone symptoms are bothering you, talk to your provider. They may refer you to an ENT — an ear, nose and throat specialist. The ENT can discuss your surgical options with you.

Healthcare providers may recommend surgical tonsil stone removal if tonsil stones are:

• Large.
• Causing pain or other problems.
• Causing recurrent tonsil infections or sore throats.

Will I need a tonsillectomy because of tonsil stones?

In some cases, healthcare providers recommend a tonsillectomy — having your tonsils removed. This procedure may help if tonsil stones keep coming back or if they are causing repeated infections.

Prevention

How can I prevent tonsil stones?

You can take steps to prevent tonsil stones:

• Brush and floss regularly. Make sure to brush the front and back of your tongue, too.
• Quit smoking.
• Gargle with salt water after eating.
• Use a water pick to clean your mouth and help dislodge any tonsil stones.
• Stay hydrated by drinking plenty of water.

Outlook / Prognosis

What’s the outlook for people with tonsil stones?

Tonsil stones are common. They rarely cause serious health problems. Many people have tonsil stones and don’t even know they have them. You can treat them at home. If tonsil stones keep coming back, you and your healthcare provider can discuss a more permanent solution.

Living With

How do I take care of myself if I have tonsil stones?

If you have tonsil stones, these at-home remedies can help:

• A warm saltwater gargle helps with swelling and discomfort. Gargling can even help dislodge the stone. Try a gargle of 1 teaspoon salt mixed with 8 ounces of water.
• Use a cotton swab to remove a tonsil stone that’s bothering you.
• Brush and floss regularly.

When should I see a healthcare provider about tonsil stones?

Talk to your provider if:

• At-home remedies aren’t working as they should.
• Tonsil stones keep coming back or are bothering you.
• You want to discuss other treatment options.

What else should I ask my provider?

If you have tonsil stones, ask your provider:

• How can I get rid of tonsil stones at home?
• What can I do to improve my symptoms?
• What should I do if tonsil stones come back?
• Will I need surgery?

A note from Cleveland Clinic

Tonsil stones are small lumps of hardened material that form on your tonsils, in the back of your throat. They usually don’t cause serious health problems. The main sign of tonsil stones is bad breath. You can usually try to get rid of tonsil stones using at-home methods, such as saltwater gargles. If home tonsil stone removal doesn’t work, or the stones keep coming back, talk to your provider. If the issue is recurring infections, you may need a tonsillectomy to remove your tonsils.

Last reviewed by a Cleveland Clinic medical professional on 05/11/2021.

References

• Babu BB, Avinash TML,Avinash CKA, Chittaranjan B. (2013). Tonsillolith: A Panoramic Radiograph Presentation. (https://www.jcdr.net/article_fulltext.asp?id=3530) Journal of Clinical and Diagnostic Research. 7(10), 2378-2379. Accessed 11/18/2021.
• 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. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3920671/) ISRN Dentistry. 2014;2014:839635. Published 2014 Jan 22. Accessed 11/18/2021.
• HealthDirect. Tonsil Stones. (https://www.healthdirect.gov.au/tonsil-stones) Accessed 11/18/2021.
• Healthwise. Tonsil Stones: Care Instructions. (https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=ace4965#ace4969) Accessed 11/18/2021.
• Masters KG, Zezoff D, Lasrado S. Anatomy, Head and Neck, Tonsils. (https://www.ncbi.nlm.nih.gov/books/NBK539792/) [Updated 2020 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan. Accessed 11/18/2021.

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How to get rid of tonsil stones

Tonsil stones are small stones that form in the tonsils. They are usually symptomless but can cause minor issues such as sore throat and bad breath. Irrigation, gargles, and other home remedies can help manage them, but medical treatment is available if necessary.

The tonsils sit in the back of the throat and are part of the lymphatic and immune systems. Ideally, the tonsils capture and catch bacteria before they reach a person’s oral cavity.

However, the tonsils have small folds, also called crypts, allowing bacteria and food to collect. This can create small, stone-like formations that doctors call tonsil stones or tonsilloliths .

In addition to bad breath, these stones can cause a sore throat, painful swallowing, hoarseness, and inflamed, red tonsils. They can also be asymptomatic and require no treatment.

In this article, learn how to get rid of tonsil stones at home and when to contact a doctor.

A low-pressure water irrigator, such as a water flosser, can help loosen tonsil stones.

To use this, a person can stand in front of a well-lit mirror and aim the irrigator toward the tonsil stones. However, they should be careful when freeing a tonsil stone — it can fall toward the back of the throat and cause coughing. A person should not try this method on children, as it can pose a choking hazard.

People can also use an irrigator to regularly flush the tonsils to help prevent tonsil stones from forming.

Gently swishing a nonalcoholic mouthwash around the mouth can loosen tonsil stones and reduce the number of bacteria in the mouth. Reducing bacteria can help prevent tonsil stones from forming.

Gargling with warm salt water may help loosen tonsil stones. A person can prepare this by adding half a teaspoon of salt to a cup of warm water. They can gargle the liquid for several seconds and repeat if necessary.

Saltwater gargles may also help relieve a sore, scratchy throat.

Gargling with diluted apple cider vinegar (ACV) may help dislodge and break down the materials in the tonsil stones.

To make this mixture, a person can mix 1 tablespoon of apple cider vinegar with 1 cup of warm water. Gargling with this up to three times a day can help loosen stones.

However, it is important to note that the risks of using ACV include the possibility of digestive issues and tooth decay.

Some people use cotton swabs to dislodge tonsil stones from the back of the throat. This method poses some risk of injury, so a person should talk with a doctor before trying it. They should never attempt to use this on a child.

If an individual decides to remove their tonsil stones with a swab, they should dampen the swab, insert it toward the back of the throat, and gently sweep the stones away. They should also avoid touching the middle portion of the throat, as this can trigger the gag reflex.

Because many blood vessels surround the tonsils, it is essential to try only a few sweeps with the cotton swab. If bleeding occurs, people should stop right away.

Some people find that a strong cough can help dislodge a tonsil stone. This is a less invasive approach, so it may be a suitable idea to try coughing before using a cotton swab or toothbrush.

A person can use this method by first gargling with salt water to loosen the stone. They can then try a series of hard coughs.

Tonsil stones usually fall out with time. A person may cough out a stone or feel it dislodge before swallowing it.

However, if a person has a persistent stone that seems to be getting larger, they should speak with a doctor.

For an individual with frequent, irritating tonsil stones, a doctor may recommend a tonsillectomy, which involves surgically removing the tonsils.

While the surgery is common in children, both children and adults may experience significant bleeding and recovery times. Adults typically have longer recovery times than children.

A doctor usually only recommends a tonsillectomy if a person is experiencing significant pain, infection, or problematic halitosis due to their tonsil stones.

Individuals can speak with a doctor if they have questions.

If a person cannot remove a tonsil stone with the above home remedies, they should not try to force the stone out with a sharp object. This can cause bleeding and infection.

The area around the tonsils contains many blood vessels, so people should not attempt to remove tonsil stones with sharp objects, such as toothpicks, pens, or safety pins.

If a person has a tonsil stone that persists for several weeks, or if they experience symptoms relating to tonsil stones, they can contact a doctor. It is also a good idea to seek medical attention if they have removed a tonsil stone but are still experiencing pain or bad breath.

People should seek medical attention for signs of tonsil infection , such as:

• difficulty swallowing
• enlarged tonsils
• pain that radiates to the ears
• pus or white discharge from the tonsils
• bleeding in the tonsil area
• sleep-disordered breathing

A doctor can decide on the best course of action for a child with tonsil stones or inflamed tonsils. Trying to dislodge a tonsil stone in a child can cause choking.

People may require antibiotics and rest to treat an active infection.

While tonsil stones are usually a minor irritation, they sometimes lead to infection and discomfort. People can often resolve them at home with strategies such as salt water gargling, coughing, and using a cotton swab or toothbrush.

If tonsil stones persist or cause painful symptoms, a person should contact a doctor.

Last medically reviewed on July 29, 2022

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