How to Identify and Treat Tonsil Stones

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Consulting an ENT Specialist:

It's important to note that tonsil stones are often best handled by an Ear, Nose, and Throat (ENT) specialist. ENTs have the expertise to safely and effectively manage tonsil stones, particularly if they are recurrent or causing significant discomfort.

To begin, let’s start with a little tonsil 101:

What are tonsils? Your tonsils are masses of tissue that live on either side of the back of your throat. They are a type of lymph node and are a part of your immune system.

Why do we have tonsils? Good question! They are there to filter out bacteria, viruses and foreign objects that might otherwise slip into the lungs. They also produce antibodies and white blood cells. They may be more of a vestigial organ, however, as many experts agree that they don’t do their job very well - in fact sometimes they can be more of a bane than a blessing!

Now on to the problem at hand - the tonsil stone.

What is a tonsil stone? Tonsils have deep crevices, referred to as crypts, that accumulate debris and bacteria. Occasionally, these crypts are so deep that these particles get stuck and harden or calcify, forming a tonsil stone (aka tonsillith). This is more common in people with chronic tonsil inflammation and infection.

Are there symptoms? Not always, as many stones are too small to be much trouble. Symptoms of the larger stones include:

• Redness, swelling and irritation of the tonsils
• White, yellow or grey formations visible on the tonsils
• Bad breath - this is a common one!
• The feeling of something being stuck in your throat, or a sore throat
• Difficulty swallowing
• Ear pain - even though the stones are not touching the ear, pain can refer there due to shared nerve pathways

How can I remove a tonsil stone? For stones that are causing you discomfort, there are a couple of options:

• Saltwater gargling: often gargling with a saline solution is enough to dislodge the pesky stones.
• Energetic coughing: sometimes this motion is sufficient to shake the stones loose
• At home manual removal: IF you can identify your tonsils and see the tonsilliths, you may be able to dislodge them with a toothbrush or cotton swab. Be VERY careful! The tonsils are made of delicate tissue and it is easy to do more harm than good here.
• Antibiotics: while these will often dissolve the stones, they can have their own side effects and do not address the underlying cause of the stones, so should be used with caution
• Cryptolysis: the use of a laser or charged ions to eliminate the deep crypts that accumulate the tonsilliths
• Tonsillectomy: for people with chronic stones and/or infection, removal may be the best option. Studies have shown that people with intact tonsils are no less likely to suffer from bacterial/viral infections than those who have had them removed, so you may be gaining more than you’re losing

Can tonsil stones be prevented? Often you can keep tonsilliths at bay by committing to good dental hygiene! Brushing, flossing and using an antiseptic rinse regularly are the best ways to keep your mouth clean and healthy, and to remove bacteria that might otherwise get stuck in the tonsil crypts. However, if your oral hygiene routine is on point and tonsil stones are still an issue, removal of the tonsils may be the only way to prevent future occurrences.