Tonsil stones

Cufflinks are small stones made up of bacterial deposits, food debris and dead cells. They get stuck in the recesses of the tonsils, where they can harden and form visible or palpable lumps. Tonsil stones are usually not dangerous, but they can cause discomfort, difficulty swallowing and bad breath.

"Tonsil stones are not dangerous in themselves, but if they cause symptoms such as bad breath or difficulty swallowing, they should be examined. With proper hygiene, it is often possible to reduce the symptoms."
- Erik, dentist at Dentme

What are tonsil stones?

Tonsil stones (tonsilloliths) are small, hardened deposits that form in the natural crypts - deep grooves - of the tonsils. They can be white or yellowish and vary in size from a grain of rice to several millimeters. Sometimes they are visible, but often they are only noticeable through symptoms such as bad breath or the feeling of something stuck in the throat.

Why do tonsil stones form?

Tonsil stones form when bacteria, mucus, food debris and dead cells accumulate in the crypts of the tonsils and solidify. The risk increases if you have:

- Large or deep tonsils

- Recurrent throat infections

- Dry mouth or thick mucus

- Poor oral hygiene

- Smoking or snoring

People with a history of tonsillitis or inflamed tonsils often have more pits where material can get stuck.

Common symptoms

Most tonsil stones do not cause any symptoms. But larger or repeated stones can cause:

- Bad breath (halitosis)

- Difficulty swallowing or discomfort in the throat

- Sore throat or an irritated feeling

- Feeling that something is stuck

- White or yellow dots on the tonsils

- Sometimes earache (due to nerve reflexes)

Differential diagnosis - what else could it be?

Tonsil stones can sometimes be mistaken for:

- strep throat - bacterial infection with pus-filled spots on the tonsils

- Leukoplakia - white changes on the mucosa that cannot be scraped off

- Mouth fungus - white coating that often sits on the tongue and cheeks

This is why a professional assessment is important.

When should you seek medical help?

Contact your doctor or dentist if:

- The stones cause prolonged discomfort or difficulty in swallowing

- You get recurrent stones that do not come loose

- You have signs of infection or severe bad breath

- You are unsure if they are really tonsil stones

Treatment of tonsil stones

Mild cases

Many stones come loose by themselves. You can make this easier by:

- Gargle with lukewarm salt water

- Drink plenty of water

- Cough gently

- Avoid picking at the almonds

Medical treatment

If you have problems, you can see a doctor or dentist:

- Remove the stones manually with special instruments

- Burning away the crypts with lasers

- Recommend tonsillectomy (surgery) for repeated problems

However, tonsillectomy is rare and only used in more severe cases.

Preventive measures

You can reduce your risk of getting tonsil stones by

- Brush your teeth thoroughly twice a day

- Flossing or interdental brushing daily

- Cleaning the tongue withtongue depressor

- Use antibacterial mouthwash if necessary

- Drinking water regularly

- Avoid smoking and sugar

Frequently asked questions about tonsil stones

Are tonsil stones dangerous?
No, they are not dangerous in themselves but can cause discomfort. Contact your healthcare provider if you experience recurring symptoms.

How to remove tonsil stones at home?
Gargle with salt water, drink plenty of water and let the stones loosen naturally. Do not use tools in your throat yourself.

Why do tonsil stones smell bad?
They contain sulfur-producing bacteria that cause bad breath.

Can tonsil stones go away by themselves?
Yes, many come off through swallowing, coughing or at meals.

Are tonsil stones contagious?
No, they are not. They are formed by the body's own bacteria and are not contagious.

Can children get tonsil stones?
Yes, but it is more common in adults. Children with large tonsils or throat infections can also be affected.

Can tonsil stones affect the voice?
In rare cases, larger stones may cause a grating sensation or temporarily affect the voice.

When is surgery needed?
Only in case of repeated infections or severe problems that cannot be managed by other means.

Sources used by Dentme:

NHS UK - Tonsillitis and tonsil stoneshttps://www.nhs.uk/conditions/tonsillitis/

1177 Vårdguiden - Sore throat and tonsil problemshttps://www.1177.se/behandling--hjalpmedel/behandling-med-lakemedel/antibiotika/halsfluss/

Tandläkartidningen - Tonsils and oral diseases https://www.tandlakartidningen.se/

1177 Vårdguiden - Questions and answers about tonsils: https://www.1177.se/fragor--svar/nationellt/sjukdomar--besvar/varfor-har-jag-hal-pa-halsmandlarna/

1177 Vårdguiden - Surgery of tonsils: https://www.1177.se/undersokning-behandling/operationer/operationer-av-ogon-oron-nasa-och-hals/operation-av-halsmandlar/

1177 Vårdguiden - Bad breath: https://www.1177.se/sjukdomar--besvar/mun-och-tander/mun-lappar-och-tunga/dalig-andedrakt/