What Are Tonsil Stones? What Causes Tonsil Stones? And Who Gets Tonsil Stones?
Tonsil stones are growths that can form, harden, and grow on and inside the tonsils, which are the oval-shaped pads of tissue that sit on either side of the back of the mouth. These stones are not a sign of illness or disease and they do not cause other negative outcomes for your health.
But they can cause symptoms such as bad breath and discomfort in the back of the throat. They can also be a nuisance, because they may repeatedly grow back after they’re removed. (1,2)
How and Why Tonsil Stones Form
In some people, the surface of the tonsils is more irregular than smooth, with crevices and pockets that are deep enough to trap food particles, bacteria, saliva, and other debris. “Food, plaque, cellular debris such as skin cells and the lining of the mouth all collect in the pits and crevices,” says Jennifer Setlur, MD, an otolaryngologist at Massachusetts Eye and Ear, in Boston. Over time, these materials become impacted, and eventually they develop into stones.
Tonsil stones are usually about gravel-size, but they can also be quite small — sometimes even too tiny to be seen with the naked eye. They can also potentially grow to be even as large as a golf ball or bigger, especially if they go unchecked. They’re usually soft but they can harden, and they are light yellowish or white in color. Unfortunately, they often smell extremely unpleasant because of the bacteria that is a component of tonsil stones. (One of the most commonly noticed symptoms of tonsil stones is bad breath.)
Your Tonsils’ Structure Determines Your Risk of Developing Tonsil Stones
There’s a common misconception that having tonsil stones means you have poor oral hygiene. But the fact is that people who brush and are vigilant about oral hygiene can also be prone to developing tonsil stones. What does determine who is and is not prone to developing these growths is usually the presence of crypts on the surface of the tonsils. “It has to do with the structure of tonsils,” says Aaron Thatcher, MD, an assistant professor with the University of Michigan’s Department of Otolaryngology–Head and Neck Surgery in Ann Arbor. The crypts in the tonsils allow material like food and debris to build up and eventually turn into tonsil stones.
It should be noted, though, that poor oral hygiene can indeed contribute to the development of tonsil stones, and brushing, flossing, and gargling water in the back of your throat regularly are important ways to help prevent the problem.
An individual’s propensity to develop tonsil stones may change over time, meaning that someone who once regularly got tonsilliths may get them less frequently, or vice versa. That’s because tonsils can develop more crypts as we reach adolescence and into young adulthood, and then become smaller and less prone to tonsil stones as we age, Dr. Setlur explains.
The Most Common Symptoms of Tonsil Stones Include Bad Breath and Discomfort in the Back of the Throat
If you have tonsil stones, you may experience common symptoms, such as bad breath and discomfort, and you may also see the stones on your tonsils. The most common symptoms of tonsil stones are what usually sends people to the doctor to inquire about what end up being tonsil stones, says Dr. Thatcher. “Some patients might see spots in their mouth and some might have chronic sore throat or pain,” he says. “Others may see a doctor or dentist for bad breath.”
It’s also possible that you won’t experience any symptoms at all. “Tonsil stones may be very common,” says Thatcher. “But in some people, they may be small and buried so deep that they might not see them.” This is one reason why doctors think the condition is underestimated, Thatcher notes.
Some typical symptoms of tonsil stones include:
- Persistent bad breath
- Pale yellow or white gravel-size bumps on your tonsils
- Sore throat
- Discomfort and a sensation of something being stuck in the back of your throat
- Problems swallowing
If you see swelling, inflammation, or bleeding in your tonsils, or any asymmetry (if one side is bigger, looks different from the other, or is more painful), or you have trouble swallowing or have a sore throat that lasts for more than a month, be sure to see your doctor, because these symptoms may be signs of a more serious illness.