Name some of the most common causes of bad breath (known as halitosis), and you’ll probably think of poor dental hygiene, eating garlic or onions or having a chronically dry mouth.
But what about tonsil stones?
Your tonsils are located on either side of the back of your throat. They are covered with mucous membranes and have multiple nooks and crannies called crypts that can trap bacteria, dead cells and food particles. Tonsil stones — also known as tonsilloliths or tonsilliths — develop when the trapped materials bind together and form hard calcium deposits that build up on the tonsils.
“Anyone can get tonsil stones, but they are most common in people who have frequent tonsil infections or long-term inflammation of the tonsils,” says Michael Van Buskirk, MD, a family medicine physician at Scripps Clinic Encinitas.
“Though they are rarely a serious problem, tonsil stones can cause bad breath and other unpleasant or painful symptoms that can require medical treatment,” he says.
Most tonsil stones are very small, even as small as a grain of rice, and may not be visible to the naked eye. You may have a single tonsil stone or several.
Visible tonsil stones may look like a whitish lump on your tonsil.
Some tonsil stones don’t cause any symptoms. If you have symptoms, they may include:
- Bad breath — Tonsil stones can have a foul odor, making severe bad breath one of the main symptoms.
- Sore throat or cough — Sometimes, tonsil stones can irritate the throat and cause a sore throat or cough. A tonsil infection also may lead to throat pain.
- Difficulty swallowing — Swallowing may be affected depending on the size or location of a tonsil stone.
- Inflamed tonsil — A tonsil stone can irritate the tonsil and cause it to swell or become infected.
- Ear pain — A tonsil stone located near the nerve that leads into the ear may cause ear pain.
Tonsil stones that don’t cause problems do not need treatment, but if you have bad breath or other symptoms, you might want to treat them. Gargling vigorously with half a teaspoon of salt dissolved in a cup of warm water can help loosen and remove tonsil stones as well as eliminate the unpleasant odor that causes bad breath.
“Do not try to scrape off or manually remove tonsil stones,” says Dr. Van Buskirk. “Your tonsil tissue is very sensitive and easily damaged, and you could cause bleeding or infection. If tonsil stones are bothering you, call your doctor to get them checked out.”
If tonsil stones can’t be easily seen, you may have X-rays or imaging to help diagnose them.
Your doctor may prescribe antibiotics to help reduce the bacteria that contribute to tonsil stones. However, antibiotics should not be used long-term, and they will not prevent tonsil stones from coming back.
Treatment may include surgical removal of the stones; in some cases, a laser may be used to eliminate the crypts where the stones form. If you frequently have problems with your tonsils. your doctor may recommend a tonsillectomy to remove them.
You can take several steps at home to help prevent tonsil stones. Brush and floss your teeth regularly to remove food particles and discourage bacteria from building up and getting lodged in your tonsil crypts. Drink plenty of water. Finally, gargling with salt water to help rinse your mouth and throat to remove debris.
“When tonsil stones become a recurring problem, a tonsillectomy may be the best course of action,” says Van Buskirk. “It is usually a simple outpatient procedure that takes less than an hour, and without your tonsils, you can’t get tonsil stones.”
If you have bad breath and believe tonsil stones may be the cause, make an appointment with your doctor. Even if tonsil stones are not the culprit, your doctor can help you determine what is.