5th August, 20204 min read

What are tonsil stones — and what causes them?

Medical reviewer:
Healthily's medical team
Healthily's medical team
Alex Bussey
Alex Bussey
Last reviewed: 06/08/2020
Medically reviewed

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If you’ve noticed small white or yellow lumps at the back of your throat, you may have tonsil stones.

Your tonsils are a pair of organs found at the back of your throat. They contain cells that help fight infections.

Tonsil stones (or tonsilloliths) are lumps of hard material made up of mucus and bacteria that build up in the tonsils.

They're a common problem (around 10% of people get them in their lifetime), but they’re thought to be more common in young adults.

What are the symptoms of tonsil stones?

Tonsil stones don’t always cause symptoms, which is why some people don't notice them until they have a scan, X-ray or dental examination.

But tonsil stones can sometimes cause discomfort and pain. You may feel like there’s something stuck in the back of your throat, or notice that it’s hard to swallow. Other common symptoms include:

  • a sore throat
  • a cough
  • an earache
  • a foul taste in your mouth

Because tonsil stones often contain bits of mucus and bacteria, they can also cause bad breath (halitosis).

Most are harmless and you won’t need to have them removed unless they’re causing you significant problems.

Man coughing

How do tonsil stones form?

Your tonsils are a pair of organs found at the back of your throat and it’s thought that they support your immune system.

Your tonsils contain folds, known as tonsillar crypts. If bits of food or bacteria get stuck in these folds, they can harden and form foul-smelling white or yellow tonsil stones.

Tonsil stones are normally 1 to 2mm wide, but they can be as large as 1cm. Some studies have recorded so-called “giant tonsilloliths” that measure more than 4cm at their widest point.

How are tonsil stones treated?

Tonsil stones are normally managed at home. Experts recommend gargling with mouthwash or a saltwater solution to dislodge the stones without damaging the tissue around them.

You can also try to remove them using a cotton swab or the back of your toothbrush. Be careful if you do decide to do this — damaging your tonsils can increase your risk of infection.

Large, difficult or painful tonsil stones can be removed by a doctor.

White spots on tonsils: Causes and treatments

When should I see a doctor about tonsil stones?

Most tonsil stones can be treated at home. However you should visit a doctor if they’re causing you a lot of pain or discomfort, or if you have any concerns or feel generally unwell.

You should also seek medical attention immediately if you develop any of the following symptoms:

  • severe throat pain that quickly gets worse
  • difficulty opening your mouth
  • pain when opening your mouth
  • difficulty swallowing
  • drooling or struggling to swallow saliva
  • swelling in your face and neck, or inside your mouth or throat
  • fever
  • headache
  • difficulty talking or breathing
  • swollen glands near your jaw or in your neck

These may be symptoms of a peritonsillar abscess, which is a collection of pus or infected fluid in your tonsil(s). This condition is normally linked to tonsillitis.

Speak to a doctor if you’re worried about any symptoms you have.

You can also use our Self-Assessment Tool for more information.

Key points:

  • Tonsil stones (or tonsilloliths) are hard lumps made up of mucus and bacteria that build up in the tonsils
  • Around 10% of people will develop them at some point in their lives
  • Most are harmless — you won’t need to have them removed unless they’re causing you significant problems
  • Most tonsil stones can be treated at home
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