This blog was originally published on 9/17/2010 and was updated on 10/23/2020

They are common and embarrassing. Tonsil stones, a familiar condition among thousands of Americans, can lead to chronic bad breath, tonsil pain and even swallowing problems.

We’ve got all the information you need to know on what tonsil stones are, how to get rid of tonsil stones and how to prevent them. We also provide the latest treatments to help you.

What Are Tonsil Stones?

Tonsils stones (or tonsilliths) are small clumps of whitish, odorous debris that collect in the surface crevices (crypts) of the tonsils. You can often see them in the mirror, looking like white “dots” in your tonsils.

Many people think they are food particles, but they are primarily made up of shed epithelium. 

Why Do People Get Tonsil Stones?

The epithelium is the surface lining of the tonsil, and it will shed, much like skin sheds. As a result, it collects in the crypts of the tonsils. 

This happens because the tonsils have irregular surfaces. Some of these craters and crypts are so deep that bacteria, food particles and mucus may also be  caught in them (in addition to the epithelium). 

These substances are “compacted” when pressed into the crypts, hardening into tonsil stones.

The good news is that while they are bothersome, they are not serious. 

Are Tonsil Stones Normal?

While they are not necessarily normal, they are common. While the shedding of the epithelium is a part of the tonsil’s natural process, the particles getting caught in the crypts is not. 

Because fewer and fewer people are getting tonsillectomies, incidences of tonsil stones are increasing. 

While tonsil stones are not serious, there are a few things you should keep your eye on.

If your tonsils are extremely red, bleed easily, or if you have tonsil pain that extends all the way to your ear, this could be an indicator of a deeper and possibly more serious problem. If you have these symptoms, we recommend you schedule an appointment with us as soon as possible. 

What Are the Symptoms of Tonsil Stones?

The most obvious symptom is a small, whitish object on the tonsils. Other symptoms include:

  • Chronic bad breath
  • Difficulty swallowing
  • Low-grade sore throat

In more severe cases, bacteria harbored in the area may lead to a throat infection. 

Do Tonsil Stones Go Away on Their Own?

When these stones fill the crypt areas, they may be coughed out or sometimes removed with pressure from a Qtip or your finger. After removal, they will generally recollect within weeks to months.

So if they are noticed infrequently and are only mildly symptomatic, they do not require treatment. However, for some patients, tonsil stones can be a weekly or even daily annoyance, and these patients often seek remedies.

What Is the Best Way to Get Rid of Tonsil Stones?

The only permanent solution for tonsil stone removal is taking out the tonsils (tonsillectomy). A tonsillectomy is generally performed as an outpatient procedure under general anesthesia and the postoperative course is often quite painful. Sometimes it may require as much as a week out of work or school.

One alternative to complete tonsillectomy is cryptolysis or laser ablation of the tonsils. 

At Raleigh Capitol ENT, this procedure is performed in our office under local anesthesia with the use of the carbon dioxide laser. The laser is used to remove enough of the tonsil to open up the crypts and therefore prevent re-accumulation of the tonsilliths.

Generally, there is less pain than that associated with complete tonsillectomy and some patients may be able to return to work the next day.

Not all patients may be appropriate for this procedure based on their anatomy as well as the activity of their gag reflex.

How to Prevent Tonsil Stones

Good oral hygiene goes a long way to prevent tonsil stones from forming. It’s important to brush your tongue every time you brush your teeth, and we recommend brushing your teeth after meals, in the morning and before bed. Daily flossing will also help.

We suggest using mouthwash regularly as long as that mouthwash does NOT have an alcohol base.

While this may not prevent tonsil stones completely it will reduce your likelihood of developing them. 

Raleigh Capitol Ear, Nose and Throat Is Here to Help You Get Rid of Tonsil Stones

We understand the annoyance that tonsil stones can cause. That’s why we offer extensive services from the convenience of our office

We’ve been the leading ear nose and throat doctors in the Raleigh and Triangle area, offering extensive outpatient services, most of which are performed in our practice. 

We’ve been caring for adults and children, offering expertise, compassion and important information you need to remain healthy. 

Having problems with tonsil stones? Don’t put up with this inconvenience. We encourage you to schedule an appointment today. 


Raleigh Capitol Ear, Nose, and Throat is the area's premier physician-owned ENT practice with seven convenient locations throughout Wake County. Our board-certified physicians have extensive experience in treating both common and complex cases to help adults and children alike. For more information or to schedule an appointment, contact us.