Tonsil Stones (Tonsilloliths): Treatment and Prevention

If someone asked you where stones can form in the human body, you might immediately think of the kidneys. But, the kidneys aren't the only place. The tonsils are another location where hard, and sometimes, painful stones may develop in certain people.

What are tonsils?

Your tonsils are gland-like structures in the back of your throat. You have one located in a pocket on each side. Tonsils are made of tissue that contains lymphocytes -- cells in your body that prevent and fight infections. It is believed that the tonsils play a role in the immune system and are meant to function like nets, trapping incoming bacteria and virus particles that are passing through your throat.

Most medical experts agree that the tonsils often do not perform their job well. In many instances, they become more of a medical hindrance than a help. It may be that tonsils evolved in an environment where humans were not exposed to as many germs as we encounter today as a result of living in areas with relatively high populations. Evidence suggests that people who have had their tonsils removed are no more likely to suffer from bacterial or viral infections than people with intact tonsils.

What causes tonsil stones (tonsilloliths)?

Your tonsils are filled with nooks and crannies where bacteria and other materials, including dead cells and mucous, can become trapped. When this occurs, the debris can become concentrated in white formations that occur in the pockets.

Tonsil stones, or tonsilloliths, are formed when this trapped debris hardens, or calcifies. This tends to occur most often in people who suffer from chronic inflammation in their tonsils or repeated bouts of tonsillitis.

While many people have small tonsilloliths that develop in their tonsils, it is quite rare to have a large and solidified tonsil stone.

What are the symptoms of tonsil stones (tonsilloliths)?

Many small tonsil stones do not cause any noticeable symptoms. Even when they are large, some tonsil stones are only discovered incidentally on X-rays or CT scans. Some larger tonsilloliths, however, may have multiple symptoms:

• Bad breath. One of the prime indicators of a tonsil stone is exceedingly bad breath, or halitosis, that accompanies a tonsil infection.

One study of patients with a form of chronic tonsillitis used a special test to see if volatile sulfur compounds were contained in the subjects' breath. The presence of these foul-smelling compounds provides objective evidence of bad breath. The researchers found that 75% of the people who had abnormally high concentrations of these compounds also had tonsilloliths, or tonsil stones. Other researchers have suggested that tonsil stones be considered in situations when the cause of bad breath is in question.

• Sore throat. When a tonsil stone and tonsillitis occur together, it can be difficult to determine whether the pain in your throat is caused by your infection or the tonsil stone. The presence of a tonsil stone itself, though, may cause you to feel pain or discomfort in the area where it is lodged.
• White debris. Some tonsil stones are visible in the back of the throat as a lump of solid white material. This is not always the case. Often they are hidden in the folds of the tonsils. In these instances, they may only be detectable with the help of non-invasive scanning techniques, such as CT scans or magnetic resonance imaging.
• Difficulty swallowing. Depending on the location or size of the tonsil stone, it may be difficult or painful to swallow foods or liquids.
• Ear pain. Tonsil stones can develop anywhere in the tonsil. Because of shared nerve pathways, they may cause a person to feel referred pain in the ear, even though the stone itself is not touching the ear.
• Tonsil swelling. When collected debris hardens and a tonsil stone forms, inflammation from infection (if present) and the tonsil stone itself may cause a tonsil to swell or become larger.