Why You Keep Getting Tonsil Stones and How to Prevent Them

Why You Keep Getting Tonsil Stones and How to Prevent Them

Why You Keep Getting Tonsil Stones and How to Prevent Them
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For people who are prone to tonsil stones, the most effective and permanent way to remove existing ones and prevent future stones from developing is to have your tonsils removed surgically (the procedure is called a tonsillectomy). But if you prefer not to go that route (after all, tonsils are an important part of the immune system, and they protect us by helping prevent harmful bacteria and viruses from entering the body through the mouth), or if your doctor doesn’t recommend surgery as an option for you, then other preventive strategies are key to keeping tonsil stones at bay. (1,2,3)

The good news is that there are measures you can take to reduce the chances that these growths will form, or at least minimize their occurrence. And if tonsil stones do start to crop up, these steps can help keep their size and number in check.

Good Oral Hygiene Is One of the Most Important Ways to Prevent Tonsil Stones

In some people, the surface of the tonsils can be very irregular and marked by pits and craters. Tonsil stones, also known as tonsilloliths or tonsilliths, form when food particles, bacteria, mucus, and saliva become trapped in these crevices, or crypts. (2,3)

RELATED: Why Tonsil Stones Form in the First Place

One of the best ways to prevent tonsil stones from forming is to practice good oral hygiene. That means you should brush your teeth regularly, as well as rinse well, especially after a meal. You should also be vigilant about flossing and brushing your tongue — all these steps help reduce the amount of bacteria in your mouth, which is a factor that can lead to tonsil stones. (1,2)

But while doctors recommend good oral care to prevent tonsil stones from forming, that doesn’t mean oral hygiene is necessarily to blame for tonsil stones showing up in the first place. The distinction is important.

Poor oral hygiene, as well as tobacco use, can increase the likelihood of tonsil stones. But in other individuals, it’s the structure of the tonsils themselves that makes them more prone to developing tonsil stones. Even if some people do take diligent care of their teeth and mouth, they will get stones because of the anatomy (the specific size and shape) of their tonsils. If the tonsils have a lot of crypts and crevices, they’re more likely to have debris trapped in them and form tonsil stones than tonsils that are smooth.

“We think they form because material enters the crypts,” says Aaron Thatcher, MD, a clinical assistant professor with the department of otolaryngology at the University of Michigan Medicine in Ann Arbor. “We don’t think it’s hygiene” he adds — because some people with meticulous oral hygiene still develop tonsil stones.

How to Prevent Tonsil Stones

Learn practical steps to prevent tonsil stones. Start your journey to a healthier mouth today!
How to Prevent Tonsil Stones

If You’re Prone to Recurring Tonsil Stones, Your Doctor May Suggest These Ways to Prevent Them

Aside from practicing good oral care to reduce bacteria in your mouth, you can also try doing the following to help prevent tonsil stones from forming.

  • Gargling “Gargling can help clean out debris and prevent buildup before stones form,” says Dr. Thatcher. Whether you use mouthwash or water doesn’t matter as much as the act of gargling to flush out germs and dislodge any small particles that may be gathering on the tonsils. Though some people say gargling with salt water or baking soda may help prevent or remove tonsil stones, Thatcher and Jennifer Setlur, MD, an otolaryngologist at Massachusetts Eye and Ear in Boston, note that there’s probably not a lot of difference between using some type of solution and just plain water. (1,2)
  • Using a water flosser to clean your mouth regularly Dislodging tonsil stones with a stream of water from a power flosser is a great way to remove tonsil stones, and it’s also an effective way to prevent them from forming in the first place, says Dr. Setlur. “You can aim the water more directly at the stones and safely rinse them out,” she says. (1,2,3)

When Your Doctor Might Recommend Surgery to Prevent Tonsil Stones

The most effective way to permanently prevent tonsil stones from forming is to get a tonsillectomy, or surgical removal of the tonsils. “Tonsillectomy is a very painful procedure, and it can involve at least two weeks of moderate or severe pain,” says Thatcher. “There is also a risk of bleeding.” (1,2)

Another procedure is laser tonsil cryptolysis, in which a laser is used to remove the tonsil crypts and resurface the troublesome areas. (4) A newer surgical option is coblation cryptolysis, a procedure that uses lower temperatures and utilizes radio frequency and saline to smooth out crevices in the tonsils, Thatcher says. (5)

As with any surgery, these procedures are not without risks. That’s why many people opt to take measures to prevent tonsil stones from forming and deal with tonsil stones when they crop up rather than go under the knife (or laser or radio waves).

But some people may be so bothered by tonsil stones symptoms, like bad breath or persistent and frequent stones, that they may opt for surgery, Thatcher says. Some people may cough up irksome stones every couple of days. (1,2) For others, it’s how the stones and symptoms affect their career or social life. If your job requires you to interact with people frequently, for example, or if you’re a dentist who needs to be in close proximity to patients, chronic bad breath can be problematic, says Thatcher.

RELATED: What’s Causing Your Bad Breath?

In some cases, frequent tonsil stones may increase your risk of tonsillitis, or infection of the tonsils, says Setlur. (1)

The key to deciding whether or not to choose tonsillectomy to prevent tonsil stones, says Thatcher, is to understand the risks and go over your options with your doctor. “Discuss the benefits and complications,” says Thatcher. “It’s very personal. Weigh and balance how deeply it affects your life.”

RELATED: Everything You Should Know About Home and Other Remedies for Tonsil Stones

Common Questions & Answers

What are tonsil stones and how do they form?
Tonsil stones, or tonsilloliths, form when food particles, bacteria, mucus, and saliva get trapped in the crevices of the tonsils.
Practicing good oral hygiene, such as regular brushing, rinsing, flossing, and brushing the tongue, can help reduce the amount of bacteria in the mouth, which is a factor that can lead to tonsil stones.
Yes, there are other preventive strategies to keep tonsil stones at bay, such as gargling to flush out debris, using a water flosser to remove and prevent stones, and maintaining good oral hygiene.
The most effective way to permanently prevent tonsil stones is to have a tonsillectomy, but it is a painful procedure with potential risks. Other surgical options include laser tonsil cryptolysis and coblation cryptolysis (both of which smooth out crevices), but these also have risks. The decision to undergo surgery should be discussed with a doctor.
Surgery may be considered if tonsil stones cause frequent symptoms, such as bad breath, or if they significantly affect a person's career or social life. Or if they increase your risk of tonsillitis. The decision should be based on weighing the benefits and complications with a doctor.
Justin Laube

Justin Laube, MD

Medical Reviewer

Justin Laube, MD, is a board-certified integrative and internal medicine physician, a teacher, and a consultant with extensive expertise in integrative health, medical education, and trauma healing.

He graduated with a bachelor's in biology from the University of Wisconsin and a medical degree from the University of Minnesota Medical School. During medical school, he completed a graduate certificate in integrative therapies and healing practices through the Earl E. Bakken Center for Spirituality & Healing. He completed his three-year residency training in internal medicine at the University of California in Los Angeles on the primary care track and a two-year fellowship in integrative East-West primary care at the UCLA Health Center for East-West Medicine.

He is currently taking a multiyear personal and professional sabbatical to explore the relationship between childhood trauma, disease, and the processes of healing. He is developing a clinical practice for patients with complex trauma, as well as for others going through significant life transitions. He is working on a book distilling the insights from his sabbatical, teaching, and leading retreats on trauma, integrative health, mindfulness, and well-being for health professionals, students, and the community.

Previously, Dr. Laube was an assistant clinical professor at the UCLA Health Center for East-West Medicine and the David Geffen School of Medicine at UCLA, where he provided primary care and integrative East-West medical consultations. As part of the faculty, he completed a medical education fellowship and received a certificate in innovation in curriculum design and evaluation. He was the fellowship director at the Center for East-West Medicine and led courses for physician fellows, residents, and medical students.

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Katherine Lee

Author

Katherine Lee is a writer and editor who specializes in health, science, and parenting content. She has written for Verywell, where she covered school-age parenting, and worked as an editor at Parenting and Working Mother magazines. She has written and edited numerous articles and essays on science, parenting, and children's health and development for What to Expect, the American Association for the Advancement of Sciences, the American Psychological Association, and Newsweek, among others

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Additional Sources
  1. Tuesday Q and A: Self-Care Steps May Help Prevent Tonsil Stones From Returning. Mayo Clinic. October 14, 2014.
  2. Tonsil Stones. Cleveland Clinic. May 11, 2021.
  3. Alfayez A, Albesher MB, Alqabasani MA. A Giant Tonsillolilth. Saudi Medical Journal. April 2018.
  4. Krespi YP, Kizhner V. Laser Tonsil Cryptolysis: In-Office 500 Cases Review. American Journal of Otolaryngology. February 8, 2013.
  5. Chang CY, Thrasher R. Coblation Cryptolysis to Treat Tonsil Stones: A Retrospective Case Series. Ear, Nose & Throat Journal. June 4, 2012.