Understandably, the sight of these bumps growing in the back of your mouth can be a cause of concern and alarm. “People may think it’s an infection or a growth of some kind,” says Jennifer Setlur, MD, an otolaryngologist at Massachusetts Eye and Ear in Boston. Tonsil stones (also referred to as tonsilloliths or tonsilliths) are in fact deposits that can form in the crevices and pits on the surface of the tonsils (usually because of the buildup of food particles, bacteria, or other debris. And fortunately, they are usually harmless. (1,2) RELATED: All About What Causes Tonsil Stones
Chronic bad breathVisible pale-yellow or white deposits on your tonsilsPersistent sore throatSensation of a foreign object in the back of your throatTrouble swallowingPainCoughEaracheBad taste in the mouthThroat infections that are hard to treat with antibiotics
RELATED: Everything You Need to Know About a Sore Throat One of the most common ways people find out they have tonsil stones is by spotting these growths while looking in the mirror. “You may notice them when flossing your teeth,” Dr. Setlur says. But in other cases, tonsil stones are not visible to the naked eye. (1) Sometimes the formations may be too small to see with your naked eye, or they may be buried too deep in the tonsillar tissue, explains Aaron Thatcher, MD, a clinical assistant professor with the department of otolaryngology at the University of Michigan Medicine in Ann Arbor. Another common symptom of tonsil stones is bad breath, caused by the unpleasant odor in the masses themselves. “Some people may go to the doctor or dentist because of their bad breath,” says Dr. Thatcher. But, it’s worth noting that not everyone with tonsil stones experiences bad breath, or indeed, any symptom at all. Indeed, the lack of symptoms experienced by many people may mean this condition is much more prevalent (and underdiagnosed) than we realize, says Thatcher. (1) “Some can grow to be golf-ball size,” says Thatcher. When they grow to be very large, they can lead to breathing or swallowing problems. (1,2) Tonsil stones can smell unpleasant, which is why an unfortunate effect of tonsil stones can be bad breath. “The bacteria produce sulfur compounds, which can cause odor,” says Thatcher. (1) But there have been some recent studies that suggest that tonsil stones are much more common than previously thought. For example, a 2018 study analyzed almost 4,000 computed tomography (CT) scans and found that up to 30 percent of patients had tonsil stones. (4) A 2013 study analyzed 150 CT scans and found that tonsil stones were present in as many as a quarter of the scans. (5) The researchers note that the rates may be higher in the general population (since this study only involved patients who were scanned). If you suspect that you have tonsil stones, or if you see growths on your tonsils that look like they may be tonsil stones, you should see your doctor to get a diagnosis and discuss your treatment options. “Typically, people will see a primary-care physician or dentist first,” says Setlur. But you may be referred to an otolaryngologist if your doctor or dentist suggests the stones should be removed by a specialist. RELATED: What You Should Know About Preventing Tonsil Stones
Tonsils that are inflamed or look very red (especially if one side is different from the other)Pus coming from the tonsil or area around itProblems swallowingPain (especially if it’s more on one side than the other)Sore throat that lasts more than a monthBreathing problemsBleeding of the tonsilsPain in your ear
