Trouble With Tonsil Stones and Bad Breath

First off, how do you find your tonsils? Just look into a mirror (or camera phone), open your mouth, and say "ah" like you're at the doctor's office. You should have a great view of the back of your throat, with two glands called the tonsils sitting on either side. 

Surprisingly, the tonsils are part of your body's defense system. They assist the immune system by blocking unwanted viruses and bacteria from entering your body through your mouth and throat. The same layer of mucous that protects your mouth covers your tonsils to help them do their job.

Around the tonsils are pits and crypts (small crevices) that sometimes get clogged with bacteria, food, minerals (like calcium) or other material. If this material gets stuck and hardens or calcifies, it can turn into a tonsil stone, also known as a tonsillolith,

A tonsil stone is small and round, usually measuring no more than 3mm in diameter, with an off-white or yellow color. You might be able to see tonsil stones when you look at the back of your throat, or you may feel them in your mouth when they’re expelled from the tonsils. You might just have one, or you could have several.  

Some people are more likely to develop tonsil stones than others. If you have frequent tonsil infections (tonsillitis), dehydration, or large tonsillar crypts, you’re at greater risk. Tonsil stones are also more common in teenagers.

Bad breath, also called halitosis, is the most common complaint of those with tonsil stones.

Tonsil stones smell bad for some, but others don't notice any symptoms. Some people may never get a tonsil stone, while others may get several a week without issue. In most cases, they aren't of concern to your health.

Remember that just because you have bad breath doesn't mean you have tonsil stones. There are many causes of bad breath, and tonsil stones are among the less likely reasons.

Tonsil stones can be irritating if you can feel them, but they’re usually harmless. However, for some people, tonsil stones can lead to a sore throat, swelling, or even difficulty swallowing.

The stones vary in size, from barely noticeable to several centimeters large. The smaller they are, the less likely they are to cause problems. Doctors even removed a tonsil stone that was 3.1 x 2.3 cm large from a 45-year-old man. It's highly unlikely that yours are anywhere close to as large, so don't worry!

If you're experiencing any severe symptoms, be sure to check in with a doctor.

We know that tonsil stones can be annoying, but remember, they’re usually harmless and they don't require treatment in most cases. If you do want to get rid of your tonsil stones, though, we’ve got your back! Try: 

• Gargling with warm salt water. This can help with discomfort as well as dislodging the stones.
• Aiming at a water flosser at the tonsil stones to dislodge them. 
• Coughing vigorously to try and force the stones out.
• Using a clean cotton swab to push the stone out. 

If your tonsils are sore, swollen or infected, it’s best to stick to salt water and avoid touching your tonsils at all, even with a water flosser. Instead, see your doctor to check for tonsillitis and treat any infection first.

Use mouthwash to help manage bad breath, and follow these tips to prevent tonsil stones in future:

• Brush your teeth twice daily and floss once to minimize bacteria.
• Avoid smoking and other tobacco products.
• Stay hydrated.

Unfortunately, tonsil stones will not go away on their own. If your tonsil stones are bothering you and you can’t remove them yourself, your dentist or doctor can remove them for you. For larger tonsil stones, your doctor may recommend surgical removal. 

The only way to permanently stop tonsil stones is removal of the tonsils themselves. Your doctor would likely only recommend this if your tonsil stones were large, persistent, painful, or affecting your ability to eat, speak or breathe. 

Surgery to remove the tonsils is called a tonsillectomy. It is performed under general anesthetic, and involves burning or cutting away the tonsil tissue and removing it through the mouth. 

A tonsillectomy is a very short, routine operation that typically only requires an overnight stay in hospital. Complications are uncommon, but they might include bleeding and infection. You won’t need stitches to close any wounds, so you won’t need to go back to have your stitches removed like you might after other surgeries.

Recovery from a tonsillectomy is fairly quick, and you should be back to normal activities in around one week. You’re likely to have a sore throat and some discomfort in the days afterwards, but this can usually be managed easily with over-the-counter painkillers. You will be advised to eat soft foods while you recover. 

Take heart in the fact that tonsil stones are usually harmless and often require no treatment. But if your tonsil stones are causing extreme discomfort, difficulty breathing or swallowing, or any other symptoms, be sure to talk to a doctor. You can minimize your chances of getting tonsil stones with easy steps like practicing proper dental hygiene, gargling with a salt-water rinse, and avoiding tobacco products. Luckily, these tips will also help out with any bad breath you might be experiencing.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.