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What is a Tonsillolith?

By C. Ausbrooks
Updated May 17, 2024
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Tonsillolith is the medical term for a tonsil stone, or small deposit of calcium, bacteria and mucus that forms in the crevasses of the tonsils in the back of the throat. In appearance, tonsil stones are usually white to whitish-yellow in color and irregularly shaped. They often emit a foul odor similar to that of halitosis, which is caused by bacteria in the throat. Tonsilloliths are not particularly harmful, but they may become uncomfortable and cause chronic bad breath if left untreated.

Tonsil stones occur when the bacteria trapped in the crevasses, or tonsil crypts, calcifies. While small, unnoticeable tonsilloliths are quite common, the larger calcified stones are much rarer. The problem is more common in adults than in children, particularly in smokers and individuals prone to tonsil inflammation and chronic tonsillitis.

Small tonsilloliths often cause no symptoms at all, and may only be discovered accidentally through x-rays or tests for other conditions. When symptoms are present, it usually means the tonsillolith has become large enough to protrude and irritate the throat. Common symptoms of these large tonsil stones include increased coughing, metallic taste in the mouth, choking, bad breath, painful or difficult swallowing, sore throat, swelling, infection of the tonsils and white debris visible in the back of the throat.

In many cases, a tonsillolith will require no special treatment, particularly when there are no symptoms. The stone will eventually become dislodged on its own. If the tonsil stone becomes uncomfortable, there are several home treatments used to deal with the problem. A cotton swab is sometimes used to manually dislodge the stone and salt-water gargles are also effective in dislodging the tonsillolith and relieving discomfort. If tonsilloliths become very large, painful or symptomatic, a doctor's intervention may be necessary.

Antibiotics are sometimes prescribed by doctors to treat tonsilloliths, although they cannot treat the underlying cause of the condition and may also cause side effects. As a last resort, a doctor may recommend surgery for the removal of tonsil stones. This treatment is only necessary when a stone is large or infected and cannot be removed using any other method.

If an individual is prone to forming tonsil stones, the best method of prevention is to have the tonsils completely removed through a procedure known as a tonsillectomy. During this surgery, the tonsil tissue is removed, which eliminates the chance of tonsillolith formation. Other forms of prevention include gargling with anti-bacterial mouthwash, flossing and brushing the teeth several times per day, and generally keeping the mouth and throat free of debris.

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