A Surprising Cause of Bad Breath Millions of People Have—but No One Talks About

Tonsil stones, or tonsilloliths, are small, firm, whitish deposits that may form in the deep pockets and corners of your tonsils. These lumps, which are common, rarely cause serious symptoms or complications. Home remedies can help treat and dislodge most tonsil stones, although large stones may require medical attention.

Smaller tonsil stones may not cause symptoms. If you do have tonsil stone symptoms, they may include:

• Deposits: Yellow or white lumps, usually pea-sized or smaller (though they can be larger), develop in pockets within the tonsils, called the tonsillar crypts. You may cough these deposits up.
• Bad breath: Chronic bad breath, or halitosis, is the most common symptom.
• Unpleasant taste: Along with halitosis, an unpleasant, unusual taste in your mouth can be another symptom.
• Feeling of something stuck in your throat: You may sense a foreign body in your throat, which may be slightly uncomfortable.
• Sore throat: Some people experience a painful, sore throat, either due to the tonsil stones themselves or an associated tonsil infection. This can make swallowing painful.
• Earache: Pain or pressure in the ear may occur with infections that sometimes accompany tonsil stones.  
• Difficult throat infections: Throat infections that don’t go away with antibiotics or treatment often occur with tonsil stones.

Tonsil stones occur when trapped food debris, bacteria, dead cells, or other material calcify (harden) to form solid lumps in your tonsillar crypts.

Researchers don’t fully understand why tonsil stones form. However, they’re most often associated with frequent tonsilitis, or repeated tonsil infections.

Risk Factors

Anyone can develop tonsil stones, but some factors may increase your chances. These include:

• Having certain mouth bacteria that may make tonsil stones likely
• Not brushing or flossing enough
• Frequent tonsillitis or viral infections
• Having naturally deep tonsillar crypts
• Dehydration

You may not need a formal diagnosis to recognize and manage tonsil stones. In some cases, though, a healthcare provider may make an initial diagnosis. For example, a dentist or doctor may notice a tonsil stone during an exam of your mouth or throat.

If you have imaging tests, such as an X-ray, done for other reasons, tonsil stones may also be visible on those scans.

Tonsil stones may fall out on their own, or you can encourage them to come out with these strategies:

• Gargle with a solution of 8 ounces of warm water and 1 teaspoon salt.
• Cough heavily and repeatedly to dislodge stones.
• Use a water pick or cotton swab to help gently push the stones out.

Antibiotics aren’t necessary for tonsil stones, unless you also have an infection or tonsillitis. If your tonsil stones are severe or keep coming back, your healthcare provider may recommend tonsillectomy, or surgery to remove your tonsils.

You may not be able to prevent tonsil stones completely, but taking certain steps can help. Try these approaches:

• Keep up good oral hygiene habits, including brushing twice daily, flossing daily, and cleaning your tongue.
• Get regular dental cleanings and exams.
• Drink plenty of water and stay well hydrated.
• Gargle with warm salt water or a mouth rinse after eating.
• Seek medical treatment if you have recurring tonsil stones.

Tonsil stones rarely cause serious problems. However, severe and untreated cases may have the potential to develop into the following complications:

• Tonsillitis: Frequent or recurring tonsillitis can trigger tonsil stones. In turn, tonsil stones can make tonsillitis more severe.
• Compression: Large tonsil stones may put pressure on surrounding tissues, damaging them. 
• Necrosis: Another danger of compression from large tonsil stones is that they can cut off blood supply, causing some tissues to die.

Tonsil stones are whitish deposits that can form in the back of your throat when food, bacteria, and other materials get trapped in your tonsillar crypts. You may notice bad breath, a feeling that something is stuck in your throat, and an unpleasant taste.

You can try to cough up a tonsil stone or help dislodge it with a swab or water pick. Severe cases, which are rare, may need surgical removal. To help avoid tonsil stones, maintain your oral hygiene by brushing, flossing, and visiting the dentist regularly.