Tonsil Stones (Tonsilloliths): Causes, Symptoms, and Treatment
A Hampshire ENT Clinics patient guide
Tonsil stones—also known as tonsilloliths—are a common cause of bad breath, throat irritation, and the sensation of something stuck at the back of the throat. While not dangerous, they can be persistent, unpleasant, and frustrating.
At Hampshire ENT Clinics, we regularly assess patients with troublesome tonsil stones and provide clear advice on effective management, from conservative care to surgery where appropriate.
What Are Tonsil Stones?
Tonsil stones are small, white or yellowish deposits that form within the natural crevices (crypts) of the tonsils. They are made up of:
Trapped food debris
Dead cells
Bacteria
Over time, this material hardens and can produce a strong, unpleasant smell due to sulphur compounds released by bacteria.
Why Do Tonsil Stones Form?
Tonsil stones are more likely in people with:
Deep or irregular tonsil crypts
Recurrent tonsillitis (even in the past)
Chronic throat inflammation
Post-nasal drip or reflux
Dry mouth
Some people are simply more prone due to their tonsil anatomy.
Common Symptoms
Patients with tonsil stones may experience:
Persistent bad breath (halitosis)
A feeling of something stuck in the throat
White debris visible on the tonsils
Throat irritation or discomfort
Metallic or unpleasant taste
Some people have large stones with minimal symptoms, while others are very sensitive to small ones.
How Are Tonsil Stones Diagnosed?
Diagnosis is usually straightforward and based on:
History of symptoms
Examination of the tonsils
Occasionally, flexible nasendoscopy if symptoms are atypical
Investigations are rarely needed.
Treatment Options
1. Conservative Management
For many patients, symptoms can be controlled with:
Good oral hygiene
Gargling with salt water or mouthwash
Treating post-nasal drip or reflux
Gentle irrigation (with care)
Self-removal is not recommended due to the risk of bleeding or infection.
2. Medical Advice
ENT review helps exclude other causes of bad breath or throat symptoms and provides reassurance.
3. Tonsillectomy
In severe, persistent cases, where tonsil stones significantly affect quality of life and conservative measures have failed, tonsillectomy may be considered. This is the only definitive cure.
When to Seek ENT Assessment
You should consider specialist review if:
Tonsil stones are recurrent and troublesome
Bad breath persists despite good oral hygiene
You have frequent throat infections
There is pain, bleeding, or asymmetry of the tonsils
Frequently Asked Questions (FAQs)
Are tonsil stones dangerous?
No. Tonsil stones are benign and not cancerous, but they can cause significant discomfort and social embarrassment.
Why do tonsil stones smell so bad?
Bacteria within the stones produce sulphur compounds, which cause the characteristic unpleasant odour.
Can mouthwash cure tonsil stones?
Mouthwash can help reduce bacteria and symptoms but does not remove deep crypts or prevent stones forming permanently.
Is bad breath always caused by tonsil stones?
No. Other causes include dental disease, gum problems, reflux, and sinus disease. ENT assessment helps clarify the cause.
Should I remove tonsil stones myself?
This is not advised. Manipulation can cause bleeding, infection, or scarring and may worsen symptoms.
Do antibiotics help?
Antibiotics are rarely helpful unless there is an active infection.
Is tonsillectomy the only permanent solution?
Yes. Removing the tonsils eliminates crypts and prevents stones forming, but surgery is reserved for severe, persistent cases.
Is tonsillectomy recommended on the NHS for tonsil stones?
Tonsillectomy for tonsil stones alone is often not routinely funded on the NHS. Private assessment may be considered if symptoms are significant.
Where can I be assessed?
Assessment is available at Hampshire ENT Clinics, with consultant-led care across Portsmouth, Winchester, Salisbury, and the wider Hampshire region.
Expert Advice for Tonsil-Related Symptoms
Tonsil stones are common and usually harmless, but persistent symptoms deserve proper assessment. A tailored approach can significantly improve comfort and confidence.
📞 If tonsil stones are affecting your quality of life, contact Hampshire ENT Clinics to arrange an expert assessment.