Tonsil Stones: Signs and Symptoms

Tonsil stones, also known as tonsilloliths, are small, hard lumps of food, bacteria, and other particles trapped in the small pockets or folds of your tonsils (called tonsil crypts). Tonsil stones often do not cause symptoms. However, some people may experience bad breath (halitosis), sore throat, or a feeling that something is stuck in their throat.

Tonsil stones may get larger or move around over time but often pass out of the body without treatment. Having good oral hygiene can help prevent tonsil stones from forming.

Visible debris in the tonsils is a common sign of tonsil stones. The stones often appear as white or yellowish lumps or spots in the back of your throat.

You can sometimes see them with the naked eye, but they might be hidden within the tonsil crypts. In that case, a healthcare provider can see the stones with an X-ray or computed tomography (CT) scan.

You may find yourself spitting out small white or yellow stones as your body attempts to remove the tonsil stones. They can vary widely in size, but tonsil stones larger than 5 millimeters (mm) are rare.

One of the most noticeable symptoms of tonsil stones is bad breath.

The bacteria and debris that form the stones can produce sulfur compounds that cause a foul odor. This can lead to bad breath that doesn’t go away even with regular brushing and mouthwash. You may also experience a bad taste in your mouth.

Larger tonsil stones can also make swallowing difficult. You might feel like there’s something stuck in your throat. You might even feel sudden pain shooting through your throat or ear.

This sudden pain may result from irritation to the glossopharyngeal nerve (one of the four cranial nerves), which runs from the brain stem through the tonsils and along your ears.

Dysphagia (trouble swallowing) can be dangerous and affect your ability to eat, leading to choking and malnutrition. Speak with your healthcare provider right away if you have trouble swallowing.

Larger tonsil stones can cause irritation and inflammation in your throat. This can lead to a sore throat, which may be persistent or come and go. Your voice also may become hoarse.

Tonsil stones may trigger your cough reflex when they irritate your throat. If you feel you have something stuck in your throat, your body may automatically cough to clear it out. Sometimes, coughing can result in spitting up small tonsil stones that appear white.

Aside from possible shooting pains through your ear, you might experience a consistent earache with tonsil stones. This is because the tonsils and the ears share some of the same nerve pathways.

Tonsil stones are not contagious. However, bacteria within a tonsil stone can lead to a throat infection that may be contagious. A sore throat may feel scratchy, sore, or swollen. You may also see white patches on your tonsils. 

While tonsil stones are usually harmless, there are times when you should seek medical advice.

If you experience severe pain, difficulty swallowing, or persistent symptoms that don’t improve with home care, call your healthcare provider. If you have any signs of infection, such as fever or swollen glands, seek treatment right away.

Tonsil stones are a common condition where debris and bacteria build up in your mouth, causing small white or yellow lumps on your tonsils. They are usually harmless and may cause no symptoms before going away. Some people may experience bad breath, a sore throat, and ear pain from tonsil stones.

Consult your healthcare provider if symptoms persist without improvement. Consistently brushing, flossing, and rinsing your mouth out twice a day can help prevent a buildup of bacteria and debris in your mouth.