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Bad Breath? It Could Be Caused by Tonsil Stones

You brush your teeth twice a day – sometimes even three – floss and drink plenty of water. You’ve even cut out coffee, but you still can’t seem to curb your bad breath. What gives?

If you still have your tonsils, you may want to grab a mirror and take a closer look. Those two round things in the back of your throat may be to blame.  

Tonsils and bad breath

Your tonsils are part of your body’s immune system that help stop germs from entering your body through your mouth and nose. They do this by producing white blood cells and antibodies. Unfortunately, this process can sometimes lead to tonsil stones, a common cause of bad breath. 

Kidney stones and bladder stones are two problems that you’ve probably heard of, but you may be surprised to learn that stones can occur in several parts of the human body — even your tonsils.

Read on to learn more about tonsil stones, what causes them, their symptoms and how to treat them, both home remedies and medical treatment.

What are tonsil stones?

The food you eat and other things you take in can become trapped in your throat and become stuck on your tonsils. 

Like sponges, your tonsils have craters and grooves, called tonsil crypts, that can trap food, bacteria, viruses and other particles. As they clump together, they can begin to form into tonsil stones.

Tonsil stones, also known as tonsilloliths, begin as soft, white clumps that might not be visible by just looking in the mirror and saying “ah.” Over time, however, these stones can harden and calcify into stones — either looking like white or yellowish spots on your tonsils. In rare cases, they can grow to the size of a golf ball or larger.

Anyone can develop tonsil stones, but recurring strep throat (tonsillitis), viral infections or sinus issues, poor oral hygiene, and the shape and size of your tonsils may put you at greater risk for developing them. 

What are the symptoms of tonsil stones?

You may not notice you have tonsil stones until a dental check-up. However, some people may experience unpleasant symptoms. 

“Often, these tonsil stones are small and harmless. For others they can cause noticeable problems, such as throat irritation, difficulty swallowing, white or yellow looking stones on your tonsils and bad breath,” said Bruce Stewart, MD, an ear, nose and throat specialist at Banner Health in Tucson, AZ. “When you disturb or remove a tonsil stone, it can often produce a foul smell and bad taste in your mouth.”

Bad breath and throat irritation can also be a sign of tonsillitis or strep throat. The big difference is that tonsillitis is caused by a virus or bacteria and generally comes with a fever, headache, swollen lymph nodes and inflamed, red tonsils.

Other symptoms of tonsil stones include ear pain, an ongoing cough and swollen tonsils. 

How are tonsil stones diagnosed and treated?

“Typically, the diagnosis of tonsil stones is usually obvious, based on your health history and a physical exam of the tonsils,” Dr. Stewart said. “On rare occasions X-rays (CT or plain films) may be needed to identify ‘hidden’ tonsil stones.”

Tonsil stones that aren’t causing you problems don’t need treatment. If your tonsil stones are causing you problems, however, such as bad breath, your health care provider or an ear, nose and throat specialist may recommend at-home measures to clear them out.  

“Tonsil stones can often be removed. Gargle with warm salt water or gently pressing on the tonsil with a clean cotton swab,” Dr. Stewart said.

You may also use a Waterpik or water irrigator to flush out food and debris, but Dr. Stewart cautioned against scraping or brushing your tonsils. 

“This is typically too harsh and may cause pain and/or bleeding,” he said.

Your provider may prescribe antibiotics if a secondary tonsil infection is present, but antibiotics won’t prevent tonsil stones from coming back.

Will I need to have my tonsils removed? 

If you’re getting tonsil stones often and they are causing discomfort, your provider may recommend a tonsillectomy to remove your tonsils completely or laser treatments, like laser cryptolysis and coblation cryptolysis, to smooth the surface of the tonsils. 

“While a tonsillectomy is the most effective way to prevent tonsil stones from forming, it is a painful surgery and should only be considered if your tonsil stones continue to be a problem for you or your stones are infected or painful,” Dr. Stewart said. 

Can tonsil stones be prevented?

The best way to help prevent tonsil stones from forming again is by practicing good oral hygiene: brush and floss your teeth. 

Brush your teeth regularly (twice a day and after meals). Floss your teeth daily to remove bacteria in your mouth. Gargle daily with an antiseptic (preferably one without alcohol) or saltwater and drink plenty of water. 

In addition, kicking your tobacco habit can also help, as smoking and other tobacco products can increase your risk for developing tonsil stones.


Tonsil stones are a common issue that can cause a range of symptoms. They are caused when bacteria, food particles, dead skin and cells become trapped. When these clump together, they can form into tonsil stones.

While tonsil stones are generally harmless, they can cause some unpleasant symptoms and may even signal a more serious health issue.

If you have bad breath and believe tonsil stones are to blame, speak with your health care provider or an ear, nose and throat specialist. Even if tonsil stones aren’t the culprit, your provider can help you determine what is.

Need help treating tonsil stones?

Schedule an appointment with a primary care provider.
Schedule an appointment with an ear, nose and throat specialist

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