Tonsil stones - cause of the odd lumps that appear in your mouth (2024)

Many people will have noticed the white spots at the back of their throat or discovered a strange lump in their mouths - but are they serious and what can you do about them

Many of us will have suddenly found a small but hard discoloured lump in our mouths or on the back of our throats. But what are they and are they something we need to take seriously?

The lumps are likely to be tonsil stones - formed when food debris, bacteria and dead cells get trapped in the crevices and pits of the tonsils. This can become calcified, transforming into hard white or yellow deposits.

But while they are not really stones - squeeze them and they squash - and are unlikely to be a sign of anything serious they are still unpleasant. So what causes them and how can you reduce your chances of developing them.

With around one in 10 people developing them, Myheath Devon has explained all you need to know about tonsil stones. And the NHS organisation has also advised how to treat them and when to see your GP.

What are tonsil stones?

Tonsils are gland-like structures in the back of your throat. They are made of tissue and help the body's immune system by stopping bacteria and virus particles that are passing through your throat.

Tonsil stones are created when food debris, bacteria and dead cells get trapped in the crevices and pits of the tonsils. This can then become calcified and turn into hard white or yellow deposits.

Generally, tonsil stones cause minimal symptoms however they can lead to bad breath (halitosis) and/or discomfort in the throat. They can also accumulate leading people to even cough up a tonsil stone as a small, irregular lump of offensive cream/white matter.

Tonsil stones are not typically linked to infections such as bacterial tonsillitis, however they can appear in those with a history of recurrent tonsillitis. It is thought around 10% of the population will experience tonsil stones at some point but they tend to clear from the throat on their own. There is no evidence that the presence of tonsil stones leads to long-term health issues.

What causes them?

Causes of tonsil stones include:

• Chronically inflamed tonsils
• Large tonsils (which enable more build-up within their pits and crevices)
• Poor oral hygiene (which allows bacteria to continuously interact with the tonsils)
• Sinus issues (which increase the accumulation of mucus in the throat via post-nasal drip and catarrh)

Good oral hygiene can help to remove food debris and plaque bacteria from the surfaces of teeth, gums, and tongue which reduces the likelihood of them developing.

Symptoms of tonsil stones

Tonsil stones can vary in size, but most people may not even realise they have them and will experience no symptoms at all. In cases where the tonsil stones are larger in size, symptoms may include:

• Swollen or enlarged tonsils
• Painful swallowing
• Sore throat
• Bad breath from the bacteria build-up
• Persistent cough
• White or yellow debris at the back of the throat

Diagnosis and treatment

Usually, tonsil stones can be seen at the back of the mouth. Alternatively they can be spotted on X-rays or scans being done for other reasons.

Self-care

Tonsil stones are usually harmless and go away on their own. There are some self-administered treatments available however there is little firm evidence to recommend any of these as definitive, says MyHealth Devon.

Common self-management strategies include:

• Regular gargling with a salt-water rinse
• Drinking carbonated beverages to assist in loosening the makeup of stones so that they eventually come out on their own.
• Coughing to loosen the stones
• Maintaining good oral hygiene
• Managing any allergies causing increased nasal mucus

However, the use of water jet irrigation and manual stone removal (either by using a finger or a makeshift tool such as a co*cktail stick) should be avoided as they risk damaging the tonsils and can lead to significant complications such as bleeding, infection and inhalation of a foreign body, warns MyHealth Devon.

Tonsillectomy

It is not advised to remove tonsils to treat tonsil stones as there is evidence that the potential risks and harms associated with tonsillectomy outweigh any perceived benefits.

Other Surgical treatments

The health website says there is currently little evidence to support the use of Laser Tonsil Cryptolysis or Coblation Cryptolysis (minimally invasive medical procedures that aim to shrink or remove the pits found within the tonsils to minimise build-up opportunity) in the treatment of tonsil stones and these procedures are not available through the NHS.

When to see a GP

Tonsil stones are usually harmless and when there are no symptoms of infection or other abnormalities they do not need to see a doctor.

However, you should consult your GP if you are experiencing any of the following, says MyDevon Health:

• A chronic sore throat that lasts more than a month
• Recurrent bouts of tonsillitis that are interfering with daily activities such as school or work
• Associated breathing problems
• Trouble swallowing
• Severe pain, especially on one side. This could be a sign of an infection such as Quinsy (a peri-tonsillar abscess)
• One tonsil is larger than the other (in rare circ*mstances this may be a symptom of cancer)

How to stop them developing

Food and cell debris and bacterial build-up in the mouth and throat can be dealt with by ensuring your oral hygiene is thorough. This can help reduce tonsil stones forming, although they are not, in themselves, evidence of poor oral hygiene. You should:

• Brush your teeth twice a day or after meals: Use an anti-bacterial toothpaste to better neutralise plaque and limit the spread of oral bacteria into the throat.
• Floss at least once a day: Food and plaque gets trapped between teeth throughout the day, flossing helps remove that debris from hard-to-reach areas.
• Clean your tongue regularly: Plaque bacteria can lurk anywhere in the mouth, especially on the surface of the tongue. Consider switching to an electric toothbrush equipped with a tongue-cleaning mode.
• Rinse and gargle with saltwater or an alcohol-free mouthwash in the morning, night, and after meals to neutralise bad breath.
• See your dentist regularly for cleanings and check-ups.

In addition to a thorough oral care routine, it’s important to drink plenty of water to help prevent tonsil stones. Hydration helps limit build-up and keep saliva production up for a healthy mouth.