Tonsil stones

How it works

The tonsils are two lumps of immune tissue at the back of the throat. Their surface is folded into deep pits called crypts². Food debris, dead cells, mucus, and bacteria collect in the pits. Over time the material hardens with calcium salts into a stone¹. Most stones are a few millimetres across. Rare cases grow much larger¹.

The bacteria inside a stone produce sulfur compounds, so the stone smells like rotten eggs. Tonsil stones are a common cause of bad breath¹. Other signs are a feeling of something stuck in the throat, a mild sore throat, a metallic taste, and an ache in the ear, which shares nerves with the throat¹. Many people have no symptoms at all. Stones often fall out on their own during coughing, sneezing, or swallowing.

About 10% of people have tonsil stones found on examination¹. CT scans find them in up to 46% of people, most of them tiny¹. They are more common in people with large, deeply pitted tonsils and a history of repeated tonsillitis¹.

Is it a problem?

No. A tonsil stone is not an infection and it is not dangerous. You can dislodge a visible one gently with a cotton bud or a low-pressure water flosser. Gargling with salt water helps. Do not dig with anything sharp.

See a doctor if the throat pain is severe, if one side of the throat is swollen, if you have a fever, or if swallowing is hard. Those signs point to an infection or abscess, not a stone. If stones come back often enough to bother you, a doctor can discuss options, with tonsil removal as a last resort¹.

History and culture

The community at r/tonsilstones trades removal methods and, for those who want them, photos³. Removal videos have a large audience online.