Tonsil Stones: How Can They Cause Bad Breath?

tonsil stone

What are tonsil stones?

The tonsils are small oval-shaped bits of tissue at the back of the throat and are part of your immune system. They help protect you from infections by filtering bacteria and viruses that enter the body through the mouth. Tonsil stones are little hard lumps that develop in the tonsils and can produce bad breath. They are generally painless and harmless and are also referred to as tonsillitis. Tonsil stones are usually small and can look like yellow or white pebbles. In most cases, you can treat tonsil stones at home, but they may need a surgical procedure to remove the tonsils in some cases, especially if tonsil stones keep reappearing.¹

What causes tonsil stones?

Tonsil stones can result from food particles, mucus, dead cells, and bacteria trapped in small pockets on your tonsils due to improper oral hygiene. When this debris builds up and then hardens or calcifies, tonsil stones can start to form and cause soreness or swelling. Such complications happen mainly to those who have long-term tonsils inflammation (chronic tonsillitis) and get tonsillitis more often than normal. Other potential causes include poor dental hygiene, having large tonsils and chronic sinus issues.²

Symptoms of tonsillitis

People often confuse tonsillitis with having a cold or severe flu that causes tonsils inflammation. Here are some of the main symptoms of tonsillitis in children and adults:³

  1. Having a sore throat.
  2. Facing difficulty swallowing.
  3. Coughing and headache.
  4. Exhaustion and tiredness.
  5. High temperature above 38C.
  6. Earache.
  7. Bad breath.
  8. White pus-filled spots on the tonsils.
  9. Painful swollen glands.

While tonsil stones are not contagious, it is usually the result of an infection that is contagious; like a cold or flu. Hence, it is recommended to follow standard hygienic practices to stop infections from spreading when you feel any of the symptoms mentioned above.³

Tonsil stones treatment

Even though tonsil stones can be harmless, they can cause discomfort, bad breath, and other irritations in many cases. Also, large tonsil stones can damage normal tonsil tissue, leading to severe swelling, inflammation and infection. Here are some of the ways one can deal with tonsil stones or remove tonsil stones if necessary:¹

  • Gargling with salt water can help your throat feel better and dislodge tonsil stones. It can also help you get rid of bad breath or any foul taste associated with tonsillitis.
  • Medications like antibiotics prescribed by your healthcare provider can treat tonsil stones; while they don’t treat the underlying cause of tonsil stones, they help in cases that develop a bacterial infection.
  • Tonsil stones surgical removal is another treatment method if symptoms are too disturbing. Your GP may refer you to an ENT, an ear, nose and throat specialist to discuss the surgical options available depending on your case. Tonsil stone removal is recommended in cases like large tonsil stones, severe pain and recurrent sore throats or tonsil infections.
  • Tonsillectomy means having your tonsils removed completely, and it is necessary if tonsil stones keep coming back and are causing repeated infections. Note that removing the tonsils does not affect your immune system.
  • Cryptolysis is a procedure in which medical professionals use a laser or a radiofrequency wand to scar your tonsils and reduce potential tonsil stones.

Prevention of tonsil stones

The best way to prevent tonsil stones and many other oral health issues including bad breath is by following proper oral hygiene to protect your mouth from bacteria and avoid food buildup. Here are some oral health tips to help you maintain good hygiene routine: 

  1. Brush your teeth thoroughly two times a day or after every meal.
  2. Floss daily between the teeth to remove dental plaque and prevent food particles buildup.
  3. Rinse regularly using a mouthwash, gently swishing alcohol-free mouthwash around your mouth helps kill bacteria and loosen tonsil stones.
  4. Clean your tongue regularly by brushing or scraping it.
  5. Avoid smoking or using any tobacco products.
  6. Drink plenty of water.
  7. Visit your dentist every 6 months for a regular checkup.

Complications of tonsil stones

Tonsillar stones are common findings and are a known cause of bad breath (halitosis). However, the development of large tonsillar stones is rare, with only a few cases reported. A large tonsil stone is considered a complication that needs immediate attention. A large-sized tonsil stone can cause difficulty breathing and can require elective stone removal and tonsillectomy. Another form of tonsillitis complication is developing a pocket filled with pus (known as an abscess) between the tonsils and the wall of your throat. If you have any of these symptoms, get immediate medical attention:³ 

  1. Worsening severe sore throat.
  2. Swelling inside the mouth and throat.
  3. Difficulty speaking, breathing or swallowing.
  4. Difficulty opening your mouth.

References:

  1. https://www.healthdirect.gov.au/tonsil-stones

  2. https://health.clevelandclinic.org/troublesome-tonsil-stones-causing-bad-breath/

  3. https://www.nhs.uk/conditions/tonsillitis/

  4. https://www.cdc.gov/oralhealth/basics/adult-oral-health/tips.html

  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938656/