Have you ever discovered a white or yellow lump of material that seems to be attached to your tonsils? It may have been a tonsil stone.

Tonsil stones are thought to occur when bacteria, dead skin cells, and other debris collect and calcify on the surface of your tonsils. In most cases, tonsil stones do not cause problems, but they sometimes lead to bad breath, discomfort, and other worrisome symptoms.

How Do Tonsil Stones Develop?

Tonsil stones are still somewhat of a mystery to doctors and researchers, but researchers suspect that people who have had frequent episodes of tonsillitis are at increased risk of developing tonsil stones. This is because frequent infections of your tonsils make them more likely to have developed areas of excess fibrous tissue. This excess tissue on the surface of your tonsils can lead to the development of pockets and crevices on your tonsils.

Dead skin cells, bacteria, and other substances can collect within these pockets and crevices, forming a mass of debris. The salts in your saliva can cause the mass of debris to calcify, and form a "stone" of material that stays lodged in your tonsils. Tonsil stones tend to gradually get larger as bacteria grow and more debris is deposited and calcified.

How Do Your Know if You Have Tonsil Stones?

It is often hard to tell if you have tonsil stones, because they can be very small and easily hidden in the pockets and crevices of your tonsils. But when they can be seen or when they are removed, tonsil stones tend to be whitish or yellowish in color, and usually relatively small. The consistency of tonsil stones can range from soft and pliable to hard as a rock.

Most of the time, tonsil stones do not cause any symptoms at all. But when they do, symptoms may include:

Anyone can get tonsil stones, but they are most common in young adults who have a history of recurrent throat infections.

Diagnosing and Treating Tonsil Stones

Your doctor can usually diagnose tonsil stones by examining your throat or manually removing the stone. In some cases, an imaging study (for example, an X-ray or CT scan) may be required to confirm the diagnosis and better visualize the tonsil stones.

If your tonsil stones do not cause any symptoms or problems, no treatment will be required. But if you have a stone that is very large or is associated with worrisome symptoms (such as pain, swollen tonsils, or problems swallowing), you may need treatment. Tonsil stones are sometimes removed surgically, or if the stone is large and impacted within your tonsil, you may need to have a tonsillectomy (the surgical removal of your tonsils).

Preventing Tonsil Stones

The best way to prevent tonsil stones is to avoid developing pockets and crevices in your tonsils in the first place. The following steps can help you do just that, by reducing your risk of recurrent episodes of tonsillitis:

  • Wash your hands frequently.
  • Avoid sharing dishes, utensils, and toothbrushes with, and kissing people who have tonsillitis.

If you have tonsillitis frequently, ask your doctor if he or she recommends a tonsillectomy.
