How do dental providers treat chronic tonsil stones, including non-surgical options?

You finally get rid of one tonsil stone, only for another to show up in the same spot days later, with the same bad breath and the same scratchy feeling in your throat. It's frustrating, but most recurring tonsil stones don't need major treatment. A dental provider or doctor can check what's going on, help with simple care and explain when an ear, nose and throat (ENT) doctor should take a closer look. 

What you will learn in this article: 

• Small tonsil stones often improve with simple home care. 

• Antibiotics do not remove tonsil stones. 

• Laser treatment may help some adults with stones that keep returning. 

• Surgery to remove the tonsils is usually saved for select cases. 

If tonsil stones keep bothering you, schedule an appointment with an Aspen Dental provider. Your care team can look at your throat and help you find the right next step. 

What are tonsil stones, and why do they keep coming back? 

According to a review in American Family Physician, tonsil stones form when bits of food, shed cells and germs collect and harden in the deep folds of the tonsils. Some cause no symptoms. Others may cause bad breath, a sore throat, pain when swallowing or a stuck feeling in the throat.¹ One stone may pass and never return. If more material collects in the same folds, new stones may form.  

Why don't antibiotics fix chronic tonsil stones? 

Antibiotics are not needed for tonsil stones alone.² If a doctor finds a separate bacterial infection, such as strep throat, antibiotics may be part of that treatment. If you also have a fever, a very sore throat or swollen tonsils, see a doctor for an exam. 

Tonsil stones and tonsillitis can both cause throat discomfort, but they are different problems. Knowing the difference between tonsillitis and tonsil stones matters because the care is not the same. 

What home care can help with tonsil stones? 

Simple mouth care can help small stones loosen and may lower bad breath:² 

• Clean your teeth every day with a toothbrush and floss. 

• Gently clean your tongue, including the back. 

• Gargle with warm salt water after meals. 

Home care may not stop stones from returning if you have deep tonsil folds. If a stone is hard to reach or does not loosen, do not dig at it. Ask a dental provider or doctor what to do. 

When should you see a dental provider or doctor about tonsil stones? 

Talk to a dental provider or doctor if stones keep coming back, your breath stays bad despite good mouth care, or you have ongoing throat pain or pain when swallowing. A dentist can check for tonsil stones and look for dental causes of bad breath. If your tonsils may need a procedure, you may be referred to an ENT doctor. 

How do doctors treat chronic tonsil stones? 

Sometimes. If a stone is too large to pass on its own, a doctor may discuss removing it.¹ Removing one stone does not change all the folds in the tonsils, so another stone may form later. 

What is laser cryptolysis? 

Laser tonsil cryptolysis uses a laser to open or reduce the folds where stones collect without taking out the whole tonsil. It's generally used as a less invasive alternative to a full tonsillectomy. This option may work well for some adults, though it isn't right for everyone, and it doesn't guarantee stones won't return. 

What is a tonsillectomy, and when is it used? 

A tonsillectomy removes the tonsils. It is rarely needed for tonsil stones alone. A doctor may discuss it when a stone is too large to pass, when stones keep causing problems after other care, or when another tonsil problem also needs treatment. 

Will treatment stop my symptoms? 

Treatment can ease symptoms when a tonsil stone is the cause, but no option works the same for everyone. Removing one stone treats only that stone. Laser treatment changes the tonsil folds, while tonsillectomy removes the tonsils. Ask your doctor what each option can and cannot do. 

What should you expect after treatment? 

Recovery depends on the treatment. Having one stone removed is usually a smaller step than laser treatment or tonsillectomy. Ask your doctor how much soreness to expect, what you can eat, how to care for your throat and which warning signs mean you should call. 

What should you do if tonsil stones keep coming back? 

Keep a record of how often the stones appear and what symptoms come with them. Tell your dentist or doctor about bad breath, throat pain, trouble swallowing or stones that look different than usual. You can also learn more about what a tonsil stone’s color, size or texture may mean. 

Chronic tonsil stones can be frustrating, but you do not have to handle them alone. Schedule an appointment with your dental provider to discuss your symptoms and whether you should also see an ENT doctor. 

How do you treat chronic tonsil stones? FAQs 

Still have questions about chronic tonsil stones? These answers cover a few common concerns. 

Can tonsil stones go away on their own? 

Yes. Small stones often loosen and pass without treatment. Gargling with warm salt water may help. If stones are large or keep bothering you, ask a doctor what to do. 

Are tonsil stones contagious? 

No. Tonsil stones themselves are not contagious. They form from material that hardens in the folds of your own tonsils. 

How can you tell tonsil stones from tonsillitis? 

Tonsil stones often look like small white or yellow lumps and may cause bad breath or a stuck feeling in the throat. Tonsillitis more often causes a sore or swollen throat, fever or tender glands. Because the symptoms can overlap, ask a dentist or doctor if you are not sure. 

Can children get chronic tonsil stones? 

Yes. Children can get tonsil stones. Call your child’s doctor if the stones keep returning or cause pain or trouble swallowing. Do not try to dig out a deep or hard-to-reach stone. 

Should you see a dentist or an ENT doctor? 

A dentist is a good place to start, especially if bad breath or other mouth symptoms are part of the problem. An ENT doctor treats the tonsils and can discuss procedures if stones are large or keep causing trouble. 

Sources 

¹ American Family Physician: “Tonsillitis and Tonsilloliths: Diagnosis and Management.” https://www.aafp.org/afp/2023/0100/tonsillitis-tonsilloliths 

² American Family Physician: "Tonsil Stones." https://www.aafp.org/afp/2023/0100/patient-information-tonsil-stones