Can you prevent tonsil stones from coming back?

You finally got rid of one tonsil stone, and now there's another. It can feel like a losing battle. You may not be able to stop them completely, but regular brushing, flossing and warm saltwater gargles after meals may help them form less often. They return when food, dead cells and germs collect again in the small pockets of your tonsils. If they keep returning or cause bad breath or throat discomfort, a dentist or doctor can help you decide what to do next. 

What you will learn in this article: 

• Tonsil stones form when food, dead cells and germs harden in deep tonsil pockets. 

• Regular brushing, flossing and saltwater gargles after meals may help prevent them. 

• Most small tonsil stones cause no harm and may come out on their own. 

• A dental provider or doctor can help when stones keep returning or cause ongoing symptoms. 

If stones keep returning and you are unsure what to do next, schedule an appointment with an Aspen Dental provider. Your care team can check your mouth and talk through your options with you. 

Why do tonsil stones keep coming back? 

Tonsil stones can return because the pockets in your tonsils can collect food, dead cells and germs again. The American Academy of Family Physicians explains that this material can harden in deep tonsil pockets. The exact reason stones develop is not fully understood, but repeated tonsil infections may play a role.¹ 

Removing one stone does not change the pocket where it formed, so another stone may develop later. 

Which daily habits may help? 

No routine can guarantee that tonsil stones will never return. Helpful habits include brushing, cleaning between your teeth, gently cleaning your tongue and using a saltwater gargle after meals.² 

Brushing and cleaning between your teeth 

Brush your teeth each day and use floss to clean between them. Gently clean your tongue with your toothbrush too. These steps help remove food and germs left in your mouth. 

Gargling with saltwater 

After meals, gargle with warm saltwater. You can make it by stirring 1 teaspoon of salt into 1 cup of warm water. Spit it out when you finish. 

What should you avoid doing at home? 

Tonsil tissue is delicate. Do not dig at a stone with fingernails, pins, tweezers or other hard tools. Stop if you feel pain or see blood. 

If brushing and saltwater gargling do not help, do not force the stone out. A dental provider or doctor can confirm whether it is a tonsil stone and explain safer options. 

When should you see a dental provider or doctor? 

Book a visit if you notice any of these: 

• Stones that keep coming back or bother you 

• Bad breath that does not improve with regular mouth care 

• Ongoing throat pain, new swelling or a stuck feeling 

• A spot that you are not sure is a tonsil stone 

Bad breath does not always come from tonsil stones. Gum disease, dry mouth, cavities and sinus problems can also cause it.³ A dental provider can check your teeth and gums. A doctor or ENT can examine your throat if the problem seems to come from your tonsils. 

For chronic tonsil stones, a doctor can also explain medical options for stones that return. 

You do not have to keep guessing about the cause. Contact your local dental provider to review your symptoms and talk about next steps. 

Can you prevent tonsil stones from coming back? FAQs 

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

Are tonsil stones harmful? 

Most tonsil stones cause no harm and may not hurt. However, they can cause bad breath, coughing, an earache, a sore throat or a stuck feeling in the throat.² Tell your dental provider or doctor if these symptoms continue or get worse. 

Is surgery ever used for tonsil stones? 

Surgery is rarely needed. It may be considered when a stone is so large that it does not come out by itself.¹ If recurring stones keep bothering you, a doctor may refer you to an ENT to discuss your options. 

Who should I see first? 

A dental provider is a good place to start if your main concern is bad breath or your oral health. If you have ongoing throat symptoms or large, recurring stones, a doctor or ENT can check your tonsils. Either one can help guide your next steps. 

Sources 

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

² American Academy of Family Physicians, American Family Physician: “Tonsil Stones.” https://www.aafp.org/afp/2023/0100/patient-information-tonsil-stones 

³ National Library of Medicine, MedlinePlus: “Bad Breath.” https://medlineplus.gov/badbreath.html