Not only are tonsil stones a "thing," they're far more prevalent than they're discussed. One woman details her year-long mystery, solved.
‘Here’s How I Knew I Had Tonsil Stones’: How an Oddly Common Annoyance Upended A Patient’s Quality of Life
Published on Aug. 08, 2025
About the expert
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Tonsil stones are small collections of food debris, calcium deposits, and the normal bacteria that live in the mouth, explains Dr. Miriam O’Leary, MD, Chair of Otolaryngology (an ear, nose, and throat doctor) at Tufts Medical Center in Massachusetts. These elements “get lodged in the crypts, which are small ‘pockets’ in the tonsils.” Dr. O’Leary says tonsil stones are fairly common, particularly in young adults. Harvard Health reports that up to a noteworthy 40% of people have tonsil stones, and many aren’t aware of it.
One reason tonsil stones might fly under the radar is because they don’t typically cause harm if they’re left untreated, Dr. O’Leary says. “Most usually come out on their own,” she explains. “However, some patients note throat discomfort and bad breath associated with tonsil stones.”
In these cases, tonsil stones can seriously impact an individual’s quality of life. Keep reading as one patient describes the daily toll of her tonsil stones—and the treatment she turned to when common remedies didn’t work.
How I knew I had tonsil stones: An irritating year-long mystery
By Natalie from Boston, as told by Leslie Finlay, MPA
Ever since she was young, Natalie says she’s been prone to getting sore throats and strep throat. “Within the last few years, it was just more frequent—and then, for the last year maybe, I was getting tonsil stones … I always felt like my throat was sore, like something was in it,” Natalie says. “The best way I can explain it is like popcorn kernels getting stuck in my throat. It was so uncomfortable.”
She says that sometimes, it felt like something was on the back of her mouth, and her tongue would reflexively try to push it out: “All of a sudden, a little ball would pop out, and it was horrible. It was disgusting. It just had this awful smell and odor. And it makes you feel insecure, too, you feel like you always have bad breath.”
At first, she says, “I had no idea where they were coming from.” She’d never heard of tonsil stones. “I couldn’t figure out what was going on with me.”
Dr. O’Leary explains that the shape and size of someone’s tonsils vary, and large tonsils with more “pockets” are more likely to accumulate tonsil stones. “[My primary care doctor] knew I had these pockets in my tonsils,” Natalie says, “little holes that they said were from my tonsils being beat up from all the strep throat that I’d had.”
When she explained her symptoms over the phone, her PCP’s office suggested that it could be strep throat. “I didn’t have strep throat,” she says, already familiar with the effects of the bacterial infection. “But I was surprised that even [my doctor] didn’t know tonsil stones were my problem until I went and saw them.”
This mix-up isn’t uncommon, according to Dr. O’Leary. “Tonsil stones can be confused with bacterial tonsillitis, also known as strep throat, which can cause small white or yellow spots on the tonsils that are actually pus,” she explains. “However, tonsillitis has other symptoms that tonsil stones do not—throat pain, which is usually severe, acute swelling of the tonsils, fever, and swollen neck lymph nodes.”
As she tried to figure out what was going on, Natalie learned that other people she knew dealt with tonsil stones, too. “We were sharing stories, and I realized mine were just happening way too much,” she recalls. “I’d just be driving and feel like something was on my tongue, and I’m looking in the mirror and I could see this little white thing in the back of my mouth. I’d have to pull over and try to pop it out—it makes your whole mouth feel like it’s just polluted.”
How to treat tonsil stones
Dr. O’Leary says that salt water gargles after meals and the use of a Waterpik can help prevent food accumulation in the tonsils. “Patients can often remove tonsil stones on their own by using a cotton swab to gently push them out,” she says. “These conservative measures work well for many patients.”
Unfortunately for Natalie, salt water gargles had no impact on her flare-ups. “Then I was getting Q-tips and trying to push them out, not realizing that you could have like four of them in one pocket,” she says. “It was awful.”
A permanent solution to address tonsil stones
Occasionally, Dr. O’Leary says, a tonsillectomy (tonsil removal) is performed for patients with frequent, bothersome tonsil stones that don’t respond to typical treatment measures. That’s the route Natalie was advised to take: “I went to my PCP [primary care provider] because my throat was sore and my tonsils were getting all puffy and red because they were getting backed up,” she says. “I told him that there’s something in my throat, these little ball things, and he tried to get one out. It was so deep, and it hurt and started bleeding when he pushed on it. It’s kind of scary how deep they can get.”
That’s when Natalie’s doctor referred her to an otolaryngologist, where they determined that Natalie was a good candidate for a tonsillectomy—having her tonsils removed. “He told me that they’re huge, and I’ll be healthier in the long run,” she adds.
There was one issue: “The thing is that [tonsil stones] are considered a cosmetic thing, so it has to be a certain degree before they can even determine if you need your tonsils removed,” Natalie explains. “In my case, I had enlarged tonsils, so when they would get swollen, it was kind of dangerous because it was hard for me to breathe [or] swallow sometimes. I had acid reflux on top of it, which added to [the discomfort]. All of that pushed me to get my tonsils taken out as an adult.”
The other concern was her stage in life. “I remember taking both my kids to get their tonsils out—but as an adult, they say it’s much more dangerous,” she says. “They’re not lying when the nurse told me it’s one of the worst surgery recoveries. I won’t even sugarcoat it. It’s over and done with, thank God, but it took almost a month for you to even feel like you’re normal, even not [to be] afraid to eat something because you don’t want to make it bleed or cause a problem.”
In spite of her difficult treatment, Natalie says she wishes she’d had the procedure done when she was younger. “Getting used to no tonsil stones or tonsils is probably going to be a wonderful thing. Nobody should have to live like that.”
What to do if you suspect you have tonsil stones
If you notice persistent bad breath, recurring sore throats, or visible white or yellow spots on your tonsils, tonsil stones may be to blame. Other symptoms can include that feeling of something stuck in your throat—like Natalie’s “popcorn kernel” symptom—difficulty swallowing, cough, or a bad taste in your mouth.
Dr. O’Leary says that if you experience these symptoms, make an appointment with your primary care provider. Your doctor may recommend lifestyle changes that often help manage or get rid of tonsil stones, such as:
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Gargling with salt water (or using a Waterpik or other well reviewed water flosser) after meals
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Brushing and flossing your teeth regularly
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Limiting sugar intake
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Drinking enough water
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Not smoking
But if your tonsil stones are chronic, painful, and don’t respond to these standard treatments, a specialist can help. Your PCP should be able to determine whether, like in Natalie’s case, your tonsil stones are severe and should be evaluated by an otolaryngologist.
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