Can Acid Reflux Actually Cause Tonsil Stones? The Truth!

Acid reflux is a relatively common condition across the world – the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates that approximately 20% of Americans suffer from it. This tends to lead to further questions about the effects of acid stones: for example, what are its symptoms, and can it cause oral issues, such as tonsil stones?

Acid reflux does not directly cause tonsil stones. However, it can lead to issues such as dry mouth and tonsillitis, which can, in turn, encourage tonsil stones to develop. One of the leading causes of tonsil stones – larger tonsils – also results in more severe acid reflux. 

The rest of this article will examine the causes of acid reflux and tonsil stones and the link between the two. I’ll also look at what steps you can take to prevent the development of tonsil stones and acid reflux and when you should see a doctor if you’re suffering from the conditions. 

What Are the Symptoms and Causes of Tonsil Stones?

Tonsil stones are deposits of debris and bacteria that become trapped in your tonsils. 

While they start as small and soft, they harden and gain a white or yellow-colored appearance over time. It’s these hard masses that are known as tonsil stones and they smell really, really bad.

Several symptoms can indicate that you’re suffering from tonsil stones. These include halitosis (bad breath), visible flecks at the back of your throat, a persistent sore and swollen throat, trouble swallowing, and ear pain. 

While most people have tonsils, and everyone has food debris and bacteria in their mouths, there are several reasons that some people develop tonsil stones while others do not. 

These include:

  • Large, rough tonsils. The structure of your tonsils naturally includes holes or crevices. The larger these crevices, the more likely it is that particles will become trapped in them, and the more at-risk you are for developing tonsil stones. 
  • Poor dental hygiene. Among the major causes of tonsil stones is the build-up of food particles and bacteria in the mouth. If you have good dental hygiene, brush at least twice a day (including your tongue), floss, and use alcohol-free mouthwash, you can significantly reduce the risk of developing tonsil stones. 
  • Dry mouth
  • Chronic tonsillitis 
  • Chronic sinus issues

Tonsil stones are far more common today than they used to be. That’s because tonsillectomies are far less common today than they were a few decades ago. 

Once, tonsillectomies were the go-to treatment for concerns such as sleep apnea. However, the development of alternative treatments for these conditions has reduced the number of tonsil surgeries performed.  

What Are the Causes and Symptoms of Acid Reflux?

Acid reflux is the common name for two different conditions: gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR). Both result when stomach acids and digestive enzymes move up your digestive tract instead of down

However, with GERD, the acids and enzymes become backed up into your esophagus. With LPR, they back up into your throat. If you suffer from GERD, you’re likely suffering from chronic acid reflux, not just occasional issues. 

Each condition has different symptoms. 

Symptoms of GERD include:

  • Heartburn, especially chronic heartburn
  • Difficulty swallowing
  • Regurgitation of your food or a sour-tasting liquid
  • Chest pains and a chronic cough
  • Laryngitis
  • Poor or disrupted sleep

Symptoms of LPR include:

  • Dry mouth
  • Difficulty speaking
  • Chronic cough and a frequent need to clear your throat
  • Difficulty swallowing
  • Hoarseness
  • Sore throat
  • An irritated larynx

The Relationship Between Acid Reflux and Tonsil Stones

As noted, one of the symptoms of LPR is dry mouth. 

Additionally, medication for GERD can frequently cause dry mouth, particularly if you need to take medication daily. Further, when the acid from your stomach is regurgitated into your throat, it irritates your tonsils and may cause you to develop tonsillitis. 

If you’re suffering from GERD, this regurgitation can also include regurgitated food. This, in turn, can increase the chances of food debris getting trapped in your tonsils. 

Tonsillitis, food debris, and dry mouth are all significant causes of tonsil stones. While acid reflux doesn’t directly cause tonsil stones, it can increase the risks of you developing them.

Another link between acid reflux and tonsil stones comes in the form of large tonsils. Bigger tonsils are one of the risk factors for tonsil stones. 

A study presented by Iman Naseri and John M DelGaudio in 2007 revealed larger tonsils could also result in more severe acid reflux. When examining people suffering from the condition, they found more reflux in people with larger tonsils.

How Can I Prevent Tonsil Stones?

It’s nearly impossible to prevent the formation of tonsil stones completely. However, you can mitigate your chances of developing them by practicing good dental hygiene and following the many tips here on the blog

This includes brushing and flossing after eating to prevent bacteria and food debris from getting caught in your tonsils, as well as gargling after meals to prevent food build-up in your mouth. Alternatively, you can use a water flosser to flush out your mouth and cleanse it of debris and bacteria.

The only way to guarantee that you won’t develop tonsil stones is to get a tonsillectomy (palatine tonsils). However, they can still form within your lingual tonsils (throat).

Like any surgery, this procedure carries several risks, and it’s best to undergo it when it’s medically necessary. Some common reasons to have a tonsillectomy include chronic tonsillitis, bleeding of the tonsils, and complications due to enlarged tonsils.

How Can I Prevent Acid Reflux?

There are several steps you can take to manage and prevent the development of acid reflux. These are mainly lifestyle changes and include:

  • Dietary changes. Identify what foods trigger your acid reflux, and avoid them as much as possible. 
  • Losing weight. Obesity is one of the major causes of acid reflux.
  • Eat smaller, more frequent meals throughout the day.
  • Avoid lying down for about two to three hours after having a meal (this may actually cause stomach acids to damage your throat).
  • Quit smoking, drinking alcohol, and consuming caffeine.
  • Sleep with your head propped up.
  • Avoid wearing tight-fitting clothes that put pressure on your abdomen.

There are also many over-the-counter medications available to help you manage acid reflux and ensure it’s manageable. 

When Should I See a Doctor?

Usually, you can manage both acid reflux and tonsil stones without the intervention of a medical professional. However, there are some cases in which seeing a doctor is necessary. 

If you suffer from acid reflux, you need to see a doctor if:

  • You have a fever that is higher than 101°F (38°C).
  • There is blood in your saliva or phlegm.
  • You’ve been suffering from a sore throat for over a week.
  • You’ve developed heartburn that is causing nausea and vomiting.
  • You’re vomiting blood.
  • You have trouble or pain when swallowing and have experienced drastic weight loss.
  • You’re suffering from a chronic cough or choking sensation.
  • You’ve been taking over-the-counter antacid medication for over two weeks and are still suffering from heartburn.

If you suffer from tonsil stones, you’ll need to see a doctor if:

  • You’re suffering from severe symptoms, such as difficulty of swallowing.
  • Your tonsils are red and inflamed.
  • You’re suffering from ear pain.
  • You have recurrent tonsil stones.
  • You suspect that your tonsil stones are a sign of something more serious, like tonsillitis.


In general, acid reflux and tonsillitis are both relatively minor concerns that you can treat at home with lifestyle changes or over-the-counter medication. 

While there’s no direct relationship between acid reflux and tonsil stones, acid reflux can increase the chances of developing tonsil problems, including stones. 

If you’re suffering from chronic or severe acid reflux, you must get checked out by a doctor before you start suffering from other related issues as well.

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