How Quickly Tonsil Stones Can Form (and How To Prevent Them)


Although tonsil stones are rarely serious, they are be unsightly, uncomfortable, and cause secondary conditions such as halitosis so bad your friends and family may consider a restraining order. Often tonsil stones remain hidden under your tonsil tissue or seem to appear suddenly at the back of your throat. You might wonder how these stones came about and how long it took for them to form. 

Tonsil stones can form quickly from the time that debris becomes trapped in the tonsillar crypts. The food, saliva, or mucus particles calcify and the stone grows gradually over time due to bacterial action. Thus a specific oral hygiene routine is key to prevention.

Although some people are more prone to developing tonsil stones, there are methods to decrease the formation of tonsilloliths. If you are concerned about developing tonsil stones, here are some facts about how quickly they form and how to prevent this uncomfortable condition. 

How Do Tonsil Stones Form?

Tonsil stones form when debris accumulates in the cavities or crypts in tonsil tissue. This debris includes saliva, mucus, dead cells, and food particles. Once it accumulates, it invites bacterial and fungal activity, and as they feed on the debris, the debris calcifies and hardens.

Modern clinical research suggests that tonsil stones are not static accumulations of debris but actual living biofilms. Biofilms occur when free-floating bacteria attach to a living host surface (in the case of tonsil biofilms) and form a complex community to reproduce and protect themselves from host defenses

Biofilms may be resistant to antibiotics and become a site for reinfection, making them challenging to treat. 

How Quickly Can Tonsil Stones Form?

Tonsil stone formation may occur at any time, even overnight.  Tonsil stones or tonsilloliths share the same starting point regardless of the eventual size and length of development. Accumulation of debris, including saliva, mucus, dead cells, and food particles, forms the basis of tonsil stones.

However, it is not until bacterial and fungal action begins on the accumulated debris in the tonsil that an actual ‘tonsil stone’ begins. Until the accumulated debris becomes calcified, the soft debris accumulation has yet to develop into a tonsil stone even though the horrible smell is apparent.  

Once the accumulated debris settles in the tonsil crypts, the bacterial and fungal action begins. This leads to the hardening or calcification of the accumulated debris into a tonsil stone. Tonsil stones may gradually grow over weeks or even years if lifestyle factors persist in increased microbial activity.

What Causes Tonsil Stones?

Tonsil shape and surface are specific to each individual and may vary from relatively smooth to a less uniform surface area. Those genetically prone to larger tonsils with more crevices are more likely to develop tonsil stones. 

Factors that influence the formation of tonsil stones include:

  • Chronic bouts of tonsillitis
  • Sinus problems
  • Postnasal drip 
  • Some lifestyle choices such as smoking and alcohol consumption
  • Dry mouth conditions associated with medications
  • Poor oral hygiene

What Are the Symptoms of Tonsil Stones?

You may experience several symptoms depending on the severity of your tonsil stone condition. Tonsil stones average about 4mm (0.16in) and may range from 3mm (0.12in) to 11mm (0.43in) or even larger. As tonsil stones may remain hidden in the tissue of your tonsils, often only larger stones are discovered by the naked eye.

One of the key symptoms of tonsil stones is halitosis or chronic bad breath. The bacteria that live on your tonsil stones release volatile sulfur compounds from your tonsillar crypts (with the characteristic ‘rotten egg’ smell).

Other symptoms of tonsil stones include:

  • Sore throat or referred ear pain
  • Difficulty swallowing
  • Swollen and inflamed tonsil (in more severe cases)
  • Evidence of white or yellow debris in the tonsil area
  • A sensation of something lodged in the throat
  • A bad taste in your mouth may be a symptom

How to Prevent Tonsil Stones

Treatment of tonsil stones depends on the severity of your condition. Severe, persistent recurrence of tonsil stones may require surgical intervention. At the most severe, this may require a tonsillectomy, or ultrasonic and laser surgery, to prevent tonsil stone recurrence.

If you have a moderate case of tonsil stones, you may treat and prevent the recurrence of the condition by self-treatment and lifestyle changes. Prevention strategies for tonsil stones include:

Good Oral Hygiene

As tonsil stone formation rests on the accumulated debris, keeping your mouth and throat clear of debris and bacteria may help you treat and prevent tonsil stones. Keeping your mouth free of bacteria will also inhibit the calcification of debris that leads to stone formation. Other methods of preventing tonsil stones include:

Specialized Mouthwashes and Gargles 

Specially formulated mouthwash such as Therabreath may dislodge food particles that accumulate after eating and prevent debris build-up. Avoid mouthwash that uses alcohol as a base. Alcohol may disturb your saliva pH and harm the good bacteria in your oral cavity, leading to tonsil stone formation.

Regular Brushing and Flossing

Irregular teeth brushing leads may lead to a build-up of bacteria in the mouth and throat, which will exacerbate tonsil stones. Flossing also helps reduce the build-up of debris in the mouth and reduces bacterial action. It will help if you also consider investing in a tongue scraper, which can help eliminate the bacteria that often builds up towards the back of the tongue. 

Water Picks or Water Flossers

Water picks or water flossers may help the condition, provided they are the low-pressure type picks. High-pressure water picks meant for interdental debris may harm your sensitive tonsils and lead to further damage to the tissue. An excellent example of a water flosser with low pressures that I recommend using is this Manual pump water flosser from Amazon.com.

Manual Tonsil Stone Removal

You may remove your tonsil stones yourself if they are not too large. You can use a cotton swab or your finger and gently press the area surrounding the stone to dislodge it, but I recommend using a lighted pick with a soft rubber tip for the best results. Be gentle and ensure you push the particle away from your airway so that you don’t choke on the stone. 

Lifestyle Changes

Diets high in sugar promote bacterial activity and make you more susceptible to developing tonsil stones. Studies have linked alcohol and the development of harmful biofilms in the oral cavity. Alcohol may also unbalance your good and bad bacteria in the mouth, leading to a proliferation of harmful bacteria.

Alcohol reduces the bacterial diversity in your oral cavity, affects your immunity and makes you more prone to pathogenic bacteria. It also causes decreased salivary flow and creates the dry mouth conditions in which tonsil stones flourish.

Studies also link smoking and the bacterial diversity in the moth that prevents pathogens from entering the oral mucosa. Smoking also has a drying effect on the oral mucosa increasing the likelihood of particles collecting in the tonsillar crypts. 

Check out my article on recommended diet tips for tonsil stones for a more in-depth look.

Stay Hydrated

Hydration is essential in keeping the mouth cavity moist and preventing debris build-up in the tonsillar crypts. The action of drinking water regularly flushes the tonsil area and decreases the likelihood of debris build-up. Dry mouth conditions are linked to the formation of tonsilloliths. Dry mouth conditions are conducive to debris collection as normal saliva flow does not flush out the dead cells, saliva or food particles. 

Final Thoughts

Genetic predisposition and a history of recurrent tonsillitis may make you prone to tonsil stones, but they are not inevitable. With good oral hygiene, flossing, brushing, and water flossing, you can help and treat tonsil stones. Stay away from bad habits like alcohol and cigarettes and watch your sugar intake, and you find your stones go away by themselves.

Since tonsil stones can form very quickly, often overnight, I recommend a daily oral hygiene routine that only takes a few seconds that can prevent them from becoming a noticeable problem.

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