What are the treatment options for tonsilloliths (tonsillar stones)?

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Last updated: February 18, 2025View editorial policy

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From the Guidelines

Tonsilloliths, or tonsil stones, can be effectively treated with a combination of self-care measures and medical interventions.

Treatment Options

  • Initially, it is recommended to try gargling with warm salt water several times a day to help loosen and disliege the stones 1.
  • If this is not effective, a dentist or an ear, nose, and throat (ENT) specialist may recommend the use of a waterpik or an oral irrigator to help remove the stones. In some cases, antibiotics such as penicillin or clindamycin may be prescribed to treat any underlying bacterial infections that may be contributing to the formation of tonsillar stones, as noted in the context of tonsillectomy guidelines [1, 1].

Surgical Intervention

For larger or more persistent tonsillar stones, a procedure called tonsillectomy may be necessary, which involves surgical removal of the tonsils and is usually performed under general anesthesia [1, 1].

Prevention

Additionally, good oral hygiene practices such as regular brushing and flossing, and regular dental check-ups can help prevent the formation of tonsillar stones. In some cases, the use of a mouthwash that contains ingredients such as chlorine dioxide or essential oils may also be recommended to help reduce the formation of tonsillar stones.

From the Research

Treatment Options for Tonsilloliths

The treatment options for tonsilloliths (tonsillar stones) include:

  • Tonsillectomy: a surgical procedure to remove the tonsils, which can be effective in eliminating tonsil stones 2, 3
  • Coblation tonsil cryptolysis: a minimally invasive procedure that uses Coblation technology to remove the stones and reduce the size of the tonsil crypts, which can be performed under local anesthesia 4
  • Laser cryptolysis: a procedure that uses laser technology to remove the stones and reduce the size of the tonsil crypts, which can be effective in improving halitosis 5
  • Tonsillotomy: a surgical procedure that involves removing part of the tonsil, which can be an alternative to tonsillectomy in adults 3

Considerations for Treatment

When considering treatment options for tonsilloliths, the following factors should be taken into account:

  • The size and location of the stones
  • The severity of symptoms, such as bad breath (halitosis) and sore throat
  • The patient's overall health and medical history
  • The potential risks and benefits of each treatment option, including the risk of complications and the need for anesthesia 4, 5, 3, 6

Minimally Invasive Procedures

Minimally invasive procedures, such as Coblation tonsil cryptolysis and laser cryptolysis, may be preferred over traditional tonsillectomy due to their potential benefits, including:

  • Reduced risk of complications
  • Less post-operative pain and discomfort
  • Faster recovery time
  • Ability to perform the procedure under local anesthesia 4, 5, 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

A giant tonsillolith.

Saudi medical journal, 2018

Research

Halitosis and the tonsils: a review of management.

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2014

Research

Safety of cold ablation (coblation) in the treatment of tonsillar hypertrophy of the tongue base.

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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