From the Research
Tonsil stones can be managed expectantly, and small tonsilloliths are common clinical findings, rarely requiring surgical intervention if they become too large to pass on their own. The management of tonsil stones should prioritize supportive care and maintenance of good oral hygiene, including brushing twice daily, flossing daily, and using an alcohol-free mouthwash to reduce bacteria 1. Staying hydrated helps prevent dry mouth that can contribute to stone formation. For persistent or painful stones, a healthcare provider may recommend antibiotics if infection is present, such as penicillin for group A beta-hemolytic streptococcus, or alternative antibiotics like clindamycin or amoxicillin with clavulanate in cases of treatment failure or resistance 2, 3, 4, 5. However, the most recent and highest quality study suggests that tonsilloliths are managed expectantly, and small tonsilloliths are common clinical findings, rarely requiring surgical intervention 1. Key points to consider in the management of tonsil stones include:
- Maintaining good oral hygiene to reduce bacteria and prevent stone formation
- Staying hydrated to prevent dry mouth
- Using supportive care measures, such as gargling with salt water, to loosen and remove stones
- Considering antibiotic treatment if infection is present, with penicillin as the first-line option for group A beta-hemolytic streptococcus
- Rarely requiring surgical intervention for large or persistent stones.