From the Guidelines
To prevent tonsil stones, maintain excellent oral hygiene by brushing your teeth twice daily, flossing daily, and using an alcohol-free mouthwash, as recommended by the most recent guidelines 1.
Key Recommendations
- Brush your teeth twice daily to reduce bacteria and debris
- Floss daily to remove food particles and plaque
- Use an alcohol-free mouthwash to reduce bacteria that contribute to stone formation, such as rinsing with an alcohol-free mouthwash upon awakening and at least four times a day after brushing, for ∼1 min with 15 ml mouthwash; gargle; and then spit out, as suggested by 1
- Gargle with salt water (1/2 teaspoon salt in 8 ounces of warm water) once or twice daily to flush out debris from tonsil crypts
- Stay well-hydrated by drinking plenty of water throughout the day to keep saliva flowing, which naturally cleanses the mouth
- Consider using a water flosser or oral irrigator on a low setting to gently clean tonsil crevices
- Avoid tobacco products and limit alcohol consumption as these can increase mucus production and irritate tonsil tissue
- If you're prone to post-nasal drip, address underlying allergies or sinus issues with appropriate medications like antihistamines or nasal sprays
Rationale
Tonsil stones form when food particles, dead cells, and bacteria become trapped in the small crevices of your tonsils and calcify over time. By reducing the buildup of these materials through regular cleaning and hydration, you can significantly decrease your chances of developing these uncomfortable deposits. The most recent guidelines 1 emphasize the importance of oral hygiene in preventing tonsil stones, and provide specific recommendations for mouthwash use. While other studies 1 provide additional information on tonsillectomy and sleep disorders, they are not directly relevant to the prevention of tonsil stones. Therefore, the key recommendations focus on oral hygiene and hydration, as supported by the most recent and highest quality evidence 1.
From the Research
Methods for Preventing Tonsilloliths
There are several methods that can help prevent tonsilloliths (tonsil stones). Some of these methods include:
- Practicing good oral hygiene, such as brushing teeth and tongue regularly 2
- Using a tongue scraper to reduce bacteria and debris on the tongue 3
- Rinsing with an antiseptic mouthwash to help kill bacteria and reduce inflammation 4
- Avoiding sugary foods and drinks that can contribute to tooth decay and inflammation
- Staying hydrated to help keep the mouth moist and reduce bacterial growth
Reducing Bacteria and Debris
Reducing bacteria and debris on the tongue and in the mouth can help prevent tonsilloliths. This can be achieved through:
- Tongue scraping, which has been shown to be effective in reducing mutans streptococci levels 3
- Using a mouthwash that contains chemical agents that can penetrate biofilm and kill plaque biofilm bacteria, such as chlorhexidine or Listerine 4
- Brushing teeth and tongue regularly to remove bacteria and debris 2
Oral Hygiene Practices
Good oral hygiene practices are essential for preventing tonsilloliths. This includes:
- Brushing teeth at least twice a day with a fluoride toothbrush 4
- Flossing once a day to remove food particles and debris from between teeth 4
- Rinsing with an antiseptic mouthwash to help kill bacteria and reduce inflammation 4
- Visiting a dentist regularly for check-ups and cleanings to help prevent oral health problems 4