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

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Last updated: April 17, 2025View editorial policy

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From the Research

Tonsil stones can be managed expectantly, and small tonsilloliths are common clinical findings that rarely require surgical intervention. According to the most recent study 1, treatment is focused on supportive care, and watchful waiting is strongly recommended for recurrent tonsillitis. For tonsil stones, maintaining good oral hygiene is essential, including brushing twice daily, flossing once daily, and using an alcohol-free mouthwash to reduce bacteria that contribute to stone formation. Staying hydrated helps prevent dry mouth that can worsen tonsil stones.

Some key points to consider when managing tonsil stones include:

  • Gargling with salt water to dislodge the stones and reduce inflammation
  • Gently removing visible stones using a cotton swab, soft toothbrush, or water flosser on the lowest setting
  • Using over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil) for persistent or painful stones
  • Consulting a healthcare provider if home remedies don't work or if severe symptoms like difficulty swallowing, persistent bad breath, or recurrent tonsillitis occur.

It's worth noting that while Coblation tonsil cryptolysis has been proposed as a treatment option for tonsil stones 2, the most recent and highest quality study 1 suggests that expectant management and supportive care are the preferred approaches. Surgical intervention, including tonsillectomy, is rarely required and should only be considered in severe cases.

References

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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