Tonsil stones, also known as tonsilloliths or tonsillar calculi, are small accumulations of debris and calcified material that form in the crypts and crevices of the tonsils. While benign, they can cause bad breath, irritation, and discomfort. A common question regarding tonsil stones is whether they are contagious.
What are tonsil stones?
The tonsils are a pair of oval-shaped glands located at the back of the throat. The surface of the tonsils contain many small crevices where bacteria, dead cells, mucus, and other debris can become trapped and concentrated. Over time, this material hardens and calcifies into whitish or yellowish foul-smelling lumps known as tonsil stones.
Tonsil stones tend to be small, ranging from about the size of a small grain of rice up to the size of a pea. They are irregular in shape and can be soft or hard. Larger accumulations may occur as well. While they can occur in any part of the tonsils, they most commonly form in the palatine tonsils at the rear of the throat.
The medical term for tonsil stones is tonsilloliths. They are also sometimes referred to as tonsillar calculi.
What causes tonsil stones?
The exact causes of tonsil stones are not fully understood. However, some factors that allow them to develop include:
– Poor oral hygiene: Insufficient brushing and flossing allows more bacteria and detritus to accumulate in the tonsil crevices.
– Post-nasal drip: Excess mucus from allergies or sinus infections drips down the throat and coats the tonsils.
– Food debris: Food particles can readily lodge in the tonsil crypts.
– Mouth-breathing: Constant open-mouth breathing dries the mouth and allows more particles to adhere to the tonsils.
– Smoking: Chemical particulates from smoking irritate the lining of the throat and stimulate more debris accumulation.
– Acid reflux: Frequent acid regurgitation from the stomach can inflame the tonsils and lead to stone formation.
Once some material becomes lodged in the tonsil crevices, the food particles, mucus, dead cells, and other debris become a breeding ground for bacteria. The bacteria produce foul-smelling compounds like hydrogen sulfide that give tonsil stones their rotten egg odor.
Signs and symptoms
Tonsil stones often produce no signs or symptoms, and are only discovered incidentally when looking into the mouth with a flashlight. When present, common symptoms and signs include:
- Bad breath (halitosis)
- Metallic taste in the mouth
- Sore throat
- Visible white/yellow lumps in the tonsils
- Difficulty swallowing (dysphagia)
- Ear pain
- Tonsil swelling and inflammation
Larger stones may cause additional symptoms such as coughing fits when dislodged and a sensation that something is stuck or lodged in the back of the throat.
Are tonsil stones contagious?
Tonsil stones themselves are not contagious. They form as a result of debris and substances becoming trapped specifically in an individual’s own tonsil crypts. However, the bacteria and viruses that may be present in the tonsil stones could be spread to others.
Can tonsil stone bacteria be transmitted?
While tonsil stones form from substances trapped in the tonsils, they do contain colonies of bacteria as mentioned above. In theory, it is possible for some of these bacteria to be dislodged from a tonsil stone when it breaks free and become infectious when transmitted to another person. However, the risk is low and most bacteria responsible for tonsil stones are not considered contagious.
Can you get tonsil stones from kissing?
Since the bacteria present in tonsil stones are not highly contagious, getting tonsil stones from kissing or other close contact is very unlikely. There are no documented cases of tonsil stones being transmitted through kissing or sexual activity.
Are tonsil stones a symptom of COVID-19?
No, tonsil stones are not an accepted symptom of COVID-19 infection. While COVID-19 often causes sore throat, the tonsil lesions and infections seen are different than typical tonsil stones.
Prevention
Good oral hygiene is the best way to prevent tonsil stones. Practices to keep tonsil stones from forming include:
- Brushing teeth twice daily and flossing once per day
- Using an antiseptic mouthwash to kill bacteria
- Getting treated for sinus infections and allergies to reduce post-nasal drip
- Treating acid reflux if present
- Quitting smoking
- Drinking plenty of fluids to stay hydrated
For those prone to recurrent tonsil stones, regular use of a water oral irrigator may help clear debris from the tonsil crevices.
Treatment and removal
In most cases tonsil stones do not require treatment or removal. However, if they become large, cause recurring symptoms, or are easily visible they can be removed by:
- Physical removal by a doctor or dentist
- Oral irrigation with a water flossing device
- Gargling with salt water to dislodge stones
- Taking medication to shrink tonsils and decrease debris accumulation
- Tonsillectomy surgery as a last resort treatment
Self-removal should be done gently to avoid damaging the tonsils which could become infected. Only attempt to dislodge small visible stones carefully using a cotton swab or toothbrush. Do not attempt to dig out stones that are lodged deep within the tonsils.
When to see a doctor
Consult a healthcare provider if tonsil stones are:
- Large in size
- Causing recurring pain or discomfort
- Leading to difficulty swallowing
- Associated with persistent bad breath
- Obstructing breathing
Also seek medical advice if the tonsils appear very swollen or infected. Rare cases of tonsil infections requiring antibiotics have occurred after aggressively trying to remove embedded stones.
The bottom line
In summary, tonsil stones themselves are not contagious and generally do not pose a health hazard. While tiny amounts of bacteria may dislodge from stones, the risk of transmission appears negligible. Practicing good oral hygiene and addressing any underlying medical conditions is the best way to deal with tonsil stones. See a doctor if they are causing bothersome symptoms that don’t resolve with conservative measures.