Tonsil stones and tonsil resurfacing
Tonsilloliths are small calcified deposits in the surface of the tonsils that cause bad breath and a foreign-body sensation. Most are managed at home; persistent cases respond to tonsil resurfacing or, less commonly, tonsillectomy.
Tonsil stones are small pale lumps of compacted debris that form in the natural crevices (crypts) of the tonsils. They are common, rarely dangerous, and for some people the cause of persistent bad breath and an uncomfortable feeling that something is stuck in the throat.
Common symptoms
- Persistent bad breath that does not respond to dental hygiene
- A foreign-body sensation at the back of the throat
- Coughing up small pale particles, often with a strong smell
- Sometimes a visible white lump in one tonsil, or ear pain on the same side
Tonsil resurfacing (cryptolysis)
Where self-care (gargles, hygiene, gentle irrigation) is not enough, tonsil resurfacing smooths out the crypts so debris cannot lodge, preserving the tonsil itself. It is a 20 to 30 minute day-case procedure with an easier recovery and lower bleeding risk than tonsillectomy. Full removal of the tonsils remains the right option where frequent tonsillitis coexists or resurfacing has not worked.
Assessment and treatment
Assessment is a careful history and examination of the throat, with an endoscope where useful; imaging is rarely needed. A single firm lump in one tonsil that does not behave like a typical stone is examined and biopsied to exclude rare alternative causes.
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This page is general information and not a substitute for individual medical advice.