Since tonsil stones are not a serious health problem and are generally not harmful, your doctor will probably recommend preventive measures to clear them out periodically and reduce your symptoms. If they’re not bothering you and you’re not noticing unpleasant symptoms, your doctor may advise you to leave them alone, Yip says. (1,2)
In most cases, tonsil stones can be managed at home. Some people prefer to push these objects out themselves using a cotton swab or their finger. If that poses a problem because it triggers your gag reflex, using a water flosser usually allows you to flush out the stones may be a better option. (1,2)
Both Thatcher and Dr. Setlur recommend using a water flosser for tonsil stone removal because it’s effective and safe and doesn’t cause gagging. If you decide to use something else to dislodge the stones, do not use anything sharp (such as toothpicks or pins) to do so, Setlur says. Using these types of tools can cause injury to the tonsils or bleeding.
Medication Options
Your doctor may prescribe antibiotics or an anti-inflammatory medication such as a corticosteroid for tonsil stone flares, but these medications would only be used to help clear up an episode of stones and should not be prescribed for long-term use, Kezirian says. “These medications can help decrease swelling and make the crypts less shallow.”
Surgery Options
Another option for removal of tonsil stones is surgery. However, doctors generally do not recommend a tonsillectomy to treat tonsil stones unless a patient’s life is severely impacted in a negative way by the tonsilliths. (1,2,3) Frequent tonsil stones may also increase your risk of tonsillitis (an infection of the tonsils), which could be another reason for considering a surgical option to deal with serious cases, according to Kezirian.
Such surgical options to treat tonsil stones include:
- Tonsillectomy This is surgery to completely remove the tonsils, which means that the stones cannot grow back. While a tonsillectomy is the most effective way to prevent tonsil stones from forming, there are potentially serious risks to be aware of when considering this option. For one thing, a tonsillectomy requires general anesthesia, and it can involve a great deal of pain that may last for weeks, says Thatcher. And, as with any surgery, there is a risk of bleeding and infection. (1,2)
- Laser Tonsil Cryptolysis In this procedure, surgeons use a laser to get rid of tonsil crypts to prevent tonsil stones from forming. (4)
- Coblation Cryptolysis In this procedure, surgeons use radiofrequency energy and saline to remove tonsil crypts and crevices. Because surgeons are able to do this procedure at a lower temperature than with laser tonsil cryptolosis, there is lower risk of certain complications. (5)
Both methods of cryptolysis require only local anesthesia — unlike tonsillectomy, which is done under general anesthesia — so they may result in less pain afterward and faster recoveries. (4,5)
However a review published in August 2017 in the Cochrane Database of Systematic Reviews concluded that there’s not enough evidence yet to show that coblation cryptolysis is safer or better tolerated in patients or results in improved post-operative outcomes compared with other procedures, such as tonsillectomy or laser tonsil cryptolysis. (6)
Learn More About Treatment for Tonsil Stones: Medication, Surgery Options, and More
