Why You Keep Getting Tonsil Stones, and How to Prevent Them

But if you prefer not to go that route (after all, tonsils are an important part of the immune system), or if your doctor doesn’t recommend surgery as an option for you, then other preventive strategies may help keep tonsil stones at bay.

And if tonsil stones do start to crop up, these steps can help keep their size and number in check.

“We think they form because material enters the crypts,” says Aaron Thatcher, MD, clinical assistant professor of otolaryngology at Nationwide Children’s Hospital in Columbus, Ohio. “We don’t think it’s hygiene” he adds, as some people with meticulous oral hygiene still develop tonsil stones.

Aside from practicing good oral care to reduce bacteria in your mouth, you can also try the following tricks to help prevent tonsil stones from forming.

• Gargling “Gargling can help clean out debris and prevent buildup before stones form,” Dr. Thatcher says. Whether you use a mild antiseptic mouthwash or water doesn’t matter so much as the act of gargling to flush out germs and dislodge any small particles that may be gathering on the tonsils.

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  Though some people say gargling with salt water or baking soda can help prevent or remove tonsil stones, Jennifer Setlur, MD, an otolaryngologist at Mass Eye and Ear at Mass General Brigham in Boston, notes that there’s probably not a lot of difference between using some type of solution and just plain water.
• Using a Water Flosser to Clean Your Mouth Regularly Dislodging tonsil stones with a stream of water from a power flosser is a great way to remove tonsil stones, and it’s also an effective way to prevent them from forming in the first place, Dr. Setlur notes. “You can aim the water more directly at the stones and safely rinse them out,” she says.
• Staying Hydrated Drinking water regularly throughout the day helps maintain moisture in your mouth and clear out debris, which help prevent stones from forming.

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But some people may be so bothered by tonsil stones symptoms, like bad breath or persistent and frequent stones, that they opt for surgery, Thatcher says. Some people may cough up irksome stones every couple of days. For others, it’s how the stones and symptoms affect their career or social life. If your job requires you to interact with people frequently, for example, or if you’re a dentist who needs to be in close proximity to patients, chronic bad breath can be problematic, Thatcher says.

The key to deciding whether or not to choose tonsillectomy to prevent tonsil stones is to understand the risks and go over your options with your doctor. “Discuss the benefits and complications,” Thatcher says. “It’s very personal. Weigh and balance how deeply it affects your life.”

• Good oral hygiene, including regular brushing, rinsing, flossing, and tongue cleaning can reduce bacteria that contribute to tonsil stones.
• Strategies like gargling and using a water flosser can help dislodge deeper food particles, preventing tonsil stones from forming.
• For some, surgical removal of the tonsils, known as a tonsillectomy, is recommended as a permanent solution — but this involves significant pain and risk, requiring careful discussion with a healthcare professional.