Tonsil stones, also known as tonsilloliths, are mineralizations of debris within the crevices of the tonsils. When not mineralized, the presence of debris is known as chronic caseous tonsillitis. Symptoms may include bad breath. Generally there is no pain, though there may be the feeling of something present.
Risk factors may include recurrent throat infections. Tonsil stones contain a biofilm composed of a number of different bacteria. While they most commonly occur in the palatine tonsils, they may also occur in the lingual tonsils. They are often discovered during medical imaging for other reasons.
If tonsil stones do not bother the patient, no treatment is needed. Otherwise gargling salt water and manual removal may be tried. Chlorhexidine or cetylpyridinium chloride may also be tried. Surgical treatment may include partial or complete tonsil removal.

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