Tonsillar cryptsare pockets or folds that occur naturally intonsils, which are lumps of soft tissue on each side of the throat that are part of the immune system.
Crypts in thetonsilsare usually small and relatively debris-free. However, if food, mucus, and other debris collects in them and gets stuck, it can harden intotonsil stones, also calledtonsilloliths.
This article will explore common symptoms, causes, and treatment for tonsil stones that form in the crypts.
Verywell / Cindy Chung
Symptoms of Tonsil Stones in Cryptic Tonsils
Mosttonsil stonesare harmless and do not lead to pain. If they are small, they may not cause any symptoms.
If there are symptoms, they can include:
Bad breath is the most common symptom of tonsil stones.
Tonsil stones can look like white or yellowish flecks at the back of the throat. Some are large enough to stick out from the tonsils, resembling tiny rocks.
The crypts have low levels of oxygen, making the environment susceptible to bacteria that do not need oxygen, which are calledanaerobes. When a mixture of bacteria starts to build up in the crypt, it can lead to an infection.
The infection can cause inflammation that is sometimes referred to as chronic caseous tonsillitis or fetid tonsils.
The “caseous” refers to a cheese-like formation in the crypts. If this cheese-like mix of bacteria, mucus, or other debris does not go away, it can harden or calcify into stones.
Causes
You can get an infection or tonsil stones in the crypts if you have naturally large or wrinkly tonsils, which are more prone to trapping food.
Other debris can build up in these holes in your tonsils as well, including pus—a thick fluid that is part of the body’s inflammatory response to an infection—and bacteria that produce sulfur compounds and create bad breath.
Cryptic tonsils account for only about 3% of cases of bad breath, though.
Inflamed cryptic tonsils often look similar tostrep throator other throat infections. Fortunately, cryptic tonsils alone are not generally harmful to your health.
Folds in tonsils called crypts are normal. If food and other material gets trapped in the crypts, it can lead to infections or harden into tonsil stones, causing bad breath and/or throat irritation.
How to Treat Tonsil Stones in Cryptic Tonsils
There are several options for removing tonsil stones if you have cryptic tonsils, depending on the severity of the condition.
Do not try to remove a tonsil stone on your own. Using a Waterpik may only force a stone deeper into the tissues. Tongue depressors, tweezers, dental picks, and even cotton swabs are more likely to cause harm than not.
Tonsil Stone Removal
Common methods a healthcare provider may use to remove tonsil stones include:
The laser for carbon dioxide laser cryptolysis works like peeling an onion. By doing so, it exposes the crypt and allows for the removal of the tonsil stone. You will be given alocal anestheticto prevent pain during the procedure, which will generally take about 20 minutes.
Tonsillectomy Surgery
The last option to treat cryptic tonsils is surgical removal of the tonsils, which is called atonsillectomy.
Removing the tonsilsis highly effective, but the surgery has risks that must be considered, such as a risk of bleeding after the procedure.It also may includegeneral anesthesia, which puts you into a sleep-like state for the surgery.
Tonsillectomy is usually only recommended if other treatments weren’t effective or if you have additional conditions such assleep apnea(pauses in breathing during sleep), chronic strep throat, or other chronic conditions affecting the throat.
Summary
If food and debris gets trapped in the pockets and folds of yourtonsils, it can harden into yellow or white deposits called tonsil stones.
Tonsil stones in the crypts are usually harmless but can lead to bad breath and throat irritation.
It’s not recommended to try to remove a tonsil stone on your own. An ear, nose, and throat specialist or dentist can use tools to remove them safely and fully.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tonsil stones.AFP.2023;107(1):41C-41C.Bamgbose BO, Ruprecht A, Hellstein J, Timmons S, Qian F.The prevalence of tonsilloliths and other soft tissue calcifications in patients attending oral and maxillofacial radiology clinic of the University of Iowa.ISRN Dentistry. 2014;2014:1-9. doi:10.1155/2014/839635Ferguson M, Aydin M, Mickel J.Halitosis and the tonsils: a review of management.Otolaryngol Head Neck Surg. 2014;151(4):567-74. doi:10.1177/0194599814544881Bollen CM, Beikler T.Halitosis: the multidisciplinary approach.Int J Oral Sci. 2012;4(2):55-63. doi:10.1038/ijos.2012.39Krespi YP, Kizhner V.Laser tonsil cryptolysis: In-office 500 cases review.American Journal of Otolaryngology. 2013; 34(5), 420–424. doi:10.1016/j.amjoto.2013.03.006Siber S, Hat J, Brakus I, et al.Tonsillolithiasis and orofacial pain.Gerodontology. 2012;29(2):e1157-60. doi:10.1111/j.1741-2358.2011.00456.xUpToDate.Tonsillectomy in adults.Additional ReadingWetmore, RF.Tonsils and Adenoids. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, Behrman RE, editors.Nelson Textbook of Pediatrics. New York: Elsevier; 2015: 2023-2026.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Tonsil stones.AFP.2023;107(1):41C-41C.Bamgbose BO, Ruprecht A, Hellstein J, Timmons S, Qian F.The prevalence of tonsilloliths and other soft tissue calcifications in patients attending oral and maxillofacial radiology clinic of the University of Iowa.ISRN Dentistry. 2014;2014:1-9. doi:10.1155/2014/839635Ferguson M, Aydin M, Mickel J.Halitosis and the tonsils: a review of management.Otolaryngol Head Neck Surg. 2014;151(4):567-74. doi:10.1177/0194599814544881Bollen CM, Beikler T.Halitosis: the multidisciplinary approach.Int J Oral Sci. 2012;4(2):55-63. doi:10.1038/ijos.2012.39Krespi YP, Kizhner V.Laser tonsil cryptolysis: In-office 500 cases review.American Journal of Otolaryngology. 2013; 34(5), 420–424. doi:10.1016/j.amjoto.2013.03.006Siber S, Hat J, Brakus I, et al.Tonsillolithiasis and orofacial pain.Gerodontology. 2012;29(2):e1157-60. doi:10.1111/j.1741-2358.2011.00456.xUpToDate.Tonsillectomy in adults.Additional ReadingWetmore, RF.Tonsils and Adenoids. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, Behrman RE, editors.Nelson Textbook of Pediatrics. New York: Elsevier; 2015: 2023-2026.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Tonsil stones.AFP.2023;107(1):41C-41C.Bamgbose BO, Ruprecht A, Hellstein J, Timmons S, Qian F.The prevalence of tonsilloliths and other soft tissue calcifications in patients attending oral and maxillofacial radiology clinic of the University of Iowa.ISRN Dentistry. 2014;2014:1-9. doi:10.1155/2014/839635Ferguson M, Aydin M, Mickel J.Halitosis and the tonsils: a review of management.Otolaryngol Head Neck Surg. 2014;151(4):567-74. doi:10.1177/0194599814544881Bollen CM, Beikler T.Halitosis: the multidisciplinary approach.Int J Oral Sci. 2012;4(2):55-63. doi:10.1038/ijos.2012.39Krespi YP, Kizhner V.Laser tonsil cryptolysis: In-office 500 cases review.American Journal of Otolaryngology. 2013; 34(5), 420–424. doi:10.1016/j.amjoto.2013.03.006Siber S, Hat J, Brakus I, et al.Tonsillolithiasis and orofacial pain.Gerodontology. 2012;29(2):e1157-60. doi:10.1111/j.1741-2358.2011.00456.xUpToDate.Tonsillectomy in adults.
Tonsil stones.AFP.2023;107(1):41C-41C.
Bamgbose BO, Ruprecht A, Hellstein J, Timmons S, Qian F.The prevalence of tonsilloliths and other soft tissue calcifications in patients attending oral and maxillofacial radiology clinic of the University of Iowa.ISRN Dentistry. 2014;2014:1-9. doi:10.1155/2014/839635
Ferguson M, Aydin M, Mickel J.Halitosis and the tonsils: a review of management.Otolaryngol Head Neck Surg. 2014;151(4):567-74. doi:10.1177/0194599814544881
Bollen CM, Beikler T.Halitosis: the multidisciplinary approach.Int J Oral Sci. 2012;4(2):55-63. doi:10.1038/ijos.2012.39
Krespi YP, Kizhner V.Laser tonsil cryptolysis: In-office 500 cases review.American Journal of Otolaryngology. 2013; 34(5), 420–424. doi:10.1016/j.amjoto.2013.03.006
Siber S, Hat J, Brakus I, et al.Tonsillolithiasis and orofacial pain.Gerodontology. 2012;29(2):e1157-60. doi:10.1111/j.1741-2358.2011.00456.x
UpToDate.Tonsillectomy in adults.
Wetmore, RF.Tonsils and Adenoids. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, Behrman RE, editors.Nelson Textbook of Pediatrics. New York: Elsevier; 2015: 2023-2026.
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