Tonsillitis and tonsil stones are two different conditions that affect the tonsils. Tonsillitis is inflammation, usually caused by a viral infection and sometimes by bacteria, while tonsil stones are small, hardened collections of material that form in the small pockets of the tonsils.
Tonsillitis commonly causes a sore throat, fever and swollen tonsils, whereas tonsil stones are more often linked with bad breath, a feeling of something stuck in the throat and small white or yellow lumps.
Dr Nick Hamilton ENT, is the founder of The Throat Specialist – Get in touch to discuss tonsil stones treatment in London by email on secretary@throatspecialist.co.uk or call us on 020 7034 6053.
Key Takeaways
- Tonsillitis is usually an infection or inflammation of the tonsils.
- Tonsil stones form when debris collects and hardens in the tonsil pockets.
- The two conditions can occur together, but they are not the same thing.
Tonsil Stones and Tonsilitis – A Comparison
| Tonsillitis | Tonsil Stones |
|---|---|
| What is it? Inflammation or infection of the tonsils. | What is it? Small, hardened lumps that form in the pockets of the tonsils. |
| Main cause Usually caused by a viral infection, sometimes by bacteria. | Main cause Food particles, bacteria, dead cells and other debris becoming trapped in the tonsils. |
| Common symptoms Sore throat, swollen tonsils, difficulty swallowing, fever and sometimes white patches. | Common symptoms Bad breath, unpleasant taste, a feeling of something stuck in the throat and visible white or yellow lumps. |
| Pain Often causes a painful or sore throat. | Usually causes little or no pain, although larger stones can cause irritation. |
| Fever A fever can occur. | Fever is not usually associated with tonsil stones. |
| Treatment Often gets better with rest and fluids; bacterial cases may sometimes need antibiotics. | Often needs no treatment; good oral hygiene and gargling may help. |
| Can it come back? Yes, tonsillitis can occur repeatedly. | Yes, tonsil stones can return, particularly if the tonsils have deep pockets. |
| Is it an infection? Yes, tonsillitis is usually linked to an infection. | No, tonsil stones are not the same as an infection. |
What is tonsillitis?
Tonsillitis means that the tonsils have become inflamed. It is usually caused by a virus, such as those responsible for colds and flu, but bacteria can also cause it.
Typical symptoms include a sore throat, difficulty swallowing, swollen tonsils and a high temperature. Some people also have white or yellow patches on the tonsils.
Tonsillitis can be uncomfortable, but it often improves without specific treatment. The NHS says symptoms usually go away after around 3 to 4 days, although they can last longer.
If bacteria are responsible, a GP may consider antibiotics depending on the symptoms and assessment.
How is tonsillitis treated?
Tonsillitis is usually treated with rest, plenty of fluids and pain relief such as paracetamol or ibuprofen to help ease a sore throat and fever.
Most cases are caused by viruses and get better without antibiotics. If tonsillitis is caused by bacteria, a GP may prescribe antibiotics.
Gargling with warm salty water may also help soothe the throat in adults and older children. In severe or recurring cases, particularly when tonsillitis causes ongoing problems, a doctor may discuss further treatment such as a tonsillectomy.
What are tonsil stones?
Tonsil stones, also called tonsilloliths, are hard deposits that develop inside the small folds and pockets of the tonsils.
Food debris, bacteria, dead cells and other material can collect in these spaces. Over time, the material can harden into a small stone.
Tonsil stones can be white, cream or yellow and may look like small pieces of food stuck in the tonsils.
They are relatively common. NHS clinical guidance says tonsil stones can occur in up to 10% of the population.
Do tonsillitis and tonsil stones have different symptoms?
Yes. Tonsillitis usually produces symptoms of inflammation or infection, while tonsil stones often cause local irritation.
With tonsillitis, you are more likely to have a painful sore throat, swollen tonsils, difficulty swallowing and a temperature.
Tonsil stones are more commonly associated with bad breath, an unpleasant taste, a feeling that something is stuck in the throat or small visible lumps on the tonsils. Some people have no symptoms at all.
This difference can be useful when trying to understand what is happening in your throat.
Can you have tonsillitis and tonsil stones together?
Yes. Having tonsil stones does not prevent you from developing tonsillitis.
In fact, tonsil stones can be associated with a history of repeated tonsillitis because repeated inflammation can affect the structure of the tonsils and their small pockets.
However, seeing a white spot on your tonsil does not automatically mean you have an infection. It could be a tonsil stone.
A healthcare professional can examine your throat if you are unsure.
How are tonsil stones treated?
Tonsil stones do not always need treatment, particularly if they are small and cause no symptoms.
Good oral hygiene can help reduce the amount of debris and bacteria in the mouth. Brushing your teeth twice a day, cleaning between your teeth and keeping the tongue clean may help.
Gargling with salt water or an appropriate mouthwash may also help loosen debris.
Tonsil stones are not usually treated with antibiotics because they are not the same as a bacterial tonsil infection. NHS guidance also notes that tonsillectomy is not routinely recommended simply for tonsil stones.
When should I see a GP about my tonsils?
You should seek medical advice if your sore throat is severe, keeps returning or does not improve.
The NHS advises contacting a GP if tonsillitis symptoms have not gone away within a week or if you keep getting throat infections.
Get urgent help if you cannot swallow, have difficulty breathing, develop swelling in the mouth or throat, or have a severe sore throat that is rapidly getting worse.
Understanding the difference between tonsillitis and tonsil stones can make throat symptoms less worrying, but persistent or severe symptoms should always be checked by a healthcare professional.
