[1] Symptoms may include bad breath,[1] foreign body sensation, sore throat, pain or discomfort with swallowing, and cough.

[1] The presence of tonsil stones may be otherwise undetectable; however, some people have reported seeing white material in the rear of their throat.

Tonsilloliths that exceed the average size are typically seen in older individuals as the likelihood of developing tonsil stones is linear.

[1] Biological sex does not influence the chance of having tonsil stones,[1] but older people are more commonly affected.

[2] Many people opt to extract their own tonsil stones manually or with developments in dental hygiene products.

This involves loudly producing a voiceless velar fricative sound, at various pitches to shake both the palatine and lingual tonsils.

[12] A medical study conducted in 2007 found an association between tonsilloliths and bad breath in patients with a certain type of recurrent tonsillitis.

The mechanism by which these calculi form is subject to debate,[3] though they appear to result from the accumulation of material retained within the crypts, along with the growth of bacteria and fungi—sometimes in association with persistent chronic purulent tonsillitis.

Tonsilloliths are difficult to diagnose in the absence of clear manifestations, and often constitute casual findings of routine radiological studies.

Tonsils are filled with crevices where bacteria and other materials, including dead cells and mucus, can become trapped.

[17] On average, tonsil stones should appear within a similar range of the image shown here; however, individuals with extenuating cases have been reported.

Imaging diagnostic techniques can identify a radiopaque mass that may be mistaken for foreign bodies, displaced teeth or calcified blood vessels.

The differential diagnosis must be established with acute and chronic tonsillitis, tonsillar hypertrophy, peritonsillar abscesses, foreign bodies, phlebolites, ectopic bone or cartilage, lymph nodes, granulomatous lesions or calcification of the stylohyoid ligament in the context of Eagle syndrome (elongated styloid process).

[18] Differential diagnosis of tonsilloliths includes foreign body, calcified granuloma, malignancy, an enlarged temporal styloid process or rarely, isolated bone which is usually derived from embryonic rests originating from the branchial arches.

Irrigators that connect directly to the sink tap via a threaded attachment or otherwise are suitable for tonsil stone removal and everyday washing of the tonsils because they can jet water at low-pressure levels that the user can adjust by simply manipulating the sink tap, allowing for a continuous range of pressures to suit each user's requirements.

Larger lesions may require local excision, although these treatments may not completely help the bad breath issues that are often associated with this condition.

This technique flattens the edges of the crypts and crevices that collect the debris, preventing trapped material from forming stones.