While there’s no established link between lupus and tonsil stones, the inflammation associated with lupus may contribute to their formation.

Tonsil stones, or tonsilloliths, aren’t specific to lupus. However, people with lupus may be at a higher risk due to the chronic inflammation and immune system dysregulation associated with the disease.

Lupus can also lead to swelling in the tonsils and throat, which can result in dry mouth and a greater accumulation of bacteria and debris.

This environment may promote tonsil stone formation, especially in those who experience recurrent throat infections or have other autoimmune conditions affecting oral health.

Tonsil stones form when debris — such as food particles, dead cells, and bacteria — accumulates in the crevices of the tonsils.

Over time, this debris can harden or calcify, leading to the formation of small, often foul-smelling stones.

Contributing factors include:

  • Inconsistent oral hygiene: Inadequate brushing and flossing can allow bacteria and food particles to accumulate.
  • Chronic tonsillitis: Recurrent infections can lead to inflammation and enlargement of the tonsils, creating more crevices for debris to collect.
  • Dry mouth: Reduced saliva flow makes it difficult to wash away debris, increasing the risk of stone formation.
  • Large tonsils: Anatomically, larger tonsils can have deeper crypts (pockets), making it easier for debris to become trapped.

Lupus can indirectly contribute to the development of tonsil stones through several mechanisms:

  • Chronic inflammation: Lupus causes persistent inflammation in various body parts, including the tonsils. This inflammation can lead to enlarged tonsils, increasing the likelihood of debris accumulation.
  • Dry mouth: Many people experience dry mouth (xerostomia) as a side effect of medications or the disease itself. Reduced saliva decreases the natural cleansing of the mouth, allowing debris to build up and form stones.
  • Immunosuppression: Lupus can alter immune function, making you more susceptible to tonsillitis and other infections, which can further contribute to inflammation and stone formation.
  • Reduced hygiene: Additional lupus-related symptoms, such as fatigue or general malaise, may lead to less attention to oral hygiene, increasing the risk of tonsil stones.

The tonsils play a key role in your immune system. Researchers in Sweden looked at data from 179,875 people who had a tonsillectomy between 1997 and 2012 and tracked them for the development of autoimmune diseases.

They found that 5,357 of these individuals were later diagnosed with autoimmune diseases, which is about 1.34 times more than what would be expected in the general population.

Tonsil stones may be treated in the following ways:

  • Saltwater gargle: Rinsing with warm salt water can ease discomfort and help loosen tonsil stones naturally.
  • Manual removal: Stones can sometimes be gently removed with a cotton swab or dental tool, but it should be done carefully to avoid injury.
  • Coblation cryptolysis: This is a minimally invasive procedure using radiofrequency energy to dissolve tonsil tissue with minimal heat. Research suggests it promotes shorter surgeries, less bleeding, reduced need for pain medication, and faster recovery compared to more invasive methods, such as monopolar or bipolar diathermy and cold dissection.
  • Monopolar or bipolar diathermy: These techniques use electrical energy to cut tissue and stop bleeding during tonsil removal. While effective, they generate heat that can cause more postoperative pain and a longer recovery time.
  • Tonsillectomy: Complete removal of the tonsils, typically recommended for people with recurring tonsil stones or infections to prevent future issues.
  • Oral irrigation: A water irrigator with low pressure can flush out debris lodged in the tonsils.
  • Antibiotics: If an infection occurs, antibiotics may be prescribed, but this only addresses symptoms, not the underlying stones.

Good hygiene and daily habits may help prevent tonsil stones:

  • Stay hydrated: Drinking water helps maintain saliva flow, preventing dryness that can encourage stone formation.
  • Practice consistent oral hygiene: Brush your teeth and tongue regularly, and floss daily to remove food particles and bacteria.
  • Try a water flosser: This device can help flush out debris from the tonsil crypts.
  • Use a mouthwash: Non-alcoholic antibacterial rinses or saltwater gargles can reduce bacterial growth.
  • Gargle regularly: Gargling with salt water can loosen particles stuck in the tonsils.
  • Manage postnasal drip: If allergies or sinus issues contribute to mucus buildup, addressing them may help prevent stones.
  • Limit or avoid smoking and alcohol: These can dry out the mouth and promote bacterial growth.
  • Consider tonsillectomy: In recurrent or severe cases, removing the tonsils might be the best preventive option.

While there is no established direct link between lupus and tonsil stones, individuals with lupus may be at a higher risk due to inflammation and dryness associated with the condition.

Further research is needed to explore the underlying mechanisms connecting autoimmune conditions like lupus with tonsil stone formation.

Managing lupus symptoms effectively and maintaining good oral hygiene can help reduce the likelihood of developing tonsil stones.