If your tonsils sense that foreign substances are present in the back of your throat, they will stimulate a localized immune response to combat any potential infection. To trap harmful materials, the tonsils function like nets by snagging incoming particles in small channel and pits along their surfaces, which are called the tonsillar crypts. Additionally, the tonsils filter lymphatic fluid. However, the tonsils tend to retain bits of matter without always discriminating between harmful and benign particles. As a result, excessive debris can accumulate on the surface of the tonsils, combine with lymphatic fluid, and settle into deep recesses of the tonsillar crypts. If this situation persists, the debris attracts bacteria and other pathogens, which then calcify into hard, pale tonsil stones.

Tonsil stones can lead to multiple negative effects, although the exact symptoms vary between patients because of their individual tonsillar characteristics and personal health conditions. Some common side effects of tonsil stones include bad breath, earaches, visible white spots on the tonsils, and an unpleasant metallic taste in the mouth.

This condition also affects the immune system by contributing to tonsillar swelling, which can impair the tonsils' local immune function. As collected debris hardens into tonsil stones in the tonsillar crypts, inflammation from infection or from pressure can prompt your tonsils to become enlarged and inflamed. Additionally, tonsil stones can also affect the respiratory and gastrointestinal tracts, as accumulated material can prompt coughing fits, impaired swallowing, or the sensation that something is lodged near your airway.

Although these symptoms have been noted in some individuals with tonsil stones, not everyone who develops this condition will manifest symptoms. Often, people are unaware that they have tonsil stones until their family doctor discovers the condition incidentally. Those who have large or solidified tonsil stones, however, are more likely to develop unpleasant symptoms and to seek treatment.