Tonsil stones form when debris such as food particles, dead cells, mucus, and bacteria get trapped in the crevices or folds of the tonsils called tonsillar crypts. Over time, this trapped debris can harden or calcify, mainly due to minerals like calcium and magnesium present in saliva, forming small white or yellow lumps that resemble pebbles

. People with enlarged tonsillar crypts, chronic inflammation, or repeated tonsillitis are more prone to developing tonsil stones because the damaged or swollen tonsils have deeper or more numerous crypts where debris can accumulate

. Bacteria and fungi involved in tonsillitis can also contribute to the formation of these stones

. In summary, tonsil stones form through a process of:

• Debris accumulation in tonsillar crypts (food, dead cells, mucus, bacteria)
• Mineral deposition and calcification of this debris
• Formation of hard or rubbery lumps within the tonsil crevices

This process is more common in individuals with chronic tonsil issues or enlarged tonsillar crypts