While many tonsil stones are small and don’t cause any discomfort, when larger calcifications form, they can make swallowing painful. “When [the tonsil stones] are rock hard, they can act as a foreign body and cause localized discomfort,” says Murray. “When you swallow, it is like you have a pin in your throat.” If you are experiencing swallowing discomfort and don’t have allergies or a virus like strep throat, the pain may be caused by large tonsil stones. Sometimes you can dislodge the tonsil stones at home by vigorously gargling salt water or even coughing. However, larger tonsoliths may require a consultation with an ear, nose, and throat (ENT) specialist to discuss professional removal options such as laser tonsil cryptolysis. According to the New York Head and Neck Institute, during this procedure, which is done under local anesthesia (meaning you’re awake), a doctor inserts a tube containing a laser through your nostrils and down your throat to blast through tonsil stones.