Basically, it's food bits that get stuck and rot. My doctor calls them tonsiliths (not sure I spelled that correctly) or tonsil stones. One of my kids get them. She usually just lets them come out on their own. I get them too but I have a salon tool for blackheads , but I use it to get it to dig them out cuz it has kind of like a loop.on it. It's made by Tweezerman and is easily sanitized. If you gag easily, then just wait for them to come out or try to loosen it with a q-tip. They really do come out on their own, they just smell bad but are harmless (I've been getting them my whole life).