I did some searching for "white and tonsils" and found this about tonsilloliths .

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Q: I hope this doesn't sound too gross, but both my sister and I get white particles in the pockets of our tonsils. She thinks it is food buildup but I think it is the bacteria that the tonsils build up.

The stuff is like cauliflower, kind of hard and with a foul odor. She thinks she needs to have her tonsils out. Can you advise us on this? We both have it regularly, but our throats are not really sore.

A: Doesn’t sound gross to me, but it’s probably a pretty gross problem for you and your sister.

These things are called tonsilloliths ("tonsil stones.") You have described them perfectly. They are typically white, or whitish-yellow, irregularly-shaped, foul-smelling, and usually smaller than a pea.

The tissue lining the tonsils (oral mucosa) is fairly sensitive, so people with this problem often report that they feel an irritation in the back of their throat and are able to pick these critters out of their tonsils.

Like your skin, oral mucosa sheds continuously. The dead cells become incorporated in your saliva and then you swallow them. Yum!

One more anatomical fact that you need to know: the surface of your tonsils is pockmarked with deep pits, appropriately called "crypts" (since dead stuff accumulates in these pits.)

Oral mucosa lines the crypts. Under normal circumstances, as this mucosa sheds, the dead cells leave the crypts and are swallowed.

In some unlucky people, like you and your sister, the dead cells accumulate and glom together to form hard little balls.

All of this dead stuff makes great food for bacteria, and of course your oral cavity is colonized by all kinds of bacteria. Consequently, the tonsilloliths are ripe with bacteria. This accounts for the smell.

The only sure-fire method for ridding yourself of this problem is to have your tonsils removed (tonsillectomy), but there are nonsurgical alternatives which you should certainly pursue before you ask an ENT to take out your tonsils:

– You could try gargling frequently with warm salt water (1 teaspoon of table salt mixed with one pint of water– gargle with about 1/4 cup of this mixture three times per day, after meals.)

– You could also gargle with a mouthwash called Alkalol, which is essentially salt water combined with a variety of natural aromatic extracts; some people prefer Alkalol to plain salt water. Most other commercial mouthwashes contain sugar or alcohol, which are pleasant-tasting but are, in the long run, fairly irritating if used frequently.

– There is a doctor in Los Angeles, Murray Grossan, who markets a water-jet device for "hosing down" the tonsils. Relative to gargling, this device provides a more aggressive technique for clearing out those nasty crypts.

– In the hopes of avoiding tonsillectomy, I will often put my patient on a long (3 to 4 week) course of antibiotics in the hope that this will allow the tonsils to "settle down" (become less inflamed.) I must admit that antibiotics are not a very effective cure for this problem.

If I had this problem, I would try all of these things before resorting to a tonsillectomy. You should also discuss your problem with an ENT, since he/she may have other suggestions to help eradicate these nasty critters, and could also give you information on what to expect from a tonsillectomy.

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Their description doesn't quite match mine. Mine isn't a white ball. Mine looks more like a canker sore or something and doesn't stink.

Oh well, I will go to the doctor and ask about it.