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Taking Care of Your Voice

On this page:

What is voice?

What are some causes of voice problems?

How do you know when your voice is not healthy?

Tips to Prevent Voice Problems

What research on voice is NIDCD supporting?

Additional Resources

CHID Database Search

PubMed Database Search

Where can I get more information?

What is voice?

We rely on our voices to inform, persuade, and connect with other people. Your voice is as unique

as your fingerprint. Many people you know use their voices all day long, day in and day out.

Singers, teachers, doctors, lawyers, nurses, sales people, and public speakers are among those

who make great demands on their voices. Unfortunately, these individuals are most prone to

experiencing voice problems. It is believed that 7.5 million people have diseases or disorders of

voice. Some of these disorders can be avoided by taking care of your voice.

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What are some causes of voice problems?

Causes of vocal problems may include upper respiratory infections, inflammation caused by acid

reflux, vocal misuse and abuse, vocal nodules or laryngeal papillomatosis (growths), laryngeal

cancer, neuromuscular diseases (such as spasmodic dysphonia or vocal cord paralysis), and

psychogenic conditions due to psychological trauma. Keep in mind that most voice problems are

reversible and can be successfully treated when diagnosed early.

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How do you know when your voice is not healthy?

Has your voice become hoarse or raspy?

Have you lost your ability to hit some high notes when singing?

Does your voice suddenly sound deeper?

Does your throat often feel raw, achy, or strained?

Has it become an effort to talk?

Do you find yourself repeatedly clearing your throat?

If you answer "yes" to any of these questions, you may be experiencing a voice problem. You

should consult a doctor. An otolaryngologist (oh-toe-lar-in-GAH-luh-jist) is the physician and

surgeon who specializes in diseases or disorders of the ears, nose, and throat. He or she can

determine the underlying cause of your voice problem. The professional who can help you with

improving the use of your voice and avoiding vocal abuse is a speech-language pathologist.

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Tips to Prevent Voice Problems

Limit your intake of drinks that include alcohol or caffeine. These act as diuretics

(substances that increase urination) and cause the body to lose water. This loss of fluids

dries out the voice. Alcohol also irritates the mucous membranes that line the throat.

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Overview on Voice, Speech,

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Vocal Abuse and Misuse

Statistics on Voice, Speech,

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Voice Disorders at

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Drink plenty of water. Six to eight glasses a day is recommended.

Don't smoke and avoid second-hand smoke. Cancer of the vocal folds is seen most often in

individuals who smoke.

Practice good breathing techniques when singing or talking. It is important to support your

voice with deep breaths from the diaphragm, the wall that separates your chest and

abdomen. Singers and speakers are often taught exercises that improve this breath control.

Talking from the throat, without supporting breath, puts a great strain on the voice.

Avoid eating spicy foods. Spicy foods can cause stomach acid to move into the throat or

esophagus (reflux).

Use a humidifier in your home. This is especially important in winter or in dry climates. Thirty

percent humidity is recommended.

Try not to overuse your voice. Avoid speaking or singing when your voice is hoarse.

Wash your hands often to prevent colds and flu.

Include plenty of whole grains, fruits, and vegetables in your diet. These foods contain

vitamins A, E, and C. They also help keep the mucus membranes that line the throat

healthy.

Do not cradle the phone when talking. Cradling the phone between the head and shoulder

for extended periods of time can cause muscle tension in the neck.

Exercise regularly. Exercise increases stamina and muscle tone. This helps provide good

posture and breathing, which are necessary for proper speaking.

Get enough rest. Physical fatigue has a negative effect on voice.

Avoid talking in noisy places. Trying to talk above noise causes strain on the voice.

Avoid mouthwash or gargles that contain alcohol or irritating chemicals. If you still wish to

use a mouthwash that contains alcohol, limit your use to oral rinsing. If gargling is

necessary, use a salt water solution.

Avoid using mouthwash to treat persistent bad breath. Halitosis (bad breath) may be the

result of a problem that mouthwash can't cure, such as low grade infections in the nose,

sinuses, tonsils, gums, or lungs, as well as from gastric reflux from the stomach.

Consider using a microphone. In relatively static environments such as exhibit areas,

classrooms, or exercise rooms, a lightweight microphone and an amplifier-speaker system

can be of great help.

Consider voice therapy. A speech-language pathologist who is experienced in treating voice

problems can provide education on healthy use of the voice and instruction in proper voice

techniques.

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What research on voice is NIDCD supporting?

The National Institute on Deafness and Other Communication Disorders (NIDCD) supports and

conducts research and research training on the normal and disordered processes of hearing,

balance, smell, taste, voice, speech, and language. NIDCD also supports the development of

assistive or augmentative devices that improve communication for individuals who have

communication challenges. Within the research support for voice is a range of activity from the

molecular mechanisms of disease processes, such as papilloma virus, to clinical research that

identifies strategies for diagnosis, treatment, or cure of voice disorders.

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An active area of research is examining the dose of vibrational exposure that human vocal folds

receive during phonation. At the cellular level, the effect of gene expression and protein production

are being studied as a function of this vibrational dose. Results may lead to engineered vocal fold

tissues that can withstand vibrational stress.

Other studies of voice disorders focus on determining the nature, causes, diagnosis, and

prevention of these disorders. These studies may lead to the development of treatments and

interventions that will improve the quality of life for those who are already challenged by severe

voice disorders. Substantial progress has been made in the development of augmentative

communication devices to facilitate the expressive communication of persons with severe

communication disabilities. An investigation of conversational performance by users of

augmentative communicative devices is in progress. Other funded research evaluates whether a

low-cost, laser-activated keyboard for accessing personal computers is feasible. With access to

personal computers, individuals with disabilities can immediately use software programs and

speech synthesizers for augmentative communication. There is ongoing research on the

mechanisms of laryngeal papillomatosis and of laryngeal cancer.

Because teachers are among the individuals with a high incidence of vocal disorders, NIDCD is

supporting the development of an educational web site for teachers to support healthy behaviors

and protection of their voices.

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Additional Resources

For additional information on conditions affecting voice, the following NIDCD Fact Sheets are also

available:

Vocal Cord Paralysis

Spasmodic Dysphonia

Disorders of Vocal Abuse and Misuse

Laryngeal Papillomatosis: Quick Facts (Internet only)

Dysphagia

Here are several ways to contact us:

Toll-free: (800) 241-1044

Toll-free TTY: (800) 241-1055

1 Communication Avenue

Bethesda, MD 20892

CHID Database Search

CHID is a database produced by health-related agencies of the Federal Government. This

database provides titles, abstracts, and availability information for health information and health

education resources. The value of this database is that it lists a wealth of health promotion and

education materials and program descriptions that are not indexed elsewhere. Search the

database using "voice disorders" for health information materials.

PubMed Database Search

PubMed is a database developed by the National Library of Medicine in conjunction with publishers

of biomedical literature as a search tool for accessing literature citations and linking to full-text

journals at web sites of participating publishers. Search the database using "voice disorders" for

medical journal articles.

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Where can I get more information?

Here are some other groups that can provide information and additional publications or resources:

American Academy of Audiology

8300 Greensboro Drive, Suite 750

McLean, VA 22102

Voice: (703) 790-8466

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Toll-free: (800) AAA-2336

TTY: (703) 790-8466

E-mail: info@audiology.org

Internet: www.audiology.org

American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS)

One Prince Street

Alexandria, VA 22314-3357

Voice: 703-836-4444

TTY: 703-519-1585

Fax: 703-683-5100

Email: webmaster@entnet.org

Internet: www.entnet.org

American Laryngological Association (for professionals)

Montefiore Medical Center

Dept. of Otolaryngology

3400 Baine Bridge Ave.

3rd Floor

Bronx, NY 10467

Voice: 718-920-2991

FAX: 718-652-5194

Email: mfried@montefiore.org

Internet: www.alahns.org

American Speech-Language-Hearing Association

10801 Rockville Pike

Rockville, MD 20852

Voice: (301) 897-3279

Toll-free voice/TTY: (800) 638-8255

Fax: (301) 897-7355

E-mail: actioncenter@asha.org

Internet: www.asha.org

Voice Foundation

1721 Pine Street

Philadelphia, PA 19103

Voice: (215) 735-7999

Fax: (215) 735-9293

E-mail: voicefound@onrampcom.org

Internet: www.voicefoundation.org

National Center for Voice and Speech

University of Iowa

330 WJSHC

Iowa City, IA 52242

Voice: (319) 335-6600

Fax: (319) 335-8851

E-mail: webmaster@ncvs.org

Internet: www.ncvs.org

For questions about laryngeal cancer, contact

Cancer Information Service

Office of Cancer Communications

Public Inquiries Section

National Cancer Institute

Building 31, Room 10A16

9000 Rockville Pike

Bethesda, MD 20892

Toll-free: (800) 4-CANCER

Toll-free TTY: (800) 332-8615

Internet: www.cancer.gov

NIH Pub. No. 02-5160

September 2002

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For more information, contact the NIDCD Information Clearinghouse.

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National Institute on Deafness and Other Communication Disorders

National Institutes of Health

31 Center Drive, MSC 2320

Bethesda, MD USA 20892-2320

E-mail: nidcdinfo@nidcd.nih.gov

Page last updated: June 18, 2004

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