U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ∙ National Institutes of Health 

NIDCD Fact Sheet | Voice, Speech, and Language 

Taking Care of Your Voice 

What is voice? 

The sound of your voice is produced by vibration of the 

vocal folds, which are two bands of smooth muscle tissue 

that are positioned opposite each other in the larynx. The 

larynx is located between the base of the tongue and the 

top of the trachea, which is the passageway to the lungs 

(see figure). 

When you are not speaking, the vocal folds are open so 

that you can breathe. When it’s time to speak, however, 

the brain orchestrates a series of events. The vocal folds 

snap together while air from the lungs blows past, 

making them vibrate. The vibrations produce sound 

waves that travel through the throat, nose, and mouth, 

which act as resonating cavities to modulate the sound. 

The quality of your voice—its pitch, volume, and tone—is 

determined by the size and shape of the vocal folds and 

the resonating cavities. This is why people’s voices sound 

so different. 

Many people use their voices for their work. Singers, 

teachers, doctors, lawyers, nurses, sales people, and 

public speakers are among those who make great 

demands on their voices. This puts them at risk for 

developing voice problems. Experts estimate that 

7.5 million people have diseases or disorders of voice. 

Some of these disorders can be avoided by taking care 

of your voice. 

Structures involved in speech and voice production 

NIDCD...Improving the lives of people with communication disorders 
How do you know when your 

voice is not healthy? 

If you answer “yes” to any of the following questions, 

you may have a voice problem: 

} 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 think you have a voice problem, consult a doctor 

to determine the underlying cause. A doctor who 

specializes in diseases or disorders of the ears, nose, 

and throat, and who can best diagnose a voice disorder, 

is an otolaryngologist (oh-toe-lar-in-GAH-luh-jist), 

sometimes called an ENT. Your otolaryngologist may 

refer you to a speech-language pathologist. A speechlanguage pathologist can help you improve the way you 

use your voice. 

What causes voice problems? 

Causes of voice problems include: 

} Upper respiratory infections 

} Inflammation caused by gastroesophageal reflux 

(sometimes called acid reflux, heartburn, or GERD) 

} Vocal misuse and overuse 

} Growths on the vocal folds, such as vocal nodules or 

laryngeal papillomatosis 

} Cancer of the larynx 

} Neurological diseases (such as spasmodic dysphonia or 

vocal fold paralysis) 

} Psychological trauma. 

Most voice problems can be reversed by treating the 

underlying cause or through a range of behavioral and 

surgical treatments. 

Tips to prevent voice problems 

Stay hydrated: 

} Drink plenty of water. Six to eight glasses a day 

is recommended. 

} Limit your intake of drinks that contain alcohol or 

caffeine, which can cause the body to lose water 

and make the vocal folds and larynx dry. Alcohol also 

irritates the mucous membranes that line the throat. 

} Use a humidifier in your home. This is especially 

important in winter or in dry climates. Thirty percent 

humidity is recommended. 

} Avoid or limit use of medications that dry out the 

vocal folds, including some common cold and allergy 

medications. If you have voice problems, ask your doctor 

which medications would be safest for you to use. 

Maintain a healthy lifestyle and diet: 

} Don’t smoke and avoid second-hand smoke. Smoke 

irritates the vocal folds. Also, cancer of the vocal folds is 

seen most often in individuals who smoke. 

} Avoid eating spicy foods. Spicy foods can cause 

stomach acid to move into the throat or esophagus, 

causing heartburn or GERD. 

} 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. 

} Wash your hands often to prevent getting a cold or the flu. 

} Get enough rest. Physical fatigue has a negative effect 

on voice. 

} Exercise regularly. Exercise increases stamina and muscle 

tone. This helps provide good posture and breathing, 

which are necessary for proper speaking. 

} If you have persistent heartburn or GERD, talk to your 

doctor about diet changes or medications that can help 

reduce flare-ups. 

} 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. 

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} 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 acid reflux from the stomach. 

Use your voice wisely: 

} Try not to overuse your voice. Avoid speaking or singing 

when your voice is hoarse or tired. 

} Rest your voice when you are sick. Illness puts extra 

stress on your voice. 

} Avoid using the extremes of your vocal range, such as 

screaming or whispering. Talking too loudly and too 

softly can both stress your voice. 

} Practice good breathing techniques when singing or 

talking. Support your voice with deep breaths from the 

chest, and don’t rely on your throat alone. Singers and 

speakers are often taught exercises that improve this 

kind of breath control. Talking from the throat, without 

supporting breath, puts a great strain on the voice. 

} Avoid cradling the phone when talking. Cradling the 

phone between the head and shoulder for extended 

periods of time can cause muscle tension in the neck. 

} Consider using a microphone when appropriate. 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. 

} Avoid talking in noisy places. Trying to talk above noise 

causes strain on the voice. 

} Consider voice therapy. A speech-language pathologist 

who is experienced in treating voice problems can teach 

you how to use your voice in a healthy way. 

What research on voice is the NIDCD 

supporting? 

The National Institute on Deafness and Other 

Communication Disorders (NIDCD) supports research that 

includes laboratory studies to understand diseases and 

stresses that can harm the voice, and clinical research to 

test new ways to diagnose, treat, or cure voice disorders. 

Researchers are exploring how the brain controls the 

muscles and nerves of the larynx and tongue, and how these 

structures move to produce speech. This information may 

help other scientists design better treatments for conditions 

such as vocal fold paralysis and spasmodic dysphonia, which 

can damage the voice. It may also help researchers design 

new rehabilitation strategies to improve the quality of life for 

people challenged by severe voice disorders. 

Another area of interest to researchers is developing 

replacement tissues to repair damaged vocal folds. NIDCDfunded scientists are testing man-made and biological 

materials and stem cell technologies that may eventually be 

used to engineer new vocal fold tissues, as well as methods 

to encourage nerve regrowth to treat laryngeal paralysis. 

Researchers are also looking at new ways to assess vocal 

disorders and testing new methods of voice therapy 

for people with growths on the vocal folds. Research 

continues to explore ways to prevent scarring of the vocal 

fold after injury and to treat vocal scarring when it occurs. 

Additional ongoing research studies aim to understand 

the mechanisms of laryngeal papillomatosis caused by 

HPV (human papillomavirus), and to develop new drug 

treatments for the disorder. 

New techniques to combat age-related weakness in the 

laryngeal muscles have the potential to prevent voice 

disorders in the aging population. Recent results from 

NIDCD-funded researchers showed that, in an animal 

model of the aging voice, vocal training exercises helped 

the muscles of the larynx stay strong. 

Because teachers have a high incidence of vocal 

disorders, the NIDCD is supporting the development of 

an educational website for teachers to support healthy 

behaviors and protection of their voices. The NIDCD is also 

supporting research into the effectiveness of voice hygiene 

education and voice production training for teachers. 

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Where can I find additional 

information about voice and voice 

disorders? 

The NIDCD maintains a directory of organizations that 

provide information on the normal and disordered 

processes of hearing, balance, taste, smell, voice, 

speech, and language. Visit the NIDCD website at 

http://www.nidcd.nih.gov to search the directory. 

Use the following keywords to help you find organizations 

that can answer questions and provide printed or 

electronic information on voice and voice disorders: 

} Papillomatosis 

} Spasmodic dysphonia 

} Speech-language pathologists 

More NIDCD fact sheets on Voice, Speech, and 

Language: 

} Dysphagia 

} Hoarseness 

} Recurrent Respiratory Papillomatosis 

} Spasmodic Dysphonia 

} Vocal Fold Paralysis 

Visit the NIDCD website at http://www.nidcd.nih.gov to 

read, print, or download fact sheets. 

For more information, additional addresses and phone 

numbers, or a printed list of organizations, contact us at: 

NIDCD Information Clearinghouse 

1 Communication Avenue 

Bethesda, MD 20892-3456 

Toll-free Voice: (800) 241-1044 

Toll-free TTY: (800) 241-1055 

Fax: (301) 770-8977 

Email: nidcdinfo@nidcd.nih.gov 

http://www.nidcd.nih.gov 

 Follow the NIDCD on Twitter at @NIDCD 

The NIDCD supports and conducts research and 

research training on the normal and disordered 

processes of hearing, balance, taste, smell, 

voice, speech, and language and provides health 

information, based upon scientific discovery, to 

the public. 

Taking Care of Your Voice 

NIH Pub. No. 14-5160 

Updated April 2014 

NIH...Turning Discovery Into Health®