What Is Vocal Hygiene? and How to Care for your Voice

What is Vocal Hygiene?

Vocal hygiene, which most people may imagine it as, does not mean to wash your mouth but is simply a term used to  describe appropriate maintenance for a healthy voice.  As a speech pathologist any client that I am doing voice therapy with, I always ensure that I provide tips to the client for good vocal hygiene practice. Of course, there are many different ways one can maintain vocal hygiene, and this will vary for each individual client as many clients will or will not already be following these practices.

In order to maintain good vocal hygiene, one has to:

• Refrain from overusing dehydrating substance including: alcohol and caffeine.
• Increase of water intake daily.
• Minimizing coughing and clearing of the throat, a safer option is to take sips of water to clear any mucous/residue, or do a silent cough ( where you push air out).
• No yelling.
• Do not speak at a  high volume or a whisper for a long time.
• Avoid speaking for longer periods of time.
• Always making sure that background noise is reduced when talking or singing ( when background noise is present you may tend to want to raise your voice, which will strain your voice).
• No smoking.
• Do not try to talk through loss of voice when you are sick.

Impact of Medications

When it comes to medications, here is a list of medications that could have a negative impact on your voice: (the following is excerpted from The Source for Voice Disorders Adolescents and Adults, by Sandra Kasper Schwartz.

• androgens
• anabolic steroids
• central nervous system stimulants
• sedatives
• narcotics
• tricyclic antidepressants
• inhaled steroids
• antihistamines (such as allergy medications)
• (some) cardiovascular medications/ACE inhibitors
• anti-anxiety agents

Preventative Practices

These practices are important for those working in professions where they have to speak a lot such as ‘i.e. teachers, singers’ to avoid developing any voice disorder. These practices are also important for those who have developed a voice disorder for whatever reason, and want to improve their voice, or maintain it to keep it from getting even worse.

Here are some more specific practices when one is experiencing certain factors that are affecting their voice: 

1. Those who have problems with dryness or thick secretions:

• Use a humidifier at home especially during the winter when the air is drier.
• Increase water intake to ensure your vocal folds and throat remain hydrated.
• Decrease intake of caffeine and alcohol as these a dehydrating substances.
• Make sure to breathe through your nose, as mouth breathing will dry out your vocal apparatus even more
• Speak to your doctor about decreasing use of antihistamines, and possible allergy testing if not yet completed.
• If any medications, check side-effects of these medication to see if this is the cause of what you are experiencing.   

2. Those who complain that their voice gets tired:

• Rest your voice after periods of a lot of talking
• Try to reduce your ‘talk time’.
• Doing vocal warm-ups before singing/talking may help prep your voice

3. Those who have to speak in loud environments and may experience more speaking/screaming should:

• Do not yell to someone from another room to get their attention but find them and talk to them while facing them.
• You can also create a signal to get the other persons attention such as whistling instead of using your voice to get their attention. 
• Try to reduce any background noise such as music/TV/loud environments, so that you do not have to raise your voice to talk over something that is already loud.

4. Those who throat clear/cough:

• Stop smoking
• Using the ‘silent cough’ as describes above and take more sips of water
• Assess swallowing, to make sure that you are not aspirating food/drinks/saliva.
• If you have diagnosis of GERD (reflux) follow recommendations specific to this, as reflux can cause you to throat clear or cough excessively.

These are all good practices to follow, if you are experiencing difficulties with your voice. Please contact your SLP if you need more information on your specific voice difficulties that you are experiencing. An SLP can give you advice and create a plan to meet your specific voice goals.


We all know about maintaining proper hand hygiene, but what about proper vocal hygiene? Many professions are vocally demanding such as acting, singing, teaching, law, sales and many more. Learning about and implementing healthy voice habits and improving vocal hygiene can protect your most valuable instrument and keep it functioning in peak condition.

Improper speaking techniques and vocally damaging behaviours can lead to both temporary and permanent vocal damage. The first step to protecting your voice, is understanding how the voice works.

Voice Systems: Respiration, Phonation, Articulation

1. Respiration: Breath is the foundation of the voice. Diaphragmatic breathing (or “belly breathing”) is the most effective breathing pattern for speech and singing. This breathing pattern involves the belly expanding as it fills with air on inhale and then deflating as the breath is released. Speaking on the breath will allow your voice to flow freely without muscle tension and vocal strain.
2. Phonation: Your voice box or “larynx” is a structure in your neck on top of your windpipe which contains your vocal folds (More commonly referred to as vocal chords). Vocal folds are membranous structures which vibrate together as the air flows out on an exhale creating sound-waves. Vocal misuse including yelling or coughing excessively can lead to physical changes on the vocal folds including vocal polyps and vocal nodules. Structural changes to the vocal fold will lead to a rough or raspy voice quality.
3. Articulation: The final part of speech is shaping the waves created at the vocal folds into different speech sounds by moving your articulators (Mainly your lips, teeth and tongue).

To protect your voice:

DO:

1. Stay hydrated. Drinking 2 litres of water per day is recommended to maintain optimal vocal hygiene. Hydration will allow the vocal folds to move together more efficiently and it will also reduce the amount of mucous sticking to the vocal folds. There are multiple types of hydration at play when it comes to vocal health including:
   • Systemic hydration (the amount of water present in your whole body) and
   • Topical hydration (Surface hydration of the vocal folds themselves).
     • Research suggests that a combination of both systemic and topical hydration is most effective in facilitating optimal vocal quality (Sivasankar et al., 2010). 
2. Maintain good breath support: Take diaphragmatic (belly breaths) before speaking and breath often during speech. Taking a bigger breath will allow you to project your voice without straining or pushing. Establishing an effective breathing pattern is often the first step in voice therapy. 
3. Warm up your voice: If your job has high vocal demands, a good habit to develop is warming up your voice before starting your day. Warming up the vocal mechanism will not only help prevent injury, but it has also been shown to improve objective vocal quality (Lierde et al., 2011). 
4. Rest your voice when tired, sick or sore: After a vocally demanding day or during an illness, your body will let you know when you have pushed your voice too hard. Vocal fatigue, soreness and aphonia (losing your voice completely) are all indicators that your voice needs a break. As with any other message your body sends, it’s important to listen and respond accordingly by giving your voice the rest it needs.

DON’T

1. Clear your throat or cough aggressively: When you cough or clear your throat, you are essentially banging the vocal chords together in an attempt to remove an irritant. If done the wrong way, throat clearing and coughing can be considered a phonotraumatic behaviours which over time can lead to vocal injury. Healthy alternatives to a hard throat clear include swallowing, taking a sip of water or using a more gentle, light throat clear (think of the type of throat clear you use when trying to get someone’s attention in a subtle way). 
2. Speak to the end of your breath: This occurs when you attempt to say too much on one breath and run out of air by the last few words. By the end of the sentence in order to continue voicing, you must squeeze and press. This habit can lead to vocal fatigue and soreness. 
3. Shout or scream excessively: Avoid yelling when there is an alternative way of communicating. Instead of calling across the house, walk to the person and speak at a normal volume. If you need to communicate in a loud environment use proper projection techniques or use amplification. 
4. Eat, drink or smoke substances that are damaging to your voice: Minimize coffee and alcohol intake as they both lead to dehydration which negatively impacts your voice. In terms of what to eat, avoiding spicy food and fried/fatty foods is a good place to start if your voice is often hoarse. These types of food can lead to acid reflux (a.k.a. heartburn) which can irritate and damage the vocal folds. Finally, inhaling any kind of smoke should be avoided in order to maintain optimal voice health.

When you start experiencing vocal fatigue or soreness, try following these tips to start improving your vocal hygiene. it is in your control to modify your behaviour to optimize your vocal health! Phonotraumatic behaviours and improper vocal techniques have the potential to negatively change your vocal quality and damage your vocal folds. Educating my clients about what they can do outside of the clinic to protect their voice is an essential part of voice therapy. Beyond education, improving your voice quality and stamina can be significantly improved by attending regular speech therapy sessions to support you as you identify bad habits and practice new techniques and strategies. Vocal hygiene is only one piece of the puzzle but it can be a game changer for individuals in vocally demanding fields. If you are a professional voice user looking to improve your technique and your vocal hygiene, book an initial consultation to learn more about how speech therapy can help you find your ideal voice and keep it healthy.

REFERENCES:

Behlau, M., & Oliveira, G. Vocal hygiene for the voice professional. Current opinion in otolaryngology & head and neck surgery 17, 149-154.

Murry, T., & Rosen, C. A. (2000). Vocal education for the professional voice user and singer. Otolaryngologic Clinics of North America, 33(5), 967-981.

Sivasankar, M., & Leydon, C. (2010). The role of hydration in vocal fold physiology. Current opinion in otolaryngology & head and neck surgery, 18(3), 171.

Van Lierde, K. M., D’haeseleer, E., Baudonck, N., Claeys, S., De Bodt, M., & Behlau, M. (2011). The impact of vocal warm-up exercises on the objective vocal quality in female students training to be speech language pathologists. Journal of Voice, 25(3), e115-e121.

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