Laryngeal dysfunction and oral hygiene: Any relation? § Esra Eryaman a , Banu Oter Ilhan b, * a Baskent University School of Medicine, Department of Otorhinolaryngology and Head and Neck Surgery, Bahcelievler, Ankara, Turkey b Baskent University School of Medicine, Department of Pedodontics, Bahcelievler, Ankara, Turkey 1. Introduction Dental caries is deformation of the tooth enamel whereas periodontal disease is the damage in the tissues surrounding and supporting the teeth. Streptococcus Mutans is the most effective bacteria in formation of these caries and Lactobacillus plays a very important role in continuation of the caries. Anaerobes and some spirochetes also contribute to periodontal disease. Even if the teeth had recently been brushed, millions of bacteria happen to be on the dental plaque. The effects of stomach acids in the esophagus and the larynx has been a very popular topic recently. Apart from gastroesophageal reflux disease (GERD), where 40% of the patients have H. pylori infection, laryngopharyngeal reflux (LPR) produces respiratory and laryngeal manifestations [1]. In GERD, the esophagus has certain mechanisms for protection against mucosal damage (bicarbonate production, mucosal barrier, peristalsis) but the larynx and the pharynx do not. As generally known, muscle tension dysphonia (MTD, granulomas, nodules, Reinke’s edema, pseudosulcus, paroxysmal laryngospasm, laryngeal stenosis, and even cancer, may be seen as a result of LPR [1]. Dental erosion is a common finding in patients with LRP, GRP [2]. In addition to all the above factors affecting laryngeal mucosa, we think that poor oral hygiene may be a factor by itself. For this reason, in this study we explored the larynxes of patients with poor oral hygiene by stroboscopic findings, aerodynamic and acoustic measures, and discussed the results. 2. Materials and methods 43 adults who consulted with the Dentistry and Ear Nose & Throat (ENT) clinics between January and September 2010 at Baskent University Istanbul Hospital were included in this study. The low oral hygiene index score group of 18 (17 female, 1 male) patients was designated as the control group. The high oral hygiene index score group of 25 (20 female, 5 male) patients was Auris Nasus Larynx 39 (2012) 284–287 ARTICLE INFO Article history: Received 5 February 2011 Accepted 24 June 2011 Available online 8 September 2011 Keywords: Poor oral hygiene Laryngopharyngeal reflux Stroboscopy Voice disorders ABSTRACT Objective: The purpose of this study is to establish a relation between poor oral hygiene and laryngeal dysfunction. Methods: 43 adult patients were divided into two groups according to caries activity and oral hygiene. 18 patients with oral hygiene index score (OHI-S) 0-1 were grouped as the control group (good oral hygiene). 25 patients with OHI-S 2-3 were grouped as the study group (poor oral hygiene). Larygostroboscopic examination, aerodynamic measures by defining maximum phonation time (MPT) and s/z ratio and the pitch level measurements were done. Patients with gastroesophageal reflux disease (GERD), laryngopharyngeal reflux (LPR), previously confirmed laryngeal diseases or pathologies, systemic other diseases, or smokers were excluded from this study. Results: The average MPT values of the study group were found to be statistically very significantly lower than those of the control group (p < 0.01). In the stroboscopic findings, the proportion of normal closure levels were meaningfully higher in the control group than in the study group (p < 0.05). The supraglottic involvement was found statistically meaningfully higher in the study group than in the control group (p < 0.05). The proportion of normal closure phase incidences were meaningfully higher in the control group than in the study group (p < 0.05). Conclusion: So, our findings of high glottic closure impairment, supraglottic involvement and low MPT scores in the poor oral hygiene group correlate with LPR findings such as muscle tension dysphonia. Poor oral hygiene may aggravate potential LPR in people. ß 2011 Published by Elsevier Ireland Ltd. § This study was approved by the Baskent University Institutional Review board (project no: KA 10/56) and supported by the Baskent University Research Fund. * Corresponding author. Baskent Universitesi Istanbul Saglik Uygulama ve Arastirrma Merkezi Hastanesi KBB Hastaliklari A.D., Mahir Iz cad., No. 43, 34662, Altunizade, Istanbul, Turkey. Tel.: +90 5322418222; fax: +90 2166513882. E-mail address: esraer@superonline.com (B.O. Ilhan). Contents lists available at SciVerse ScienceDirect Auris Nasus Larynx journal homepage: www.elsevier.com/locate/anl 0385-8146/$ – see front matter ß 2011 Published by Elsevier Ireland Ltd. doi:10.1016/j.anl.2011.06.003