Lubrication: Making the surface of the mucosa more flexible, spongy and slippery.

How to lubricate

• Leaving saliva in the mouth and pharynx longer than usual (3-5 minutes) while producing the elongated /u:/ at a rate of 3×3, or talking or singing. As this process requires non-swallowing for longer than the usual every 2 minutes, the amount of saliva is increased and its mucins and high pH produce an efficient lubricating effect. It necessary that the saliva slips into the hypopharynx to moisture all this area.

• It is possible to use lubricants with great surfactant effect such as pectin gel (galacturonic acid). The administration is oral, mixing the pectin with the saliva, and this sweetened saliva moisturizes the pharynx mucosa and the laryngeal vestibule. It has more effect if this “pectinated saliva” is held in the pharynx for several minutes. The protocol for its used is as follows:
  • Introduce a small amount of gel into the mouth and make a paste mixing it with saliva.
  • Try to keep the paste at the back of the throat without swallowing. Consequently, the saliva mixed with the lubricant will slide towards the throat (pharynx).
  • It is essential to produce an elongated phonation with the vowel /u:/ at high volume and low tone, or with the vowel /i:/ in glissando (like a siren) or with a [mmm] with a closed mouth.
  • Keep the paste several minutes (3-5) inside the mouth and pharynx until both are well totally moisturized.
  • In case the saliva goes to the bronchi, it is necessary to cough and swallow the saliva-pectin mixture.
  • The pectin gel can be used several times a day, especially moments prior to demanding vocal use such as when speak or singing for long periods. However, we strongly discourage this practice before bedtime.
  • We do not recommend drinking or eating 30 minutes after administering the gel.

We use the oral gel lubricant of Pectin (Oral Gel of Aloe Vera 25% in Orabase® with thickener) obtained from the pharmacy as a compounded prescription. You can also get a similar effect, albeit less powerful, with a small bite of a natural or cooked apple. After making a paste with the saliva follow the same procedure as stated above.

Oral and pharyngeal lubricants can cause aspiration to lower airways if coughing is not performed as saliva tends to seek a way to enter the trachea-bronchi. Therefore, we strongly discourage the technique for people who are prone to lung aspiration, or consider themselves as being heavy smokers.

Treatment is planned to last for a month that represents the tested period. If you would like to elongate the treatment, periodical evaluations with the Phonitrician or ENT should be carried out.