Dear Dr. Jahn: I have a terrible habit of biting my lip. I know it sounds very minor, but I’ve been doing it for about 20 years now – I’m 25 – and my jaw is constantly tight and sore from the pressure of biting down on my lip. What can I do to stop this? I’m afraid it will effect my singing in the long run if I’m always clenching my jaw. Any suggestions?
Lucy
Habits like this are very difficult to break. Some people habitually bite the inside of their cheek, and actually develop little fibromas along the bite line. I have a couple of suggestions. If you do clench your teeth, especially at night, you may have your dentist make a bite block. This is a clear acrylic cover that goes over your lower teeth, and reduces clenching. It may also remind you not to bite your lip. Physical therapy to the jaw muscles and TM joint can also loosen things up. Lastly, there is now an experimental study on the use of botulinum toxin (Botox) injections to the jaw muscle, to reduce the pressure on the TM joint by slightly weakening the jaw muscles. This is not yet widely available as treatment, but it may be useful, not for stopping the lip biting but for reducing resultant jaw tension. I’m forwarding your question to my colleague Dr. Andrew Blither in New York, who is the chief investigator in this study, and if he thinks you may benefit from this, he will contact you.
Dear Dr. Jahn: I have had problems with excess phlegm for several years now, and this has made it very difficult for me to count on my voice being there consistently. I have been to multiple doctors, and all have looked at my sinuses and throat with the scopes and screens and seen mucus lacing my vocal cords and collecting inside my sinus cavities. When this mucus gets on my cords, they simply do not phonate properly and, in the worst case, I can lose my voice. I have had two sinus surgeries in the past two years, for my maxillaries and my ethmoids. I have taken countless antibiotics and steroids, plus nasal sprays such as Flonase and Atrovent. I have tried reflux medication and been tested for allergies, the latter being the standard tests, all of which have come up negative.
I have had this problem whether I have been in Europe or the States, in New York or Oregon or California. I have had it in all seasons of the year and all climates. I have had it when my weight’s been up or down, when I’ve been exercising or not, when I’ve watched my diet or not. Pedagogically, I have had it while studying with different teachers, when I’ve been singing well technically or less so, when I’ve been working a lot or not at all. The most recent lab test, of a glass slide taken about a month ago, showed that the mucus was not bacterial but in the allergic or non-allergic family. Since I have tested negative for allergies, my ENT has now suggested non-allergic rhinitis. I would appreciate any ideas that you might care to share. Perhaps I could then discuss them with my doctors out here on the West Coast. I look forward to hearing back from you. Please accept my best wishes and thanks. Ralph
Thank you for your question. In brief, my recommendations for your problem would be the following:
1) Get tested for FOOD allergies
2) Go on a non-dairy diet
3) Get tested for thyroid function
4) Drink 8-10 glasses of water a day
5) Try mucus thinners.
If you have colleagues who sing in Europe or Israel, have them bring back acetyl cysteine, which is available in those countries (not in the USA) as an effervescent tablet. This breaks up mucus quite effectively. Let me know how you make out.
Dear Dr. Jahn: I had two shots of alcohol when I went out with some friends and I have to sing Thursday. The alcohol isn’t out of my system yet and my voice sounds terrible. How can I get the alcohol out of my system by Thursday? Is it possible? Jessica
Today being Wednesday, I would assume that the alcohol will be gone by Thursday, if it was only one or two shots. Drink lots of water to rehydrate, and try to get some moderate exercise today (not exhaustive- like vigorous walking for about an hour).
The suggestions given by Dr. Jahn in these columns are for general information only, and are not to be construed as specific medical advice, or advocating specific treatment, which should be obtained only following a visit and consultation with your own physician.
