# Preoperative Assessment of the Oral Environment in Patients Undergoing Tonsillectomy

## TL;DR

This study examines how the oral environment affects tonsillitis by comparing oral health in patients undergoing tonsillectomy for different reasons.

## Contribution

The study is the first to evaluate the relationship between the oral environment and tonsillar disease based on surgical indication.

## Key findings

- Patients with habitual tonsillitis had significantly worse oral hygiene than those with tonsillar hypertrophy.
- No significant differences in oral health were found between other surgical indication groups.
- Lower OHAT scores in the tonsillar hypertrophy group may be due to a higher proportion of pediatric patients.

## Abstract

Objective: Although maintaining oral hygiene may help prevent tonsillitis, the association between the two remains unclear. Tonsillectomy is a commonly performed procedure in otorhinolaryngology and has been studied from various perspectives; however, no studies have evaluated its relationship with the oral environment. We evaluated the influence of the oral environment on the pathogenesis of tonsillitis by comparing the preoperative oral environment in patients undergoing tonsillectomy according to surgical indication in a retrospective study.

Methods: We included 123 patients (64 male patients, 59 female patients) who underwent palatine tonsillectomy between April 2020 and March 2025. The mean age of the participants was 25.6 (4-81) years. Surgical indications were categorized into four groups for comparison: recurrent tonsillitis (N=54), peritonsillar abscess (N=23), tonsillar hypertrophy (N=36), and focal infection (N=10). Oral conditions were assessed within one month prior to surgery by a dedicated dental hygienist using the Oral Health Assessment Tool (OHAT).

Results: Significant differences were observed between the habitual tonsillitis and the tonsillar hypertrophy groups in the total OHAT score and the oral hygiene components. No significant differences were observed between the tonsillar hypertrophy and focal infection groups, the tonsillar hypertrophy and peritonsillar abscess groups, the focal infection and peritonsillar abscess groups, the focal infection and habitual tonsillitis groups, or the peritonsillar abscess and habitual tonsillitis groups.

Conclusion: The low OHAT score in the tonsillar hypertrophy group may be attributable to the higher proportion of pediatric patients in this group compared to the others. Future studies should incorporate more detailed oral hygiene measures and microbiological analyses to evaluate the relationship between tonsillar disease and the oral environment.