Authors: Yamano T et al.
Cureus, Volume 18, Issue 1, Article e100782, January 2026.
Summary
This retrospective study examined whether the preoperative oral environment differs according to surgical indication in patients undergoing palatine tonsillectomy. A total of 123 patients treated between April 2020 and March 2025 were analyzed and categorized into four indication groups: recurrent tonsillitis, peritonsillar abscess, tonsillar hypertrophy, and focal infection. Oral health was assessed within one month prior to surgery using the Oral Health Assessment Tool (OHAT), which evaluates eight intraoral domains including oral hygiene, gums and mucosa, remaining teeth, and overall oral condition.
Patients undergoing tonsillectomy for recurrent (habitual) tonsillitis demonstrated significantly worse total OHAT scores and oral hygiene subscores compared with those undergoing surgery for tonsillar hypertrophy. No significant differences were observed between the other surgical indication groups across total OHAT scores or most individual components. Importantly, the tonsillar hypertrophy group was notably younger than the other cohorts, a factor the authors identify as the most likely explanation for their more favorable oral health findings rather than disease-specific pathology.
No meaningful differences were found among groups in gums and mucosa, remaining teeth, or other OHAT domains. The authors suggest that resolution of acute inflammation before preoperative evaluation and the limited sensitivity of OHAT in younger or generally healthy populations may have reduced the tool’s ability to detect condition-specific differences. Overall, the study indicates that age-related oral health factors likely play a larger role than tonsillar disease etiology in determining preoperative oral condition.
What You Should Know
Patients with recurrent tonsillitis have worse preoperative oral hygiene scores compared with those undergoing tonsillectomy for tonsillar hypertrophy.
Age appears to be a key confounding factor, with younger patients demonstrating healthier oral environments regardless of surgical indication.
Routine oral screening tools like OHAT may be insufficiently sensitive to detect microbiologic or inflammatory differences relevant to tonsillar disease.
Future studies should incorporate microbiome analysis and objective inflammatory measures to better define links between oral health and tonsillar pathology.
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