The role of oral soft tissues in swallowing function: what can tongue pressure tell us?

Abstract

Tongue pressure data taken from healthy subjects during normal oral activities such as mastication, speech and swallowing are providing us with new ways of understanding the role of the tongue in craniofacial growth and function. It has long been recognized that the sequential contact between the tongue and the palate plays a crucial role in the oropharyngeal phase of swallowing. However, because the focus of most research on intraoral pressure has been on the generation of positive pressure by the tongue on the hard palate and teeth, generation and coordination of absolute intraoral pressures and regional pressure gradients has remained unexplored. Ongoing research in our laboratory has uncovered highly variable individual pressure patterns during swallowing, which can nonetheless be divided into four stages: preparatory, primary propulsive, intermediate and terminal. These stages may further be sub-classified according to pressure patterns generated at the individual level as tipper or dipper patterns in the preparatory stage, roller or slapper in the primary propulsive and monophasic or biphasic during the intermediate stage. Interestingly, while an increase in bolus viscosity can result in significant changes to pressure patterns in some individuals, it has little effect in others. Highly individual responses to increased viscosity are also observed with swallowing duration. The above, together with other findings, have important implications for our understanding of the aetiology of widely differing conditions such as protrusive and retrusive malocclusions, dysphagia and sleep apnoea, as well as the development of novel food products.

A randomised clinical trial to determine the abrasive effect of the tongue on human enamel loss with and without a prior erosive challenge

“…The lateral borders of the tongue lie at rest on the occlusal surfaces of the lower first molars and in speech for "tooth sounds" the tongue is in contact with the palatal aspect of the maxillary anterior teeth. Swallowing is initiated by the tip of the tongue being forced on to the palatal aspect of the upper incisors and remaining in this area during the entire swallow, pressures of 80g/cm 2 being exerted, which is 20 times as great on the teeth as pressures recorded at rest, 4g,cm 2 [18,20]. seconds for the duration of tongue licking was chosen in line with previous research by Vieira et al [14] and Gregg et al [13] who applied a similar regimen.…”

Magnetic resonance imaging of swallowing-related structures in nasopharyngeal carcinoma patients receiving IMRT: Longitudinal dose–response characterization of quantitative signal kinetics

“…[16–18] Suprahyoid and floor of mouth musculature are critical for protecting the airway by preventing aspiration and penetration since they elevate the hyoid and larynx to allow for appropriate bolus diversion away from the airway and help to open the esophagus for bolus entry. [19] Many studies have reported strong correlations between dysphagia and the radiation dose to the pharyngeal constrictors.…”

“…[15, 20] During deglutition, the soft palate functions to both prevent premature entry of the bolus into the unprepared pharynx and to provide a velopharyngeal seal to allow distal driving pressure during pharyngeal transit. [18] While the effects of RAD on the soft palate have not been studied as extensively as those on the superior pharyngeal constrictor, it typically receives a large dose of radiation in the treatment of NPC and is a logical organ-at-risk to study.…”

Desempenho funcional da língua na deformidade dentofacial

“…Na mastigação, tem o papel de auxiliar a coletar e posicionar o alimento nas faces oclusais (FELÍCIO, 2004). Durante a deglutição tem o papel de impulsionar o alimento para a faringe, pois suas características estruturais lhe permitem exercer movimentos para selar o conteúdo do bolo anteriormente e lateralmente e gerar pressão para a propulsão posterior do bolo KIESER, 2014;TANIGUSHI et al, 2008). A anatomia e fisiologia da língua humana é mais complexa do que a de outras espécies, sendo claro que a língua humana executa movimentos exclusivos durante a deglutição e fala, porém muitas de suas especificações anatômicas ainda são desconhecidas (MU;SANDERS, 2010;SANDERS et al, 2013).…”

“…Suas características estruturais lhe permitem exercer movimentos para selar o conteúdo do bolo, anteriormente e lateralmente, e gerar pressão para a propulsão posterior do bolo KIESER, 2014;TANIGUSHI et al, 2008). Na mastigação, a língua realiza a manipulação e transporte do alimento para as faces oclusais (FELÍCIO, 2004) e na fala, tem ação na articulação dos fonemas (MU; SANDERS, 2010;SANDERS et al, 2013).…”