what are the 3 stages of swallowing
buccal
pharyngeal
oesophageal
what is the buccal phase
it is the voluntary phase
the bolus moves up and down against the hard palate and it is pushed into the oropharynx
what is the function of saliva in swallowing
it secretes enzymes
lingual lipase and salivary amylase
what does the water content of saliva do
it binds particles together to create a bolus
what is deglutition
food passing from mouth to stomach
consists of voluntary and involuntary contractions
what is deglutition controlled by
nervous system
what is the pharyngeal phase
involuntary
move food from pharynx to oesophagus
signals are sent from the medulla to close off the epiglottis and the uvula closes over
what is the esophageal phase
peristalsis
progression of involuntary wave like contractions
what are the two functions of swallowing
feeding function
protective function
what is swallowing
process by which the accumulated food bolus is transported through the lower pharynx and oesophagus to the stomach (feeding function)
how is swallowing preventative
it prevents ingested material from entering the lower airway
how is swallowing potentially dangerous
because the foodway crosses the airway
describe the process of swallowing liquids
liquids are gather on the tongue anterior to the pillars of the fauces
the liquid is then propelled through the oro- and hypo-pharynx and then into the oesophagus
what separates the mouth from the pharynx when swallowing liquids
the POSTERIOR ORAL SEAL
when swallowing liquid there is an oral seal
describe the process of swallowing solids
chewed food material accumulated on the pharyngeal part of the tongue and vallecula (-oro pharynx)
the bolus is then propelled through the tongue through the hypo-pharynx and then into the oesophagus
is there an oral seal when swallowing solids
NO
describe the squeeze back mechanism
the forward movement of the tongue during the occlusal and initial opening phases creates a contact between the tongue and the hard palate
the contact zone moves progressively backwards, squeezing the processed food through the fauces
what are the events of swallowing
propulsion of food
preventing of ‘reflux’
protecting the airway
what does the duration of the masticatory sequence vary with
food consistency
what do the masticatory muscles do in humans
stabilize the swallowing process
how is reflux prevented
elevation of soft palate
sides of tongue contacts pillar of fauces
dorsum of tongue contacts posterior pharyngeal wall
upper oesophageal sphincter
lower oesophageal sphincter
what is erosion
tooth surface loss
how can stomach acid erode teeth
by reflux
vomiting
regurgitation
rumination
when palatal erosion is seen what is most likely
stomach acid
what is attrition
tooth wear occlusally caused by contact between occluding teeth
what is attrition usually due to
bruxism/parafunction
what is seen in attrition
the teeth inter digitate indicating that attrition is occurring
equal amounts between upper and lower
what is recommended for those with bruxism
psychological caused condition
can’t ‘treat’
can offer relaxation techniques
mouthguard to protect teeth
what is abrasion
due to another object
what may abrasion be caused of
might be caused by biting or chewing objects between the teeth for example tobacco pipes, nails or pens
what is the most common presentation of tooth wear
the result of a combined lesion involving erosion and abrasion
why does acid make the teeth more susceptible to abrasion from toothbrushing
acid weakens the outer 3-5 microns of mineralized tissue
what is abfractions
stress lesions
how does abfractions present
wedge shaped notch
what is abreaction’s caused by
flexure and ultimate material fatigue of susceptible teeth at locations away from the point of loading (cervical regions)
what is the breakdown of abfractions depend on
magnitude, duration and frequency and location of the occlusal forces
how is the airway protected
upward and forward movement of the larynx
closure of laryngeal inlet (aryepiglottic muscles and epiglottis)
adduction of vocal folds
stop breathing (apnea)
what is dysphasia
a specific language disorder
what does dysphasia involve
damage to particular parts of the brain:
broca’s area
wercicke’s area
what is dysphagia
difficulty swallowing
what is odynophagia
pathological condition in which the affected person experiences extreme pain when swallowing
what is dysarthria
difficulty speaking that is caused by problems with the muscles used in speech
what is dysarthria due to
neuromuscular defects
lesions in descending neural pathways, cranial nerves, vocal muscles, neuromuscular junctions
what are the oral causes of language and speech defects
malocclusions loss of teeth and denture related cleft lip/palate tongue related dry mouth
what are the different reasons for anterior open bites
digit sucking
skeletal origin
tongue thrust
what is a cleft palate
oral and nasal cavities are not separated
how is speech effected in a cleft palate patient
it has nasal quality
how is cleft palate treated
has to be repaired or filled with an obturator
what are conditions affecting the tongue
tongue tie
partial atrophy
tongue stud
what is xerostomia
dry mouth
what is one fo the serious repercussions of dry mouth
impeded speech
without adequate saliva production, pronouncing words becomes difficult
how do those with xerostomia find difficult in relation to speaking
they cannot swallow and start talking normally
what is a tori
benign bone tumor
no malignant transformation
what is the effect of tori
won’t cause any issues
difficult to have RPD with it due to its interference with the major connector
what are denture related speech problems
problems mainly arise from restricted tongue space
the denture base plate being too thick
the artificial teeth not being set properly
what sounds does the position of the tongue involved in
th/s/sh
how should the denture base be shaped
so the tongue can form narrow channel in the midline for producing the s sound
what does excessive thickening of the palate laterally resulting
prevents close adoption of the tongue to the palate so that the s becomes sh
what problems does a wrong occlusal plane result in
issues pronouncing f v and ph
labiodental sounds
fricative sounds
how should dentures be fabricated
to a morphology that does not cause interference with tongue/lip/cheek movement
what may loss of maxillary anterior teeth prevent
clear reproduction of certain sounds particularly f and v
how are f and v sounds made
lower lip contacting the edges of maxillary incisors
during fricative sounds what do the tips of maxillary incisor teeth touch
the vermillion border of the lip
what are the terms in regards to anatomy of the lips
philtrum cupids bow vermillion border commisure vermillion zone
how may the tone of the lips and cheeks be assessed when replacing missing teeth
by asking fundamental questions
this will indicate the functional relationship of the lips and tongue to dentures in speech
what do the aerodigestive tract and facial tissues produce
vocal sounds
contribute to the playing of wind instruments
what is embouchure
the position and use of lips and tongue and teeth in playing a wind instrument
what factors might influence the final choice of treament
cost effects on adjacent teeth aesthetics function life span
what does the trumpet tend to do
its mouthpiece is usually centered on the lips
tends to move all front teeth back
what are issues for musicians and dentists
teeth - restorations, loss and replacement aesthetics
tongue
facial muscles - lips and cheeks
when do we find out about wind instruments players
during social history taking
How is the airway protected during swallowing
apnea
upward and forward movement of hyoid-laryngeal complex and a closure of the laryngeal inlet (depression of epiglottis and adduction of vocal cords)
