Oral Functions: Swallowing and Speech

Question 1

What causes variations in the durations of the masticatory sequence components?

Answer 1

food consistency

Question 2

What are the 3 stages of swallowing?

voluntary or involuntary?

Answer 2

1. buccal/oral - voluntary
2. pharyngeal - involuntary
3. esophageal -involuntary

Question 3

What is swallowing?

Answer 3

Process by which the accumulated food bolus is transported through the lower pharynx and oesophagus to the stomach (feeding function)

Question 4

What does the process of swallowing prevent?

Answer 4

Prevents ingested material from entering the lower airway (protective function)

Question 5

What are swallowing forces strong enough to do?

Answer 5

move a bolus ‘uphill’ as well as ‘downhill’

Question 6

What are the components of the preventing reflux?

Answer 6

• Elevation of soft palate
• Tongue (sides) contacts pillars of fauces
• Tongue (dorsum) contacts posterior pharyngeal wall
• Upper oesophageal sphincter
  -reflux from oesophagus into pharynx
• Reflux from oesophagus into pharynx
  -reflux from stomach into oesophagus

Question 7

How can stomach acid erode teeth?

methods of contact

Answer 7

reflux, vomiting, regurgitation, and rumination.

Question 8

What is attrition?

how can it be noticed?

Answer 8

tooth wear occlusally caused by contact between occluding teeth (bruxism/parafunction)

• The teeth inter-digitate indicating that attrition is occurring.
• Equal amounts between upper and lower

Question 9

What is abrasion?

Answer 9

loss of tooth surface due to friction and rubbing, can occur anywhere on the tooth and is from external sources (not like attrition)

for example, brushing too hard or chewing on pens

erosion can make it worse as weakened enamel is more susceptible

Question 10

What does abrasion usually present with?

Answer 10

erosion

Question 11

How does abrasion occur?

Answer 11

Acids weaken the outer 3-5 microns of mineralised tissue and increase the susceptibility of the enamel and dentine to abrasion from tooth brushing with or without toothpaste.

Question 12

What is abfraction?

Answer 12

Wedge-shaped notch caused by flexure and ultimate material fatigue of susceptible teeth at locations away from the point of loading (cervical regions).

Question 13

What is abfraction dependant on?

Answer 13

magnitude, duration, frequency and location of the occlusal forces.

Question 14

How is the airway protected during swallowing?

Answer 14

• Upward and forward
  movement of larynx
• Closure of laryngeal inlet
  – aryepiglottic muscles
  – epiglottis
• Adduction of vocal folds
• Stop breathing (apnoea)

Question 15

What is dyspasia?

what areas of the brain are damaged?

Answer 15

(sometimes called ‘aphasia’) – a specific language disorder

– involving damage to particular parts of brain
– Broca’s area
– Wernicke’s area

Question 16

What is dysphagia?

Answer 16

difficulty/inability in swallowing

Question 17

What is odynophagia?

Answer 17

pathological condition in which the affected person experiences extreme pain when swallowing

Question 18

What is dysarthria?

and what causes it?

Answer 18

difficulty speaking that is caused by
problems with the muscles used in speech.
– due to neuro-muscular defects
– lesions in descending neural pathways, cranial nerves, vocal muscles, neuromuscular junctions

Question 19

What are the oral causes of language and speech defects?

Answer 19

• Malocclusions
• Loss of teeth and denture related
• Cleft lip/palate
• Tongue - related
• Dry mouth

Question 20

What is cleft palate?

Answer 20

• Oral and nasal cavities are not separated
• Speech has ‘nasal’ quality

Question 21

What are conditions affecting the tongue?

Answer 21

tongue tie
partial atrophy
tongue stud

Question 22

What can occur in dry mouth regarding speech?

Answer 22

One of the serious repercussions of dry mouth is impeded speech.
With inadequate saliva production, pronouncing words becomes difficult.
People who have dry mouth and difficulty speaking cannot simply ‘swallow’ and start talking normally.

Question 23

What are torus?

mandibularis or palatinus

Answer 23

bony growth

can be removed

Question 24

Why can dentures cause speech issues?

Answer 24

• Problems arise mainly from restricted tongue space
• denture base plate is too thick
• artificial teeth not set properly

Question 25

What can excessive thickening of the denture palate change the sound of?

Answer 25

laterally prevents close adaptation of the tongue to the palate so that the /s/ becomes /sh/

Question 26

What can loss of maxillary anterior teeth cause?

Answer 26

may prevent the clear reproduction of certain sounds particularly ‘F’ and ‘V’

Question 27

What are the f, v and ph sounds made be?

Answer 27

made by the lower lip (vermillion border) contacting the edges of maxillary incisors.

Question 28

How can the tone of the lips and cheeks be assessed when patient is wearing dentures?

Answer 28

buy asking fundamental questions (eg address, family details). This will indicate the functional relationship of the lips and tongue to dentures in speech.

Question 29

What is embouchure?

Answer 29

the position and use of lips, tongue and teeth in playing a wind instrument

Question 30

When may embouchure be affected?

Answer 30

loss of teeth

Question 31

What are the two types of wind instruments?

Answer 31

intra-oral mouthpieces extra-oral mouthpieces

Question 32

What changes in the playing of different mouthpiece instruments?

Answer 32

Position of mouthpiece relative to teeth Mouth opening (gape) Relation of jaws Position of hyoid bone Position of dorsum of tongue

Question 33

What does the trumpet mouthpiece do to the teeth?

Answer 33

The trumpet mouthpiece is usually centered on the lips It tends to move all front teeth backwards

Question 34

What should be considered for wind instrument players?

Answer 34

Wind instrument players may have special needs in respect to the retention of an appliance and placement of teeth.