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BDS2 BAMS > Feeding - chewing and chewing performance > Flashcards

Feeding - chewing and chewing performance Flashcards

1
Q

3 feeding sequence components

A

ingestion

stage I transport

mechanical processing

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2
Q

ingestion is

A

movement of food from the external environment into the mouth

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3
Q

how is ingestion accomplished

A

by biting (anterior teeth) and/or using ‘tools’ (cutlery, cups, etc)

Lips provide anterior oral ‘seal’.

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4
Q

What muscle is involved in controlling this seal?

A

Orbicularis Oris

and buccinator control food bolus and maintaining seal

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5
Q

what provide the anterior oral seal

A

lips

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6
Q

stage I transport is

A

Moving material from the front of the mouth to the level of the posterior teeth

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7
Q

steps in stage I transport

A

Food is gathered on tongue tip

Tongue retracts, pulling the material to the posterior teeth (pull back process; takes about one second).

associated with retraction of the hyoid bone and narrowing of the oropharynx, in order to keep mastication effective before swallowing

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8
Q

what bone retracts in chewing?

A

hyoid bone

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9
Q

what is mechanical processing

A

Some solid foods must be broken down and mixed with saliva before they can be swallowed

Moist solid foods (e.g. fruit) have to have fluid removed before transport and swallowing

Some soft foods are ‘squashed’ by tongue against hard palate (involved)

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10
Q

what teeth are involved in chewing?

A

premolars and molars

sometime squashed against hard palate by tongue

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11
Q

what muscles are involved in food processing

A

o the “mandibular muscles”
o the supra-hyoid muscles
o the tongue muscles
o the lips and cheeks

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12
Q

what is the role of sternocleidomastoid

A

turning head from side to side and flexing neck

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13
Q

tongue key role

A

controlling and transporting the food ‘bolus’ within the mouth.

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14
Q

extrinsic tongue muscles

A

are involved in altering the shape and position of muscles

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15
Q

intrinsic tongue muscles

A

alter the shape

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16
Q

what does the tongue do when food initially enters the mouth

A

gathers food and rotates to reposition the bolus on the occlusal table

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17
Q

how does the tongue and cheeks work together

A

cheeks act in a reciprocal manner to place the food on the occlusal surfaces of the teeth.
- “Tongue-pushing” (red) and “cheek-pushing” cycles (blue) are observed during chewing.
(they keep the bolus on the chewing surfaces)

Helps in crushing bolus and effective chewing

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18
Q

how does the tongue move the bolus

A

from side to side of mouth

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19
Q

style of chewing

A

bilateral

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20
Q

issue with unilateral chewing

A

unilateral chewing can develop mandibular muscle problems

  • can tell by symmetry of face,
  • hypertrophy of masseter muscle on Extra oral examination
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21
Q

how is the contact between the tongue and hard palate created initially

A

forward movement of the tongue during the occlusal and initial opening phases creates a contact between the tongue and the hard palate.

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22
Q

how does the contact zone of the bolus with the tongue and hard palate move

A

moves progressively backwards, squeezing the processed food through the fauces
- the so-called ‘squeeze-back’ mechanism

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23
Q

squeeze back mechanisms

A

contact zone (bolus, tongue, hard palate) moves progressively backwards, squeezing the processed food through the fauces

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24
Q

where does the bolus accumulate before swallowing occurs

A

on the pharyngeal surface of the tongue

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25
Q

what is the oropharynx like during the processing of solid foods

A

continuous with the oropharynx

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26
Q

what is the oropharynx like during the ingestion of liquids

A

posterior oral seal produced

liquids are swallowed from the mouth .i.e without Stage II transport

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27
Q

what are the phases of the chewing cycle

A

Phase 1: Opening
- jaw depressor active

Phase 2: Closing
- jaw elevator active

Phase 3: Occlusal
-Mandible is stationary/ teeth joined

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28
Q

phase 1 of chewing cycle

A

opening

jaw depressor active

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29
Q

phase 2 of chewing cycle

A

closing

jaw elevator active

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30
Q

phase 3 of chewing cycle

A

occlusal

mandible is stationary/ teeth joined

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31
Q

brittle food variation in chewing cycle

A

narrower

e.g. carrot

32
Q

tough food variation in chewing cycle

A

wider

e.g. meat

33
Q

cheese, carrot and gum differences in chewing cycle strokes

A

Chewing on a carrot appears to create a broader stroke than chewing on cheese
Chewing gum produces an even broader and wider chewing stroke

34
Q

what does a good occlusal condition do to chewing stroke

A

chewing stroked are close to each other

35
Q

what does bruxism/ tooth wear do to chewing stroke

A

chewing strokes are random and wide

36
Q

whats does malocclusion do to chewing strokes

A

no consistency

37
Q

ruminatory mandibular movements

A

lots of lateral movement when chewing

38
Q

how to achieve balanced articulation in prothesis in a patient who has ruminatory mandibular movements

A

use teeth with cusps to achieve balanced occlusion (especially where patients have favourable ridge form, be stable while they chew)

39
Q

how to assess how a patient chews for a prothesis

A

assess how they chew a biscuit

40
Q

vertical (chopping) mandibular movements lead to

A

worn (flat) occlusal surfaces

41
Q

how to achieve balanced articulation in prothesis in a patient who has vertical (chopping) mandibular movements

A

cusp-less teeth

especially in flat atrophic mandibular ridges

42
Q

what can inaccurate placement of mandibular posterior teeth on prosthesis lead to?

A

interference of tongue’s movement and compromise the retention and stability of the denture

43
Q

how to ensure prosthesis teeth will not interfere with tongue space

A

ensure teeth are alligned on the ridge

44
Q

when does a patient have neuromuscular denture control

A

when there is a resorbed maxilla and mandible

-no ridge

45
Q

what is neuromuscular prosthesis control

A

Use tongue to control denture when biting

46
Q

when would a patient not be able to have neuromuscular denture control

A

If they have neuromuscular disorder will not have this mechanism
Assess how they walk

47
Q

what does mechanical breakdown of food in the mouth lead to

A

o Facilitates swallowing

o might improve digestive efficiency in G.I. Tract

48
Q

what is minimum chewing with a good dentition sufficient to ensure

A

adequate digestion of most foods

49
Q

what can deteriorated masticatory performance lead to

A

dietary restrictions

avoiding foods that are “difficult”
- such as green vegetables, some meats

50
Q

what is there no clear evidence to indicate of poor mastication

A

causes malnutrition in people with G.I. tract disorders especially with modern foods and methods of preparation.

No adverse effects on health

51
Q

what is the functional occlusal area like compared to the occlusal surface area

A

usually smaller than the total occlusal area (green outline), unless there is a lot of tooth wear

52
Q

how many healthy units are considered the minimum acceptable

A

20 healthy units

53
Q

what does 20 healthy units ensure (3)

A

masticatory function

aesthetics

maintenance of oral hygiene

54
Q

what does ‘healthy’ in a healthy unit mean

A

good perio condition

no gross caries

55
Q

what do you need to do if a patient does not have 20 healthy units

A

restore or provide RPD

56
Q

when should you replace teeth

A

only replaced if their absence gives rise to problems.

57
Q

3 things a Shortened Dental Arch provides

A

sufficient occlusal stability.

satisfactory comfort

satisfactory appearance

58
Q

if a SDA exists what must be given attention

A

possibility of simply maintaining the status quo rather than providing an RPD.
- need to do work to maintain teeth

Need good attender, good oral hygiene – assess patient

59
Q

correlation of number of people with functional SDA with age

A

fall dramatically with age

60
Q

why are biting forces reduced in people with complete dentures

A

lack of periodontal mechanoreceptors

Biting load carried by mucosa of residual ridge
- not designed to bear masticatory loads
Support area is reduced (mucosa vs. PDL, no mechanoreceptors)

61
Q

how can bite force be increased in patients with prosthesis need

A

supporting dentures on teeth or implants

62
Q

replacing missing teeth in mucosa supported prosthesis

A

complete or partial denture

63
Q

replacing missing teeth in tooth supported prosthesis

A

removable (have occlusal rests)

fixed (bridges)

64
Q

replacing missing teeth in bone supported prosthesis

A

implants

65
Q

acrylic partial denture (mucosa supported prosthesis) disadvantage

A

Not definitive treatment option of replacement of missing teeth

Temporary or transitional

  • clasp is on gingival margin, gum stripper, sink on mucosa cause gum recession
  • lacks support no occlusal rest seats
  • force on bone and bone resorbs
66
Q

cobalt chrome partial denture (tooth supported prosthesis) support is

A

on occlusal surfaces and cingulums (rests)

67
Q

bridges are

A

(tooth supported prosthesis)

prepared teeth with pontic inbetween

68
Q

fixed-fixed bridges (tooth supported prosthesis)

A

all ceramic

retainers with joining pontics

69
Q

cantilever bridge (tooth supported prosthesis)

A

a pontic connected to a retainer at one end only

used to replace single teeth and only one retainer is used to support the bridge

70
Q

when is a cantilever bridge not recommended

A

when occlusal forces on the pontic are heavy

71
Q

adhesive/ resin bonded/ maryland bridge (tooth supported prosthesis)

A

An immediate, temporary adhesive bridge is appropriate, followed by a permanent bridge once the tissues have settled.

Quick, non-destructive (conservative of tooth tissues), aesthetic, and durable (good life span)

Least destructive

  • Wing-pontic-wing from palatal aspect of teeth
  • Stuck with adhesive material (composite) on the palatal side – no whole retainer teeth
72
Q

advantage of adhesive/ resin bonded/ maryland bridge

A

Least destructive

  • Wing-pontic-wing from palatal aspect of teeth
  • Stuck with adhesive material (composite) on the palatal side – no whole retainer teeth
73
Q

occlusal load transmission from RPD of mucosa born prosthesis

A

Occlusal load transmitted to bone via the oral mucosa, to mucosa and bone
- Bone resorbed

NOT RECOMMENDED

74
Q

occlusal load transmission from RPD of tooth born prosthese

A

Occlusal load transmitted to bone via the rests and PDL to PRDL and bone

  • Greater distribution and dissipation of forces
  • Less resorption

RECOMENDED

75
Q

why is tooth preparation needed for RPDs

A

to create rest for support in CoCr RPD

76
Q

implants not indicated for use if

A

Systemic disease, diabetes - affect healing

Smoker – not NHS implants, effects osteointegration of implant

77
Q

advantages of implants

A 
Bone supported (best)
- screws/fixtures will bare forces

Fixed (permanent change patient life and appearance)
-Aesthetically acceptable and functions well

BDS2 BAMS (54 decks)

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