Oral Functions 4 - Swallowing

Question 1

What are the 3 stages of swallowing and what types of control are they under?

Answer 1

Buccal - voluntary
Pharyngeal - involuntary
Oesophageal - involuntary

Question 2

What are the differences between swallowing liquids and swallowing solids?

Answer 2

Liquid:
True posterior oral seal
Swallowed from the mouth

Solids:
No true posterior seal
Mouth and the oropharynx are continuous so they are swallowed from the oropharynx

Question 3

Describe the tongue movements in SWALLOWING solids.

Answer 3

Squeeze back Mechanism:
Contact between tongue and hard palate in the opening and occlusal stage of the chewing cycle.

Contact zone moves progressively backwards and the tongue squeezes the processed food through the fauces.

Question 4

What does the duration of the masticatory sequence depend on?

Answer 4

Consistency of the food.

Question 5

How does the body prevent reflux whilst swallowing?

Answer 5

Elevation of the soft palate
Sides of the tongue contact the pillars/fauces
Dorsum of the tongue contacts the posterior pharyngeal wall.
Lower oesophageal sphincter
Upper oesophageal sphincter

Question 6

List the types of tooth wear.

Answer 6

Erosion
Abrasion
Attrition
Abfraction

Question 7

What are the types of erosion? What causes each of them?

Answer 7

Intrinsic - stomach acid from reflux/regurgitation/vomiting.

Extrinsic - dietary factors

Question 8

What is an indication of erosion?

Answer 8

Palatal cupping

Question 9

What is attrition?

Answer 9

Contact between 2 occluding teeth.

Occlusal surface of both upper and lower equally affected.

Question 10

What usually causes attrition?

Answer 10

Parafunction - bruxism

Question 11

How is attrition treated?

Answer 11

As dentists we can only manage

Treatment is psychological.

Question 12

What is usually associated with erosion and why?

Answer 12

Abrasion.

Erosion weakens the surface of the tooth and makes it more susceptible to wear from an object that will come into contact with the tooth surface i.e. toothbrush.

Unusual to see abrasion on its own - if it is, it’s caused by chewing/biting of an object.

Question 13

What is abfraction?

Answer 13

Stress lesions on the teeth

Question 14

Where is abfraction most commonly seen in the oral cavity?

Answer 14

Cervical regions of premolars

Question 15

How does the body protect the airway during swallowing?

Answer 15

Upwards and forwards movement of the larynx
Retraction of the laryngeal inlet - aryepiglottic muscles and epiglottis
Adduction of the vocal chords
Apnoea (stop breathing)

Question 16

What is Dysphasia?

Answer 16

Specific language disorder

Question 17

What is the name given to a specific language disorder?

Answer 17

Dysphasia

Question 18

What cause Dysphasia?

Answer 18

Injury to the brain in specific regions: Wernicks and brocas areas.

Question 19

What is the name given to the condition which involves severe pain on swallowing?

Answer 19

Odynophagia

Question 20

What is Odynophagia?

Answer 20

Extreme pain on swallowing

Question 21

What is Dysarthria?

Answer 21

Difficulty speaking as a result of problems to the muscles of speech.

Question 22

What is the name given to the condition which involves difficult speaking due to problems with the muscles of speech?

Answer 22

Dysarthria

Question 23

What causes Dysarthria?

Answer 23

Neuromuscular defects that affect descending neural pathways, cranial nerves and vocal muscles.

Question 24

What are the oral causes of speech defects?

Answer 24

Malocclusion
Missing teeth 
Dentures 
Cleft lip/palate 
dry mouth (xerostomia) 
Anterior open bite - thumb sucking, skeletal defects and tongue thrust.

Question 25

What speech problems occur from loss of anterior teeth?

Answer 25

Inability to pronounce ‘f’ ‘v’ ‘ph’

incisal edge of the anterior teeth have to contact the vermillion border of the lip to verse these sounds

Question 26

What causes rocking of the denture?

Answer 26

Restricted tongue space

Question 27

What occurs if the base plate of the denture is too thick?

Answer 27

Prevents tongue closely adapting to the plate

‘s’ sounds become ‘sh’ sounds

Question 28

What happens if there is limited salivary production?

Answer 28

Difficulty in pronouncing certain words

Cannot swallow