Oral functions - speech

Question 1

What are the 3 stages of swallowing called?

Answer 1

1. buccal phase (voluntary)
2. pharyngeal stage (involuntary)
3. esophageal stage (involuntary)

Question 2

What are the two purposes of swallowing

Answer 2

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

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

Question 3

Why is swallowing potentially dangerous

Answer 3

the ‘foodway’ crosses the ‘airway’

Question 4

How are liquids swallowed

Answer 4

1. Liquids are gathered on the tongue, anterior to the pillars of the fauces
2. the mouth is separated from the pharynx by a POSTERIOR ORAL SEAL
3. The liquid ‘bolus’ is then propelled through the oro- and hypo-pharynx, and then into the oesophagus

Question 5

How are ‘solid’ bolus’s swallowed

Answer 5

1. Chewed food material accumulates on the pharyngeal part of tongue and vallecula (oro-pharynx).

THERE IS NO TRUE POSTERIOR ORAL SEAL

2. The ‘bolus’ is then propelled from the tongue through the hypo-pharynx, and then into the oesophagus

Question 6

Where are liquids swallowed from

Answer 6

the mouth proper

Question 7

Where are solids swallowed from

Answer 7

the oro-pharynx

Question 8

When swallowing liquids do you have an oral seal

Answer 8

yes

Question 9

When swallowing solids do you have an oral seal

Answer 9

no

Question 10

What is similar between liquids and solids with how they are swallowed

Answer 10

both are moved rapidly through the hypophyarynx past the laryngeal inlet

Question 11

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 is this mechanism called?

Answer 11

the squeeze-back mechanism

Question 12

Describe the squeeze back mechanism

Answer 12

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.

Question 13

What events happen during swallowing

Answer 13

• propulsion of food
• prevention of ‘reflux’
• protecting the airway

Question 14

What causes the duration of masticatory sequence to vary

Answer 14

food consistency

Question 15

How strong are swallowing forces

Answer 15

very strong - strong enough to move a bolus ‘uphill’ as well as ‘downhill’

Question 16

What actions during swallowing act to prevent reflux

Answer 16

1. elevation of soft palate
2. tongue (sides) contacts pillars of fauces
3. tongue (dorsum) contacts posterior pharyngeal wall
4. Upper oesophageal sphincter (reflux from oesophagus into pharynx)
5. Lower oesophageal sphincter (reflux from stomach into oesophagus)

Question 17

How can stomach acid erode teeth?

Answer 17

By:

• reflux
• vomiting
• regurgitation
• rumination

Question 18

How often is stomach acid responsible for palatal surface erosion

Answer 18

in 2/3 of cases

Question 19

What is a common characteristic of palatal erosion

Answer 19

cupping

Question 20

Name types of tooth surface loss

Answer 20

• erosion
• attrition
• abrasion
• abfraction

Question 21

define attrition

Answer 21

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

Question 22

what indicates attrition is occuring

Answer 22

the teeth inter-digitate (equal amounts between upper and lower ?)

Question 23

how does abrasion occur

Answer 23

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 24

what is the most common presentation of tooth wear?

Answer 24

a combined lesion involving erosion and abrasion

Question 25

does abrasion occur on its own

Answer 25

unusual - it might be caused by biting or chewing objects between the teeth for example tobacco pipes, nails or pens.

Question 26

what are abfractions

Answer 26

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

Question 27

what causes abfractions

Answer 27

The break down is dependent on the magnitude, duration, frequency and location of the occlusal forces.

Question 28

how is the airway protected during swallowing

Answer 28

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

Question 29

what teeth do abfractions occur on

Answer 29

premolars

Question 30

what does dysphasia mean

Answer 30

inability to generate speech

Question 31

what does dysphagia mean

Answer 31

inability to swallow

Question 32

what word describes pain on swallowing

Answer 32

odynophagia

Question 33

what areas of the brain are affected with dysphasia

Answer 33

- Broca's area | - Wernicke's area

Question 34

what word describes difficulty speaking that is caused by problems with the muscles used in speech

Answer 34

dysarthria

Question 35

what is the difference between dysphasia and dysarthria

Answer 35

dysphasia - caused by the brain (broca's and wernicke's area) dysarthria - caused by muscles used in speech

Question 36

what causes dysarthria

Answer 36

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 37

What are some oral causes of language and speech defects

Answer 37

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

Question 38

what are causes of anterior open bite

Answer 38

- digit-sucking - tongue thrust - skeletal origin

Question 39

what is a cleft palate

Answer 39

oral and nasal cavities are not separated (speech has a 'nasal' quality)

Question 40

How are cleft palates treated

Answer 40

repaired surgically or filled with an obturator

Question 41

What are conditions which affect the tongue

Answer 41

- tongue tie - partial atrophy - tongue stud

Question 42

How does xerostomia cause impeded speech

Answer 42

With inadequate saliva production, pronouncing words becomes difficult. People who have dry mouth and difficulty speaking cannot simply 'swallow' and start talking normally

Question 43

What is/ are torus mandibularis/ tori mandibular and torus palatinus/ tori palatinus

Answer 43

benign overgrowth of bone

Question 44

How can dentures cause speech impedment

Answer 44

- restricted tongue space - denture base plate too thick - artificial teeth not set properly e.g. wrong occlusal planes

Question 45

The wrong shape of palate of a denture gives problems producing which sounds

Answer 45

s becomes sh

Question 46

The wrong shape of occlusal planes of a denture gives problems producing which sounds

Answer 46

f,v and ph (labio-dental sounds/ fricative sounds)

Question 47

The loss of which teeth may prevent the clear reproduction of certain sounds particularly F and V

Answer 47

maxillary anterior teeth (they are made by the lower lip contacting the edges of maxillary incisors)

Question 48

during fricative sounds, where should the lips of the maxillary incisor teeth touch

Answer 48

the vermilion border of the lip

Question 49

How can you assess speech when replacing missing teeth

Answer 49

by asking fundamental questions e.g. address, family details

Question 50

Apart from producing vocal sounds, what else do aerodigestive tract contribute to

Answer 50

the playing of wind and brass instruments

Question 51

What factors might influence the final choice of treatment of a musician with a missing tooth

Answer 51

1. cost 2. effects on adjacent teeth; OH; preparation as abutments 3. aesthetics 4. Function. The patient is a musician, so her embrouchure is v important. She may experience pain with pressure from the trumpet mouthpiece on the healing socket 5. Life span of prosthesis and eventual replacement

Question 52

what does embouchure mean

Answer 52

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

Question 53

How do embouchures very

Answer 53

- between individuals | - particular wind instrument (intra oral = clarinet, oboe, saxophone etc), (extra oral = trumpet, flute, tuba etc)

Question 54

What might string players struggle with

Answer 54

TMJ