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BDS2 BAMS > Speech - oral function > Flashcards

Speech - oral function Flashcards

1
Q

what breaks down starch

A

salivary amylase

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2
Q

what combines with the food to form the bolus

A

water

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3
Q

what are the 2 functions of swallowing

A

protective and feeding

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4
Q

describe the protective and feeding function of swallowing

A

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)
- choke

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5
Q

how is swallowing potentially dangerous

A

the foodway crosses the airway

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6
Q

swallowing solid foods

A

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

There is no true posterior oral seal.

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7
Q

swallowing liquids

A

Liquids are gathered on the tongue, anterior to the pillars of the fauces

The mouth is separated from the pharynx by a posterior oral seal
- True oral phase (unlike solid food – no seal)

The liquid ‘bolus’ is then propelled through the oro- and hypo-pharynx, and then into the oesophagus

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8
Q

key difference in swallowing liquids and solids

A

Liquids are swallowed from the mouth proper;
- Oral Seal

Solids are swallowed from the oro-pharynx
- No oral seal

Both are moved rapidly through the hypopharynx past the laryngeal inlet

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9
Q

squeeze back mechanism

A

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.

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10
Q

the 3 events/phases in swallowing

A

Propulsion of food

Prevention of ‘reflux’

Protecting the airway

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11
Q

why does the duration of masticatory phases vary

A

durations of masticatory sequence components vary to different extents with food consistency
- not with age

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12
Q

how strong does the swallowing forces need to be

A

swallowing forces need to be strong enough to move the bolus uphill as well as downhill

Masseter muscle problem effect the process of swallowing
- Need to stabilise masticatory system to swallow

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13
Q

5 methods of preventing reflux

A

Elevation of soft palate

Tongue (sides) contacts pillars of fauces

Tongue (dorsum) contacts posterior pharyngeal wall

Upper oesophageal sphincter
- Reflux from oesophagus into pharynx

Lower oesophageal sphincter
- Reflux from stomach into oesophagus

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14
Q

dorsum of tongue

A

top side

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15
Q

ventral of tongue

A

underside

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16
Q

erosion

A

Stomach acid can erode teeth by reflux, vomiting, regurgitation and rumination

When palatal surface erosion is present, stomach acid is responsible in two thirds of cases.
- Query Bulimia

Cupping on palatal aspect of teeth (concave area)

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17
Q

cupping of palatal surface of teeth characteristic of

A

eroision

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18
Q

what can lead to erosion on the labial surface of teeth

A

high consumption of fizzy drinks

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19
Q

what can be used to gage whether teeth have been lost

A

if still have occlusal vertical dimension

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20
Q

attrition

A

tooth wear occlusally caused by contact between occluding teeth
- The teeth inter-digitate indicating that attrition is occurring.

bruxism – grinding/ clenching at night
- Parafunction

Equal amounts between upper and lower

Central nervous system controlled – stress

  • Have to manage consequence, cannot truly treat only reduce effect
  • Night guards
21
Q

what controls attrition?

A

Central nervous system controlled – stress

  • Have to manage consequence, cannot truly treat only reduce effect
  • Night guards
22
Q

abrasion

A

caused by biting or chewing objects between the teeth for example tobacco pipes, nails, pens, toothbrushes
- notch like lesion in cervical area

23
Q

what is the most common presentation of tooth wear

A

combination of erosion and abrasion

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.

24
Q

abfractions

A

stress lesions

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

The break down is dependent on the magnitude, duration, frequency and location of the occlusal forces.
- Stress accumulates on area due to high tooth load

25
Q

4 methods of airway protection

A

Upward and forward movement of larynx

Closure of laryngeal inlet

  • aryepiglottic muscles
  • epiglottis

Adduction of vocal folds

Stop breathing (apnoea)

26
Q

dysphasia

A

a.k.a aphasia

a specific language disorder

involving damage to particular parts of the brain

  • broca’s area
  • wernicke’s area
27
Q

dysphagia

A

difficulty/inability swallowing

G=GAG

28
Q

odynophagia

A

pathological condition in which the affected person experience extreme pain when swallwoing be it food, liquids and medication

pain on swallowing

29
Q

dysarthria

A

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
- spot neuro-muscular disease before enters room
- will affect their treatment e.g. complete dentures will never be stable

30
Q

5 oral causes of language and speech defects

A

Malocclusions

Loss of teeth and denture related

Cleft lip/palate

Tongue - related

Dry mouth

Not mandible tori

31
Q

an example of problem with occlusion which can affect speech and language

A

anterior open bite

due to

  • digit sucking
  • tongue thrust
  • skeletal origin
32
Q

cleft palate impact on speech and language

A

Oral and nasal cavities are not separated

Speech has ‘nasal’ quality

Palatal defect has to be repaired or filled with an obturator

  • Hard to intervene in some cases
  • But important to solve as can help with speech at later age
33
Q

3 conditions that can effect the tongue ability for speech and language

A

Tongue tie

  • can be corrected by dentist or someone who specialises in oral surgery
  • Release frenulum

Partial atrophy
- Not fully formed

Tongue stud
- Can adapt to cope with

34
Q

how does xerostomia affect speech and language

A

With inadequate saliva production, pronouncing words becomes difficult.

  • People who have dry mouth and difficulty speaking cannot simply ‘swallow’ and start talking normally.
  • Difficult to get masticatory muscle to swallow

Can be due to medication or radiotherapy

35
Q

torus mandibularis/ tori mandibular
mandibular toru/tori

Torus Palatinus (pl. tori palatinus)/ palatinus torus (pl. palatal tori)

A

2 bumps at the side of mandible

Benign overgrowth/tumour of the bone
- Can vary in size

No problems with speech

  • Issue with need RPD
  • Interfere with major connector
  • Can remove by surgery (some refuse)
  • can design major connector around it but compromise function
36
Q

denture related issues that can effect speech and function

A

Problems arise mainly from restricted tongue space

  • denture base plate is too thick
  • –effect tongue
  • artificial teeth not set properly
  • —effect stability and tongue
  • ——–wobbly in mouth

not type of material used to make the denture

37
Q

how does the thickness of denture base effect function

A

The position of tongue for producing the sounds:
/th/ /s/ and /sh/

The polished surface is correctly shaped so the tongue can form narrow channel in the middline for producing the /s/ sound

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

  • S sounds created by anterior teeth and tongue
  • –Space created between tongue and palate
  • —–Too thick from side - tunnel too big, letter won’t be made
38
Q

what sound can the loss of maxillary anterior teeth prevent

A

certain sounds like F and V

- lower lip contracting the edges of the maxillary incisors

39
Q

what are labio-dental sounds

A

f, v, ph

fricative sounds

40
Q

what should be checked to ensure in replacing teeth so fricative sounds can be made

A

The lips of the maxillary incisor teeth should touch the vermilion border of the lip during Fricative sounds.
- touching vermillion zone of lip

Dentures must be fabricated to a morphology that does not cause interference with tongue/lip/cheek movement

41
Q

what should be done when delivering a denture before the pt leaves the surgery

A

speech assessment

indicate the functional relationship of the lips and tongue to dentures in speech.

42
Q

what factors may influence the final choice of treatment for a denture pt

A

Cost

Effects on adjacent teeth

  • Oral hygiene
  • Preparation of abutments

Aesthetics

Function

  • Musician – embouchure is very important
  • May experience pain with pressure from the trumpet mouthpiece on the healing socket

Life span of the prosthesis and eventual replacement
- Temporary adhesive bridge restoration may be appropriate with follow up to review to determine the best-long term option

43
Q

embouchure

A

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

vary, both between individuals and with the particular wind instrument in use

44
Q

inra-oral mouthpieces wind instruments

A

Single reed:
- clarinet, saxophone

Double reed:
- oboe, bassoon

45
Q

extra-oral mouthpieces wind instruments

A

Piccolo, flute

Trumpet, horn, trombone, tuba

46
Q

special needs to consider if wind instrument musician in designing replacement teeth

A

in respect to the retention of an appliance and placement of teeth.

47
Q

what are some of the head and neck anatomical features contribute to instrument playing

A

Position of mouthpiece relative to teeth

Mouth opening (gape)

Relation of jaws

Position of hyoid bone

Position of dorsum of tongue

48
Q

what are issues that a dentist treating a musician needs to consider

A

Teeth

  • restorations
  • loss and replacement
  • aesthetic dentistry

Tongue

Facial muscles

  • lips
  • cheeks

BDS2 BAMS (54 decks)

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