Tongue function and swallowing in individuals with temporomandibular disorders.

Raquel Rodrigues Rosa,Giédre Berretin-Felix,Alcione Ghedini Brasolotto,Katia Flores Genaro,Renata Resina Migliorucci,Mariana da Rocha Salles Bueno

doi:10.1590/1678-7757-2019-0355

Raquel Rodrigues Rosa, Giédre Berretin-Felix + Show 4 more

Open Access

https://doi.org/10.1590/1678-7757-2019-0355

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Abstract

The tongue participates in the oral phase of swallowing by pushing the food bolus toward the oropharynx. This relationship between tongue function and swallowing is little addressed addressed in individuals with temporomandibular dysfunction (TMD).Objective:To analyze the association of functional tongue conditions on swallowing in individuals with TMD.Methodology:After approval by the Institutional Review Board, the study was conducted on 30 individuals of both sexes, aged 18 to 28 years, with TMD, and not treated for the disorder. Tongue function was assessed as to the mobility, pressure, and oral motor control. Swallowing was analyzed by clinical assessment during ingestion of solid (wafer biscuit) and liquid (water). Data regarding mobility and swallowing were collected using the orofacial myofunctional evaluation protocol. Tongue pressure was measured by the Iowa Oral Performance Instrument, during elevation, protrusion, swallowing, and resistance test. The oral motor control was assessed by the oral diadochokinesis (DDK) test by rapid and repeated emissions of syllables “ta” and “ka”. Data were statistically analyzed by the Spearman correlation coefficient, at a significance level of 5%.Results:Relationships were found between tongue function and swallowing for the following aspects: mobility (r=0.741), pressure in protrusion (r=-0.366), swallowing of saliva (r=-0.499), mean DDK rate in emissions “ta” (r=-0.424) and “ka” (r=-0.446), and mean DDK period in emissions “ta” (r=0.424) and “ka” (r=0.446). Thus, the greater the change in tongue mobility, the lower the tongue pressure in protrusion and swallowing of saliva, the lower the emissions per second, the longer the mean time between vocalizations, and the worse the swallowing of individuals with TMD.Conclusion:The functional conditions of the tongue regarding mobility, pressure, and oral DDK were associated with swallowing in individuals with TMD.

Highlights

Tongue function and swallowing in individuals with temporomandibular disorders MethodologyThe tongue and the temporomandibular joint (TMJ) are components of the stomatognathic system, and the musculature regarding the action of these structures should work in coordination for the adequate performance of orofacial functions, such as swallowing.1 In this function, the tongue participates in the oral phase by pushing the food bolus toward the oropharynx, applying force against the palate with sufficient magnitude and timing, initially at the anterior and at the posterior region.2-5 This pressure against the palate developed by the tongue is influenced by the food bolus consistency6,7 and is temporally related with the movement of hyoid and mandible during the process.8,9This description of the tongue function in orofacial functions refers to the normal physiological conditions
The scores obtained in the assessment of tongue function regarding mobility, as well as those observed in swallowing were low, indicating little change according to the protocol used
Despite the few alterations observed, a relationship was found between tongue function and swallowing (Table 2)

Summary

Introduction

Tongue function and swallowing in individuals with temporomandibular disorders MethodologyThe tongue and the temporomandibular joint (TMJ) are components of the stomatognathic system, and the musculature regarding the action of these structures should work in coordination for the adequate performance of orofacial functions, such as swallowing. In this function, the tongue participates in the oral phase by pushing the food bolus toward the oropharynx, applying force against the palate with sufficient magnitude and timing, initially at the anterior and at the posterior region. This pressure against the palate developed by the tongue is influenced by the food bolus consistency and is temporally related with the movement of hyoid and mandible during the process.8,9This description of the tongue function in orofacial functions refers to the normal physiological conditions. The tongue and the temporomandibular joint (TMJ) are components of the stomatognathic system, and the musculature regarding the action of these structures should work in coordination for the adequate performance of orofacial functions, such as swallowing.1 In this function, the tongue participates in the oral phase by pushing the food bolus toward the oropharynx, applying force against the palate with sufficient magnitude and timing, initially at the anterior and at the posterior region.. The tongue participates in the oral phase by pushing the food bolus toward the oropharynx, applying force against the palate with sufficient magnitude and timing, initially at the anterior and at the posterior region.2-5 This pressure against the palate developed by the tongue is influenced by the food bolus consistency and is temporally related with the movement of hyoid and mandible during the process.. The TMD may cause compensations and adaptations to the stomatognathic functions when present, indicating the need to understand the myofunctional alterations by detailed analysis, to define the adequate treatment planning. Few studies have analyzed the swallowing in this pathological condition, evidencing atypical swallowing and alteration in oral and pharyngeal phases of swallowing in this population

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