Abstract
AbstractTo study mastication and swallowing disorders in patients with temporomandibular disorders (TMD).Objective: To investigate mastication and swallowing disorders in patients with severe TMD referred to surgery.Materials and Methods: Clinical and experimental study involving ten individuals with TMD submitted to deglutition videofluoroscopy. These patients did not have posterior teeth, mastication pain and food replacement in favor of pasty consistence food. The assessment of the oral and pharyngeal phases approached the following aspects: side of onset and preferential side for chewing, premature escape, remains of food residues in the oral cavity or in the pharyngeal recesses, number of necessary swallowing efforts, laryngeal penetration and/or tracheal aspiration.Results: During mastication and the oral phase we observed tongue compensatory movements upon chewing (n = 7; 70%), premature escape (n = 4; 40%), food remains in the cavity after swallowing (n = 5; 50%) and an excessive number of deglutition efforts (n = 5; 50%). On the pharyngeal phase we observed food remains in the valleculae (n = 6; 60%), in the pyriform sinuses (n = 4; 40%); laryngeal penetration (n = 1; 10%) and tracheal aspiration (n = 4; 40%).Conclusion: TMD patients may have alterations in their chewing and swallowing patterns, with laryngeal penetration and/or tracheal aspiration. The study indicates the need for a multidisciplinary assessment because of dysphagia in TMD patients.
Highlights
Temporomandibular dysfunction (TMD) is a generic term which describes a broad array of changes to the masticatory and temporomandibular joint (TMJ) muscles
During mastication and the oral phase we observed tongue compensatory movements upon chewing (n = 7; 70%), premature escape (n = 4; 40%), food remains in the cavity after swallowing (n = 5; 50%) and an excessive number of deglutition efforts (n = 5; 50%)
We found the persistence of food residue in the oral cavity of 50% of the cases, 10% for liquids in the volume of 20 ml; pasty and solid consistencies, 10%; 20% for solid; 10% for all the consistencies and volumes utilized (Chart 1)
Summary
Temporomandibular dysfunction (TMD) is a generic term which describes a broad array of changes to the masticatory and temporomandibular joint (TMJ) muscles. It is a multifactorial condition which may be acquired by one or more factors, such as occlusal unbalance, stress and rheumatic or neuromuscular systemic diseases, which may manifest alone or in different associations[1,2,3]. Most TMD-related complaints include pain, especially in the masticatory muscles, pre-auricular region and/ or the very TMJ region. The prevalence of TMD signs and symptoms in the general population varies between 40% and 60%, which justifies the scientific interest on this disorder, especially concerning the professionals dedicated to the propaedeutic as well as the prevention and clinical aspects associated with the different types of treatment and rehabilitation for the stomatognathic system[4,5]
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