To give you important and useful information regarding swallowing and speech

SPEAKER #1

KIKI

The factors

a series of coordinated muscular contraction that moves a bolus of food from oral cavity through the esophagus to the stomach
Okeson, 2008

The factors

1. Degrees of fineness of the food

2. Intensity of the taste extracted

3. Degree of lubrication of the bolus

Practice : To appreciate the mechanism of masseter muscle Step : 1. Patients position: sit up straight 2. Clinicians: prependicular 3. Ask the patient to swallowing the saliva 4. Please stay attention to the symmetry of Result: Muscle function (+) Symmetry Muscle function (-) Asymmetry

Conclusion
From now on, please getting information of patients swallowing.

SPEAKER #2

MEITY

What Are They?

Clinical Examination

 Somatic Swallow:
swallowing pattern with muscular contractions and uses the teeth for mandibular stability that appear to be under control of the person

Visceral Swallow:
immature swallowing pattern of an infant or older person with tongue thrust, resembling peristaltic, and wavelike

Medilexocon.com

What Are They?

Clinical Examination

 Ask your patients to swallow her/his saliva, if theres no tongue trust SOMATIC SWALLOW

Ask your patients to swallow her/his saliva, if theres tongue trust VISCERAL SWALLOW

Highlight:
As a clinician, we must know what type of swallowing our patient has.

SPEAKER #3

NATASHA

EXPLORATION
THE IMPORTANCE

Swallowing patterns evolve as a changes adapted in the form of food, an increase in activity of muscle mastication, and the first molar tooth eruption.

Pinkham, 1999

The transition generally occurs in children aged 3-10 years. Normal adult swallowing pattern obtained at age 4 to 5 years, so that the pattern of infantile swallowing may transition to adult swallowing pattern completely at 8 years old.
Pinkham, 1999

EXPLORATION
THE IMPORTANCE

LACK OF TOOTH SUPPORT AS A RESULT POOR TOOTH POSITION OR ARCH RELATIONSHIP MAY RESULT NO TRANSITION FROM INFANTILE SWALLOW TO ADULT SWALLOW.
Okeson, 2008

OVERRETENTION OF THE INFANTILE SWALLOW CAN RESULT IN LABIAL DISPLACEMENT OF THE ANTERIOR TEETH BY THE POWERFUL TONGUE MUSCLE. THIS MAY PRESENT CLINICALLY AS AN ANTERIOR OPEN BITE.
Okeson, 2008

Essence
As a clinician, we should aware about the relation between occlusion and swallowing.

SPEAKER #4

REVINI

The Time
The Power

The Importance

Average tooth contact during swallowing is 683 msec. This is more then 3 times longer than mastication.

Okeson, 2008

The Time
The Power

The Importance

The force applied the teeth during swallowing is 66.5 pounds, is 7.8 pounds more than mastication.

Okeson, 2008

The Time
The Power

The Importance

When the mandible is braced, it is brought into a some what posterior or retruded position. If the teeth do not fit together well in this position, an anterior slide occurs to the intercuspal position.
Okeson, 2008

Bottom Line
As a clinician, we should know that the normal time of swallowing is less than 1 seconds.

SPEAKER #5

SITI

Anatomy
The Importance

Anatomy

www. Crossfitsouthbay.com

Anatomy
The Impotance

The Importance
the sensory input from the trigeminal nerve synapse in the spinal V nucleus its also important to appreciate that the most caudal region of the spinal tract nucleus extends inferiorly into the region where the upper cervical nerves enter the spinal cord (CN I V) Okeson, 2008

Getting to know
The Mechanism The Factors

The Factors
Quality of the intercuspal position will determine position mandible during swallowing, not retruded relationship with fossa. Muscle engrams and reflex activity maintain closure of the mandible into the intercuspal position
Okeson, 2008

PRACTICE
To Evaluate Mastication Muscle
1. Patient sit up straight and relax 2. Ask the patient to swallow 3. Notice the cheek while swallowing

PRACTICE
RESULT
- Masseter muscle pressing towards the midline and the cheek muscle should not move at all

NORMAL
- If left or right cheek bulging

ABNORMAL

Conclusion
As the clinician, please be familiar with mastication muscle on your patient

SPEAKER #6

ELFIRA

What is it?
The Process

What is it?
Oral phase of swallowing where the tongue cups to position the food, fluid or saliva for swallowing

www.beckmannoralmotor.com

What is it?

Okeson, 2008

What is it?
The Process

The Process
Selective parting of bolus by tongue Bolus placed on dorsum of the tongue Tongue pressed lightly against the hard palate Lips are sealed, teeth brought together Reflex contraction in the tongue, pressed bolus backward, transferred to pharynx
Okeson, 2008

PRACTICE
To evaluate first stage of swallowing
1. Patient sit up straight and relax 2. Ask the patient to swallow 3. Notice the lips while swallowing

PRACTICE
RESULT
- Lips are sealed while swallowing

Normal
- Lips are not sealed while swallowing Abnormal

Bottom Line
As the clinician, please be familiar with first stage of swallowing on your patient

SPEAKER #7

NADIA

Getting to know
The Mechanism

Getting To Know
Second Stage of Deglutition :
occurs when bolus reaches the area of palatoglossal folds. It is also known as the pharyngeal phase of swallowing.

www.ouhsc.edu

Getting To Know
Second Stage of Deglutition is under involuntary neuromuscular control which is stimulated by posterior tongue movement and stimulation of pharyngeal mucosa that stimulated the swallowing reflex.

www.ouhsc.edu

Getting to know The Mechanism

The Mechanism
Pharyngeal constrictor muscles contract

Bolus reaches the pharynx

Peristaltic wave occurs

Okeson, 2008

The Mechanism
Soft palate rises to touch posterior pharyngeal wall

Nasal passage is sealed Epiglottis blocks the pharyngeal airway to the trachea
Okeson, 2008

The Mechanism
The sequential steps to pharyngeal phase of swallowing are: 1. Velum elevating to contact posterior pharyngeal wall and block upward movement of bolus into nasopharynx 2. Elevation of the larynx and hyoid bone toward base of tongue, bringing a passive flipping over of the epiglottis to cover the glottis 3. Contraction of pharyngeal constrictor muscles from superior to inferior direction 4. Relaxation of the upper esophageal sphincter to allow passage of bolus into esophagus

www.ouhsc.edu

Practice:
to appreciate any abnormalities of second stage deglutition 1. Sit up straight and relax 2. Ask the patient to swallow his/ her saliva

Result:
Patient can swallow the saliva easily and the swallowing lasts less than 2 second NORMAL Patient has difficulty in swallowing and it lasts longer than 2 second SWALLOWING DISORDER

Essence:
From now on, lets start paying close attention to the way patients swallow.

SPEAKER #8

RIMA

?
The Process Clinical Examination

?
The third stage of swallowing consist of passing the bolus through the length of the esophagus and into the stomach.

Okeson, 2008

?
The Process Clinical Examination

The process
Peristaltic waves carry the bolus down the esophagus. The waves take 6 to 7 seconds to carry the bolus through the length of the esophagus.
Okeson, 2008

?
The Process Clinical Examination

Clinical Examination
Practice:
to appreciate the clinical examination of esophagus phase Lets swallowing

Result : Normal feel no obstacle in esophagus Problem feel an obstacle in esophagus

Important point:
As a clinician, please be aware if there is an obstacle while patients swallowing

Frequency of swallowing
Swallowing occurs 590 times during 24-hour 146 cycles during eating 394 cycles between meals while awake 50 cycles during sleep

Okeson, 2008

SPEAKER #9

LULU
SPEECH Part 1: Introduction

SPEECH Part 1: Introduction

What is it ?
The Importance The Difference

What is it ?
Speech is the third major function of the masticatory system and occurs when a volume of air is forced from the lungs by the diaphragm through the larynx and oral cavity.

Okeson, 2008

SPEECH Part 1: Introduction

What is it ? The Importance The Difference

The Importance
Controlled contraction and relaxation of the vocal cords create a sound with the desired pitch

Okeson, 2008

SPEECH Part 1: Introduction

What is it ? The Importance The Difference

The Difference
The Human Human have ability to form intricate sound using vowels and consonants The Animal Animal dont have ability to produce as many as distinguishable sounds because of simpler anatomy
www.linkedin.com

Bottom Line:
As a clinician, please be aware about articulation speech of the patient

SPEAKER #10

NINA
SPEECH Part 2: Articulation of Sound (I)

SPEECH Part 2: Articulation of Sound (I)

The importance
Assorted Sound

By varying the relationship of the lips and the tongue to the palate and teeth, one can produce a variety of sounds.
Okeson, 2008

SPEECH Part 2: Articulation of Sound (I)

The importance
Assorted Sound

Lips

m, b, and p sound the lips come together and touch S sound The incisal edges of maxillary and mandibular incisors closely approximate (but do not touch). The air is passed between the teeth d sound The tip of the tongue reaches up to touch the palate directly behind the incisors
OKESON,

Teeth

Tongue and palate

As a clinician, we should be aware if the patient cant spell obviously

SPEAKER #11

ERWINA
SPEECH Part 3: Articulation of Sound (II)

SPEECH Part 3: Articulation of Sound (II)

The importance
The Mechanism

A combination of the anatomic structures can also be use to form many of these sounds.
Okeson, 2008

SPEECH Part 3: Articulation of Sound (II)

The importance
The Mechanism

The Mechanism
The tongue touches the maxillary th sound. The lower lip touches the incisal edges of the maxillary teeth f and v sounds. The posterior portion of the tongue rises to touch the soft palate k or g

calleteach.wordpress.com

Important point:
As a clinician we should aware about combination of the anatomic structures that use to form many of these sounds.

SPEAKER #12

DINAR
SPEECH Part 4: The Role of Occlusion

SPEECH Part 4: The Role of Occlusion

THE IMPORTANCE

Early stage of life

Taught proper ariculation of speech

Tooth contact do not occur during speech

Okeson, 2008

If there is contact Sensory input information to CNS CNS perceives as damage Create new pattern of speech May result in slight lateral deviation of mandible
Biotechnol J., 2006

Highlight
As a clinician, we should give advice to our patient/parent to keep their teeth healthy.