OROFACIAL MYOLOGY: “ is the study of the facial muscles, their associated movements and how those movements affect the functions of respiration, swallowing, mastication (chewing), speech, craniofacial development and oral resting posture.When a change in patterning occurs a resulting change in muscular function and anomalies may occur. Changes can be attributed, but are not limited to genetics, birth trauma, and anomalies, lack of patent airway, surgical intervention affecting the head and neck, inappropriate developments of the swallow, or noxious habit patterns.”
-M. Billings, MS, CCC, COM
Most of us think that chewing and swallowing activities are automatic. These important mouth functions become so familiar to us that they certainly feel “automatic”. However, for some people chewing and swallowing can be very difficult. According to Andrew Kaplan, DMD and Leon Assael DMD in their book, TMJ Disorders: Diagnosis and Treatment, “One of the most commonly overlooked problems during treatment of patients with TMJ and craniocervical disorders is altered swallowing sequence and tongue position. Few other forces can match the tongues ability to cause occlusal and skeletal deformation.”
The tongue and teeth are an essential part of the muscular system that support and move the jaws, head and neck. Muscular bracing to hold the head steady takes place when swallowing. It is important that the head doesn’t move back when the jaw or tongue pushes food up against the palate. Swallowing occurs about 2,000 times a day. Misdirected forces of the tongue against the teeth over time can actually move teeth. The force applied to teeth during swallowing is approximately 66.5lbs.
A tongue thrust habit in which the tongue is thrust outward and between the teeth each time swallowing occurs can be a major cause for protruding, crowding and crooked teeth which leads to an ‘open’ bite. In some TMJ sufferers, if the swallowing function isn’t working properly, it significantly affects the functional movement of the jaw joint because the joint is moved by coordinated groups of muscles. This dysfunction leads to muscle fatigue, spasms and changes in the jaw joint due to the increased chewing effort and jaw movement it takes to prepare the food for swallowing. Swallowing and digesting food also becomes much more difficult.
OTHER BODY INVOLVEMENT: The tongue as well as swallowing is also involved in other disorders. In fact, it is a major factor in snoring and obstructive sleep apnea. Muscle tone is important for the tongue. For instance, an excessively narrow or broad mouth, crowded teeth, loss of teeth or dentures and other oral conditions can interfere with tongue space or with the normal reflex mechanisms that maintain muscle tone. In such cases, the only place the tongue can go during oral function is backward into the throat, which causes airway blockage and results in snoring. As with any health condition, people who are consistently snore need to be screened and treated early before it becomes life-threatening.
The hyoid bone located under the chin at the top of the neck and muscles around it are equally affected. This bone can be found by placing fingers above the Adam’s Apple to feel the hyoid move upon swallowing. For the muscles and teeth to function properly, the tongue should stay WITHIN the dental arch when swallowing to allow the muscular movements to continue in the waves of motion. This moves the food to the stomach.
A SWALLOWING TEST: You can perform this test yourself. Stand in front of a mirror. Place a small to moderate amount of water in your mouth. Swallow the water. Repeat 3 times. Count the number of times you must swallow for each drink of water. Watch for head movement during the swallow and notice if your teeth are together or apart when you swallow. They should be together.
Some of the common symptoms of chewing and swallowing disorders are:
- Tired jaw muscles during or after eating
- Tightness or soreness in the throat under the jaw
- Double or triple swallows in order to clear the mouth
- Head movement during chewing or swallowing
If you have any of these symptoms, your jaw muscles are out of balance. This may be a direct result of a TMJ disorder with a secondary swallowing problem o sleep problem. A trained TMJ/SLEEP dentist can identify and treat jaw muscle imbalance and can determine if treatment is needed.
- Instruction in the normal resting position of the tongue
- Instruction in proper swallowing
- Maintaining proper head and neck posture
- Treating a TMJ disorder
Article written by:
Larry Pribly, DDS, M.B.A.
2013- TMData Resources ( formerlyTMJ & Stress Centre) Albuquerque, NM
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