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Friday, September 24, 2010

Mandibular advancement, nasal breathing and swallowing.

Swallowing disorders are frequently associated with TMJ disorders. Abnormal breathing patterns are also associated with both TMJ disorders and Sleep apnea and snoring. This new study "The mandible advancement may alter the coordination between breathing and the non-nutritive swallowing reflex." in the Journal of Oral Rehabilitation (see abstract below) concludes "that mandible re-positioning may strongly influence the coordination between nasal breathing and non-nutritive swallowing by altering respiratory parameters and by inhibiting movement of the tongue-jaw complex.

This inhibition of movement may be a partial explanation of why anterior positioning appliances help muscle problems. The patients may just be breathing easier in this new position. It is another example of convergence between TMD and Sleep Apnea

J Oral Rehabil. 2010 May 1;37(5):336-45. Epub 2010 Mar 10.
The mandible advancement may alter the coordination between breathing and the non-nutritive swallowing reflex.
Ayuse T, Ayuse T, Ishitobi S, Yoshida H, Nogami T, Kurata S, Hoshino Y, Oi K.

Department of Special Care Dentistry, Nagasaki University Hospital, Nagasaki, Japan.
Abstract
The coordination between nasal breathing and non-nutritive swallowing serves as a protective reflex against potentially asphyxiating material, i.e. saliva and secretions, entering the respiratory tract. Although this protective reflex is influenced by positional changes in the head and body, the effect of mandible position on this reflex is not fully understood. We examined the effect of mandible advancement associated with mouth opening on the coordination between nasal breathing and non-nutritive swallowing induced by continuous infusion of distilled water into the pharyngeal cavity. The combination of mandible advancement and mouth opening increased the duration of swallowing apnoea and submental electromyographic burst duration. When the mandible was advanced with the mouth open, the duration of swallowing apnoea increased significantly compared with the centric position (0.79 +/- 0.23 vs. 0.64 +/- 0.12 s, P < 0.05, n = 12), and the duration of submental electromyographic activity increased significantly (2.11 +/- 0.63 vs. 1.46 +/- 0.25 s, P < 0.05, n = 12). Mandible advancement with mouth opening altered the respiratory phase resetting during swallowing and the timing of swallow in relation to respiratory cycle phase. We conclude that mandible re-positioning may strongly influence the coordination between nasal breathing and non-nutritive swallowing by altering respiratory parameters and by inhibiting movement of the tongue-jaw complex.

PMID: 20337868 [PubMed - indexed for MEDLINE]

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posted by Dr Shapira at 7:36 AM

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