Functions 4

Question 1

List the 3 stages of swallowing

Answer 1

1. Buccal phase
   - Voluntary
2. Pharyngeal phase
   - Involuntary
3. Oesophageal phase
   - Involuntary

Question 2

Define swallowing

Answer 2

Process by which bolus is transported through the lower pharynx + oesophagus to the stomach

Question 3

How does swallowing create a protective function?

Answer 3

Prevents ingested material from entering the lower airway

Question 4

How can swallowing be potentially dangerous?

Answer 4

Because the foodway crosses the airway

Question 5

3 phases to swallowing liquids

Answer 5

1. Liquids gathered on tongue, anterior to the pillars of the fauces
2. Mouth separated from the pharynx by a posterior oral seal
3. Liquid bolus propelled through the oro and hypo pharynx and then into the oesophagus

Question 6

2 phases to swallowing a solid bolus

Answer 6

1. No true posterior oral seal
   Chewed food accumulated on pharyngeal part of tongue and vallecula (oropharynx)
2. Bolus propelled from tongue through the hypopharynx and then into the oesophagus

Question 7

Compare the difference between swallowing liquids and solids

Answer 7

1. Liquids swallowed from the mouth (oral seal)

2. Solids are swallowed from the oropharynx (no oral seal)

Question 8

3 main swallowing events

Answer 8

1. Propulsion of food
2. Prevention of reflux
3. Protecting the airway

Question 9

What controls masticatory sequences?

Answer 9

Food consistency

Question 10

How is reflux prevented? (5)

Answer 10

1. Elevation of soft palate
2. Tongue contacts pillars of fauces
3. Tongue (dorm) contacts posterior pharyngeal wall
4. Upper oesophageal sphincter
   - Reflux from oesophagus into pharynx
5. Lower oesophageal sphincter
   - Reflux from stomach into oesophagus

Question 11

Examples of stomach acid issues that lead to erosion (3)

Answer 11

Stomach acid can erode teeth by reflux, vomiting and regurgitation

Question 12

What is palatal surface erosion a sign of?

Answer 12

Stomach acid issues

Bulimia can cause erosion and cupping of the palatal aspect of the teeth

Question 13

Define attrition

Answer 13

Tooth to tooth wear

- Caused by parafunction/bruxism

Question 14

Define abrasion

Answer 14

Possibly caused by biting/chewing objects between teeth

- Unusual to occur on its own (usually erosion and abrasion)

Question 15

How do acids contribute to abrasion?

Answer 15

Acids weaken the outer 3-5 microns of mineralised tissue and increase the susceptibility of the enamel and dentine to abrasion from tooth brushing with or without toothpaste

Question 16

Define abfractions

Answer 16

Wedge shaped notch caused by flexure and ultimate material fatigue of susceptible teeth at locations away from the point of loading (cervical regions)

Question 17

What factors is the breakdown of teeth dependent on? (4)

Answer 17

1. Magnitude
2. Duration
3. Frequency
4. Location

Of the occlusal forces

Question 18

What components help with airway protection? (4)

Answer 18

1. Upward and forward movement of larynx
2. Closure of laryngeal inlet
   - Aryepiglottic muscles
   - Epiglottis
3. Adduction of vocal folds
4. Stop breathing (apnoea)

Question 19

Define dysphasia

Answer 19

Language disorder involving damage to parts of the brain

• Broca’s area
• Wernicke’s area

Question 20

Define dysphagia

Answer 20

Difficulty swallowing

Question 21

Define odynophagia

Answer 21

Extreme pain on swallowing be it food, liquids or meds

Question 22

Define dysarthria (2)

Answer 22

• Difficulty speaking caused by problems within the muscles used in speech
• Due to neuromuscular defects

Question 23

Lesions present in which areas lead to dysarthria? (4)

Answer 23

1. Descending neural pathways
2. CNs
3. Vocal muscles
4. Neuromuscular junctions

Question 24

List oral causes of language + speech defects (5)

Answer 24

1. Malocclusions
2. Loss of teeth + denture related
3. Cleft lip/palate
4. Tongue related
5. Dry mouth

Question 25

What can lead to an anterior open bite? (3)

Answer 25

1. Digit sucking 2. Tongue thrust 3. Skeletal origin

Question 26

How does cleft palate lead to nasally speech?

Answer 26

Oral and nasal cavities are not separated - leading to a nasal quality speech

Question 27

How is a palatal cleft palate dealt with?

Answer 27

Repaired or filled with an obturator

Question 28

List conditions affecting the tongue (3)

Answer 28

1. Tongue tie 2. Partial atrophy 3. Tongue stud

Question 29

How can xerostomia lead to impeded speech?

Answer 29

Inadequate saliva production leads to difficulty in pronouncing words People with dry mouth + difficulty speaking can't simply swallow and talk

Question 30

When would torus mandibularis pose an issue?

Answer 30

Benign but an issue if patient needs an RPD - as it will interfere with the major connector

Question 31

How could an RPD design be modified if the patient has torus palatines?

Answer 31

Horseshoe design if patient refuses surgery

Question 32

What are some denture related problems for oral functions? (3)

Answer 32

1. Problems from restricted tongue space 2. Denture base plate is too thick 3. Artificial teeth not set properly

Question 33

How does excessive thickening of the palate affect speech

Answer 33

Excessive thickening of the palate laterally prevents close adaptation of the tongue to the palate so the s becomes sh

Question 34

How do wrong occlusal planes affect speech? (2)

Answer 34

- Problems pronouncing f v and ph: Labiodental sounds | - Dentures must be fabricated to a morphology that does not cause interference with tongue/lip/cheek movement

Question 35

How does the loss of maxillary anterior teeth affect speech?

Answer 35

May prevent the clear reproduction of certain sounds - particularly F and V (which are made by the lower lip contacting the edges of maxillary incisors

Question 36

Teeth in relation to vermillion border (2)

Answer 36

- Incisal edges of teeth should not touch the vermillion border - Should only touch the vermillion border of the lip during fricative sounds

Question 37

How to assess speech when replacing missing teeth

Answer 37

Address + family details

Question 38

What helps produce vocal sounds?

Answer 38

Aerodigestive tract and facial tissues

Question 39

What factors might influence the final choice of treatment?

Answer 39

1. Cost 2. Effects on adjacent teeth - Oral hygiene - Prep as abutments 3. Aesthetics 4. Function 5. Lifespan of the prosthesis and eventual replacement

Question 40

Define embouchure

Answer 40

Position and use of lips, tongue and teeth in playing a wind instrument