The Proper Swallow By: Dr. Nishita Ondhia

 

For far too long, the dental and medical communities have not given enough credit to one of the most amazing muscles in the body, the tongue.

The tongue is a muscular organ in the mouth.  It is known for its function in digestion, taste, speech, breathing and oral hygiene.

Interestingly, the tongue has a very important function in how one’s face grows thus affecting how the teeth erupt, in addition, it affects how one breathes, which in turn has effects on one’s overall health and wellness.

If the tongue is functioning properly, it will rest at the roof of the mouth.  While swallowing, almost twice every minute, it will travel back to the soft palate, create a seal, voluntarily block off access to the airway, create negative pressure, send food/mucus/saliva into the esophagus and open the Eustachian tubes.

This proper swallow affects function, however, it has a far more important function.  Being an active muscle, when young, the tongue also acts like your lifelong orthodontist.  If the tongue is pushing up against the palate it is also widening the palate, widening the floor of the nose and guiding craniofacial growth.  Proper craniofacial growth allows for good occlusion, dental alignment and good jaw formation. This is a concept quite often overlooked with modern orthodontic convention where we wait for all the adult teeth to erupt before we begin to consider aligning.  If we created proper swallowing early, the incidence and severity of teen orthodontics will decrease.  More importantly, we will have healthier children and a decline in adult sleep apnea.

In fact, the screening for early interventional orthodontics must be done very early and the biggest red flag is mouth breathing.  The mouth breathing is often accompanied by other signs such as bruxism, snoring, restlessness, bad sleep, tiredness, frequent ear infections,increase in caries rate, ADHD symptoms and prolonged nighttime bedwetting.  When these symptoms present, children are often in a constant fight or flight response in the sympathetic nervous with short, laboured mouth breathing. Why?  Because the tongue is not functioning properly, it is not swallowing properly and thus we are not able to breathe via our noses.

The tongue cannot function properly due to two reasons, limited range of motion and/or no space for it to function properly (interestingly, the space issue is due to the tongue not functioning properly as form affects function and function affects form).

The solutions, if needed on an individual bases, are nasal hygiene, freeing of the tongue (tie release), creating space for the tongue (early interventional orthodontics) and training the tongue (myofunctional therapy).

The goal is always to re-establish nose breathing.  In order to do this, we need the tongue to function properly with a proper swallow.

-Dr. Nishita Ondhia