Pattern of Tongue Pressure on Hard Palate During Swallowing

Dysphagia 19:259264 (2004)DOI: 10.1007/s00455-004-0010-9Pattern of Tongue Pressure on Hard Palate During SwallowingTakahiro Ono, DDS, PhD, Kazuhiro Hori, DDS, PhD, and Takashi Nokubi, DDS, PhDDivision of Oromaxillofacial Regeneration, Osaka University Graduate School of Dentistry, Osaka, JapanAbstract. Contact of the tongue against the hard

palate plays an important role in swallowing. This

study aimed to clarify the pattern of contact between

the tongue and hard palate by analyzing tongue

pressure produced in swallowing 15 ml of water by

healthy subjects wearing an experimental palatal

plate with seven pressure sensors. Tongue pressure

was generated initially by close contact with the anteriomedian part of the hard palate, then with the

circumferential part, and nally softly with the posteriomedian part. Tongue pressure reached a peak

quickly, then decreased gradually before disappearing almost simultaneously at each measured part of

the hard palate. Magnitude and duration were signicantly larger in the anteriomedian part compared

to the other six parts measured, and was signicantly

smaller in the posteriomedian part. No laterality was

found in tongue pressure produced at the circumferential parts of the hard palate. Our ndings indicate

that the order of tongue contact against each part of

the hard palate as well as duration and magnitude of

tongue pressure are coordinated precisely during

swallowing. These ndings could aid assessment of

the tongue movement of dysphagic patients during

rehabilitation.Key words: Deglutition Tongue Palate, hard

Deglutition disorders.Contact of the tongue against the hard palate plays

an important role in articulation, mastication, and

swallowing. For patients who have undergone surgery for tongue cancer, a palatal augmentation

prosthesis may be applied to compensate for decreased contact between the tongue and hard palate

[13]. Up to now dynamic palatography [4,5] and

measurement of tongue pressure have been used

to evaluate the degree of tonguepalate contact

[69], but these methods have limitations when

evaluating tongue pressure during mastication and

swallowing.Dynamic palatography eectively shows

changes in tongue contact position over time, but

it is not suitable for evaluating mastication and

swallowing because it does not work well under wet

conditions. Tongue pressure has been measured by

several groups using the Iowa Oral Performance

Instrument (IOPI) [1012] and by pressure sensors

[69]. The IOPI is useful in the assessment of

tongue pressure because its simple structure enables

it to be...