To be really healthy, you must be aware of the causes of disease
and avoid or correct them. One of the most common problems we see in
our practice has to do with the way people swallow. Few people, laymen
and doctors alike, are aware of the trouble that the abnormal swallow
can cause. Yet, studies show that 75% of the population swallows incorrectly.
In the normal swallow, the tip of the tongue should brace itself against
the roof of the mouth just behind the upper front teeth. Then the food
back and swallowed. In the abnormal swallow, the bulk of the tongue's
muscular forces is asserted against the teeth during the swallow. It can be
a forward thrust or sideways – or any combination of directions.
The problem usually starts early in life. During normal breast-feeding, infants
have to suck hard to get milk. The tongue aids in the swallowing process. But
in about ten percent of cases, the mother has what we call "fast flow." The
milk flows so rapidly that the tongue reverses its movement to keep the child
from choking. It presses forward to slow down the oncoming milk. In bottle-fed
babies, much the same happens. The speedy flow of formula causes the tongue
to move abnormally in effort to slow the flow of the fluid. In so doing, faulty
neuromuscular patterns are laid down early in life. The brain and nervous system
are programmed to send natural messages to the tongue's muscles – and
the tongue thrusts forward, sideways, or a combination of directions from then
on. In so doing, the infant swallows a lot of air with the milk. This is why
we have to remove the bottle and "burp" them so often. As children
grow older and eat more solid food, they need to drink abnormal amounts of
water during meals in order to get food down.
Another consequence of the reverse swallow is the dry mouth from which these
children suffer. They sleep with their mouths open, and this nocturnal mouth
breathing dries out their saliva. It becomes ropey and desiccated instead of
detergent and cleansing, and this leads to greater amounts of plaque formation.
Plaque consists of germ colonies around the necks of the teeth and is responsible
for gingival gum inflammation and rampart decay.
In the reverse swallow, we find that other muscles are affected. The lip muscles
are flaccid and have poor tone. And so quite often people with the reverse
swallow breathe a great deal through the mouth during the day. This perpetuates
the dry mouth, and these children, and adults, too, are inclined to combat
the parched feeling with candy suckers.
Ingested sugar acts locally on the teeth. Bacterial flora develop speedily
because of the sucrose, and this encourages even more plaque formation. The
refined sugar is in solution, and so it passes quickly into the plaque – and
then the bacteria breed more rapidly. Dental disease follows. Sugar ingestion
over a period of time can also lead to hypoglycemia, and this condition is
directly related to stress. Hypoglycemic individuals suffer greatly from the
effects of tension. They have high irritability. And this results in their
common tendency towards bruxism – clenching and grinding of their teeth.
It becomes a neuromuscular pattern, and they are often unaware of it.
When one grinds teeth, the jaw jiggles the joint that is located just in front
of the ear. It is called the temporomandibular joint. The muscles, tendons,
and ligaments associated with the joint become inflamed from the erratic movements,
and the area starts to be painful. Headaches result and so do referred aches
down the neck, shoulders, and other parts of the body. About 20% of the population
have some symptoms of this syndrome, called the temporomandibular joint dysfunction
syndrome. Some authorities feel that hypoglycemia should be suspected in cases
of this type.
Abnormal swallow patterns and temporomandibular joint dysfunction are also
closely related. Unless this is understood and considered in treatment, temporomandibular
joint problems will be likely to recur. Indeed, in cases of abnormal swallow,
correction of the tongue habit may prevent the possible future development
of temporomandibular joint dysfunction.
Adequate treatment always requires removal of the cause. When the tongue presses
on the teeth during the act of swallowing instead of pressing on the resistant
hard palate, it actually serves as an orthodontic appliance and causes the
teeth to move, however imperceptibly at first. Whenever the teeth do move,
the occlusion becomes distorted, and the relationships of the biting surfaces
of the upper and lower teeth are changed. When the jaws close as in biting,
the teeth don't fit together harmoniously. The jaws are then inclined
to search for a convenient and comfortable place to close so that the hills
and valleys of the opposing teeth do not interfere with one another. When the
jaw shifts, the joints of the jaw in front of the ear also shift, and this
triggers the temporomandibular joint dysfunction syndrome. If the syndrome
is already present, abnormal swallowing can aggravate it. This shifting of
the teeth from the pressure of the tongue can occur very slowly. The resulting
temporomandibular joint dysfunction syndrome symptoms are at first well within
patients' adaptive and resistive capacities, so that they are not aware
of the impending trouble.
When teeth don't come together accurately when closing, a tendency to
grind the teeth results. The teeth gnash in an unconscious effort to wear down
the interfering biting surfaces and to find a comfortable place to rest the
teeth together. In these cases, when the dentist adjusts the occlusion, (the
biting surfaces), the patient gets only temporary relief. One must consider
the functional movements of the tongue in order to prevent recurrence or to
prevent temporomandibular joint dysfunction initially. The abnormal swallow
continues to change the biting relationship of the upper and lower jaws by
causing the teeth to move.
About ten years ago, we successfully treated a young girl's temporomandibular
joint problem by, among other things, adjusting her bite. Yet we were all distressed
when, in three months, she returned with her headaches. We adjusted her bite
again, and again she was relieved of her discomfort. But when several months
passed, her headaches returned, and so did she. At that time, we had begun
to appreciate the importance of the abnormal swallow, so we incorporated myofunctional
therapy into our practice. We found that this young girl had an abnormal swallow.
In swallowing, her tongue pressed against her lower right premolars, changing
their relationship with the opposing upper premolars when they came together
in biting. She was highly motivated when we suggested she learn to correct
her abnormal swallow. She worked hard at it. After the initial course of myofunctional
therapy, when we were sure that she was swallowing correctly, we adjusted her
bite once more. She has been without her symptoms since then.
We have found in the vast majority of temporomandibular joint dysfunction syndrome
cases, there is an associated faulty swallowing pattern. Dr. Eugene Dryer has
called this reverse swallow by the name, "traumatic swallow" – and
with good cause.
We can help prevent the development of this unfortunate tongue problem by convincing
mothers that there are many advantages to be expected from proper breast-feeding:
Breast-fed children's teeth occlude better. They fit together better when
they bite. A great deal of orthodontic problems can be
prevented if one can avoid the development of the reverse swallow.
2. Because they receive their mother's milk, there is less likelihood
for breast-fed children to develop sensitivities to any allergic
ingredients in the formula.
3. The breast-fed child has less tendency to develop an abnormal
swallow, and therefore, less thumb sucking can be expected.
4. Because the mouth and face muscles of breast-fed children develop
more naturally, these children generally have a better facial appearance.
This has the added benefit of affording them a far better self-image
5. Less mouth-breathing is another characteristic breast-fed child.
We discussed the harmful effects of mouth-breathing and the reasons
why it should be avoided.
6. The improved nutrition of the breast-fed child increases its host
resistance to disease.
No one can argue that it is more sensible to get at the cause of
disease than have to deal later with its effects. If you're not
preventing disease, you are preventing health. One should try to prevent
the reverse swallow. But where it does exist, it makes for a happier
and healthier future for the individual if the faulty neuromuscular
patterns are relearned correctly.
The Journal of the International
Academy of Nutritional Consultants.