Skip to main content
SpringerLink
Log in

Swallowing changes related to chronic temporomandibular disorders

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

To investigate whether chronic temporomandibular disorder (TMD) patients showed any changes in swallowing compared to a control group. Moreover, it was examined whether swallowing variables and a valid clinic measure of orofacial myofunctional status were associated.

Material and methods

Twenty-three patients with chronic TMD, diagnosed with disc displacement with reduction (DDR) and pain, according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), and 27 healthy volunteers (control group) were compared. Surface electromyography (EMG) of the temporalis, masseter, sternocleidomastoid, and suprahyoid muscles was performed during swallowing tasks of thin liquid (10 and 15 mL) and spontaneous saliva. Data were normalized.

Results

Compared to the control group, TMD patients showed a prolonged duration of swallowing for liquid and saliva and required a longer time to reach the activity peak and half the integral. While the overall mean value of the relative peaks was similar for the groups, the suprahyoid peak was significantly lower in the TMD group during swallowing of liquid. Moreover, TMD patients recruited the jaw elevator muscles proportionally more than controls. The orofacial myofunctional status was moderately correlated with EMG parameters.

Conclusion

Patients with chronic TMD showed temporal prolongation and changes in the relative activity of the muscles during the swallowing tasks.

Clinical relevance

The present results contribute additional evidence regarding the reorganization of muscle activity in patients with chronic TMD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Chantaracherd P, John MT, Hodges JS, Schiffman EL (2015) Temporomandibular joint disorders’ impact on pain, function, and disability. J Dent Res 94(3 Suppl):79S–86S. https://doi.org/10.1177/0022034514565793

    Article  PubMed  PubMed Central  Google Scholar 

  2. Ferreira CL, Machado BC, Borges CG, Rodrigues Da Silva MA, Sforza C et al (2014) Impaired orofacial motor functions on chronic temporomandibular disorders. J Electromyogr Kinesiol 24(4):565–571. https://doi.org/10.1016/j.jelekin.2014.04.005

    Article  PubMed  Google Scholar 

  3. Santana-Mora U, Lopez-Cedrun J, Mora MJ, Otero XL, Santana-Penin U (2013) Temporomandibular disorders: the habitual chewing side syndrome. PLoS One 8(4):e59980. https://doi.org/10.1371/journal.pone.0059980

    Article  PubMed  PubMed Central  Google Scholar 

  4. Weber P, Correa EC, Bolzan Gde P, Ferreira Fdos S, Soares JC et al (2013) Chewing and swallowing in young women with temporomandibular disorder. CoDAS 25(4):375–380

    Article  PubMed  Google Scholar 

  5. Mapelli A, Zanandrea Machado BC, Giglio LD, Sforza C, De Felicio CM (2016) Reorganization of muscle activity in patients with chronic temporomandibular disorders. Arch Oral Biol 72:164–171. https://doi.org/10.1016/j.archoralbio.2016.08.022

    Article  PubMed  Google Scholar 

  6. Lopez-Cedrun J, Santana-Mora U, Pombo M, Perez Del Palomar A, Alonso De la Pena V et al (2017) Jaw biodynamic data for 24 patients with chronic unilateral temporomandibular disorder. Sci Data 4:170168. https://doi.org/10.1038/sdata.2017.168

    Article  PubMed  PubMed Central  Google Scholar 

  7. Gilheaney O, Bechet S, Kerr P, Kenny C, Smith S et al (2018) The prevalence of oral stage dysphagia in adults presenting with temporomandibular disorders: a systematic review and meta-analysis. Acta Odontol Scand 1–11. https://doi.org/10.1080/00016357.2018.1424936

  8. Miller A (1986) Neurophysiological basis of swallowing. Dysphagia 1:91–100

    Article  Google Scholar 

  9. Steele CM, Alsanei WA, Ayanikalath S, Barbon CE, Chen J et al (2015) The influence of food texture and liquid consistency modification on swallowing physiology and function: a systematic review. Dysphagia 30(1):2–26. https://doi.org/10.1007/s00455-014-9578-x

    Article  PubMed  Google Scholar 

  10. Avivi-Arber L, Sessle BJ (2018) Jaw sensorimotor control in healthy adults and effects of ageing. J Oral Rehabil 45(1):50–80. https://doi.org/10.1111/joor.12554

    Article  PubMed  Google Scholar 

  11. Gibbs CH, Mahan PE, Lundeen HC, Brehnan K, Walsh EK, Holbrook WB (1981) Occlusal forces during chewing and swallowing as measured by sound transmission. J Prosthet Dent 46(4):443–449

    Article  PubMed  Google Scholar 

  12. Matsuo K, Palmer JB (2008) Anatomy and physiology of feeding and swallowing: normal and abnormal. Phys Med Rehabil Clin N Am 19(4):691–707. https://doi.org/10.1016/j.pmr.2008.06.001

    Article  PubMed  PubMed Central  Google Scholar 

  13. de Felicio CM, Medeiros AP, de Oliveira Melchior M (2012) Validity of the ‘protocol of oro-facial myofunctional evaluation with scores’ for young and adult subjects. J Oral Rehabil 39(10):744–753. https://doi.org/10.1111/j.1365-2842.2012.02336

    Article  PubMed  Google Scholar 

  14. Maffei C, Mello MM, Biase NG, Pasetti L, Camargo PA, Silvério KC, Gonçalves MI (2012) Videofluoroscopic evaluation of mastication and swallowing in individuals with TMD. Braz J Otorhinolaryngol 78(4):24–28

    Article  PubMed  Google Scholar 

  15. Dantas RO, Dodds WJ (1990) Effect of bolus volume and consistency on swallow-induced submental and infrahyoid electromyographic activity. Braz J Med Biol Res 23(1):37–44

    PubMed  Google Scholar 

  16. Vaiman M, Eviatar E, Segal S (2004) Surface electromyographic studies of swallowing in normal subjects: a review of 440 adults. Report 1. Quantitative data: timing measures. Otolaryngol Head Neck Surg 31(4):548–555. https://doi.org/10.1016/j.otohns.2004.03.013

    Article  Google Scholar 

  17. Stepp CE (2012) Surface electromyography for speech and swallowing systems: measurement, analysis, and interpretation. J Speech Lang Hear Res 55(4):1232–1246. https://doi.org/10.1044/1092-4388(2011/11-0214)

  18. Ertekin C (2015) Electrophysiological techniques to evaluate swallowing in central and peripheral nervous system disorders. J Clin Neurophysiol 32(4):314–323. https://doi.org/10.1097/WNP.0000000000000189

    Article  PubMed  Google Scholar 

  19. Williamson EH, Hall JT, Zwemer JD (1990) Swallowing patterns in human subjects with and without temporomandibular dysfunction. Am J Orthod Dentofac Orthop 98(6):507–511

    Article  Google Scholar 

  20. Bazzotti L (1998) Mandible position and head posture: electromyography of sternocleidomastoids. Cranio 16(2):100–108

    Article  PubMed  Google Scholar 

  21. Ciavarella D, Tepedino M, Laurenziello M, Guida L, Troiano G, Montaruli G, Illuzzi G, Chimenti C, Lo Muzio L (2018) Swallowing and temporomandibular disorders in adults. J Craniofac Surg 29(3):e262–e267. https://doi.org/10.1097/SCS.0000000000004376

    Article  PubMed  Google Scholar 

  22. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, List T, Svensson P, Gonzalez Y, Lobbezoo F, Michelotti A, Brooks SL, Ceusters W, Drangsholt M, Ettlin D, Gaul C, Goldberg LJ, Haythornthwaite JA, Hollender L, Maixner W, van der Meulen M, Murray GM, Nixdorf DR, Palla S, Petersson A, Pionchon P, Smith B, Visscher CM, Zakrzewska J, Dworkin SF (2014) Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Groupdagger. J Oral Facial Pain Headache 28(1):6–27. https://doi.org/10.11607/jop.1151

    Article  PubMed  PubMed Central  Google Scholar 

  23. de Felicio CM, Melchior Mde O, Da Silva MA (2009) Clinical validity of the protocol for multi-professional centers for the determination of signs and symptoms of temporomandibular disorders. Part II. Cranio 27(1):62–67. https://doi.org/10.1179/crn.2009.010

    Article  PubMed  Google Scholar 

  24. Machado BC, Mazzetto MO, Da Silva MA, de Felicio CM (2016) Effects of oral motor exercises and laser therapy on chronic temporomandibular disorders: a randomized study with follow-up. Lasers Med Sci 31(5):945–954. https://doi.org/10.1007/s10103-016-1935-6

    Article  PubMed  Google Scholar 

  25. Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G (2000) Development of recommendations for SEMG sensors and sensor placement procedures. J Electromyogr Kinesiol 10(5):361–374

    Article  Google Scholar 

  26. Kim HR, Lee SA, Kim K, Leigh JH, Han TR, Oh BM (2015) Submental muscle activity is delayed and shortened during swallowing following stroke. PM R 7(9):938–945. https://doi.org/10.1016/j.pmrj.2015.05.018

    Article  PubMed  Google Scholar 

  27. Ferrario VF, Tartaglia GM, Galletta A, Grassi GP, Sforza C (2006) The influence of occlusion on jaw and neck muscle activity: a surface EMG study in healthy young adults. J Oral Rehabil 33(5):341–348. https://doi.org/10.1111/j.1365-2842.2005.01558

    Article  PubMed  Google Scholar 

  28. Crary MA, Carnaby Mann GD, Groher ME (2006) Biomechanical correlates of surface electromyography signals obtained during swallowing by healthy adults. J Speech Lang Hear Res 49(1):186–193

    Article  PubMed  Google Scholar 

  29. Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Academic Press, New York

    Google Scholar 

  30. Vaiman M (2007) Standardization of surface electromyography utilized to evaluate patients with dysphagia. Head Face Med 3:26. https://doi.org/10.1186/1746-160X-3-26

    Article  PubMed  PubMed Central  Google Scholar 

  31. Huckabee ML, Steele CM (2006) An analysis of lingual contribution to submental surface electromyographic measures and pharyngeal pressure during effortful swallow. Arch Phys Med Rehabil 87(8):1067–1072. https://doi.org/10.1016/j.apmr.2006.04.019

    Article  PubMed  Google Scholar 

  32. Musto F, Rosati R, Sforza C, Toma M, Dellavia C (2017) Standardised surface electromyography allows effective submental muscles assessment. J Electromyogr Kinesiol 34:1–5. https://doi.org/10.1016/j.jelekin.2017.02.008

    Article  PubMed  Google Scholar 

  33. Yoon WL, Khoo JK, Rickard Liow SJ (2014) Chin tuck against resistance (CTAR): new method for enhancing suprahyoid muscle activity using a Shaker-type exercise. Dysphagia 29(2):243–248. https://doi.org/10.1007/s00455-013-9502-9

    Article  PubMed  Google Scholar 

  34. Gingrich LL, Stierwalt JA, Hageman CF, LaPointe LL (2012) Lingual propulsive pressures across consistencies generated by the anteromedian and posteromedian tongue by healthy young adults. J Speech Lang Hear Res 55(3):960–972. https://doi.org/10.1044/1092-4388(2011/10-0357)

    Article  PubMed  Google Scholar 

  35. Steele CM, Van Lieshout PH (2008) The dynamics of lingual-mandibular coordination during liquid swallowing. Dysphagia 23(1):33–46. https://doi.org/10.1007/s00455-007-9093-4

    Article  PubMed  Google Scholar 

  36. Pearson WG Jr, Hindson DF, Langmore SE, Zumwalt AC (2013) Evaluating swallowing muscles essential for hyolaryngeal elevation by using muscle functional magnetic resonance imaging. Int J Radiat Oncol Biol Phys 85(3):735–740. https://doi.org/10.1016/j.ijrobp.2012.07.2370

    Article  PubMed  Google Scholar 

  37. Kumar A, Castrillon E, Trulsson M, Svensson KG, Svensson P (2017) Fine motor control of the jaw following alteration of orofacial afferent inputs. Clin Oral Investig 21(2):613–626. https://doi.org/10.1007/s00784-016-1939-4

    Article  PubMed  Google Scholar 

  38. Ikoma T, Bendixen KH, Arima T, Dawson A, Yamaguchi T, List T, Svensson P (2018) Effects of low-intensity contractions of different craniofacial muscles in healthy participants - an experimental cross-over study. Headache 58(4):559–569. https://doi.org/10.1111/head.13280

    Article  PubMed  Google Scholar 

  39. Hilgenberg-Sydney PB, Kowacs PA, Conti PC (2016) Somatosensory evaluation in dysfunctional syndrome patients. J Oral Rehabil 43(2):89–95. https://doi.org/10.1111/joor.12344

    Article  PubMed  Google Scholar 

  40. Ertekin C (2011) Voluntary versus spontaneous swallowing in man. Dysphagia 26(2):183–192. https://doi.org/10.1007/s00455-010-9319-8

    Article  PubMed  Google Scholar 

  41. Steele C (2015) The blind scientists and the elephant of swallowing: a review of instrumental perspectives on swallowing physiology. J Texture Stud 46(3):122–137. https://doi.org/10.1111/jtxs.12101

    Article  Google Scholar 

Download references

Funding

This study was funded by Provost’s Office for Research of the University of São Paulo (Process No. 11.1.21626.01.7) and National Council for Scientific and Technological Development – Brazilian Ministry of Science and Technology (Process No. 30.8689/2016-0). The first author received a fellowship from the Coordination of Improvement of Higher Education Personnel (CAPES), Brazil.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery School of Medicine of Ribeirão Preto, University of São Paulo – USP, Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14049-900, Brazil

    Carlos Eduardo Fassicollo & Cláudia Maria de Felício

  2. Craniofacial Research Support Center, University of São Paulo – USP, Ribeirão Preto, SP, Brazil

    Bárbara Cristina Zanandréa Machado, Denny Marcos Garcia & Cláudia Maria de Felício

Authors
  1. Carlos Eduardo Fassicollo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bárbara Cristina Zanandréa Machado
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Denny Marcos Garcia
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cláudia Maria de Felício
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cláudia Maria de Felício.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Research Ethics Committee of the University Hospital, Faculty of Medicine of Ribeirão Preto (USP) (protocol number 1.680.129) and performed in accordance with the Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

All participants gave written informed consent to participate in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fassicollo, C.E., Machado, B.C.Z., Garcia, D.M. et al. Swallowing changes related to chronic temporomandibular disorders. Clin Oral Invest 23, 3287–3296 (2019). https://doi.org/10.1007/s00784-018-2760-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-018-2760-z

Keywords

Search

Navigation