Diagnosis and treatment of swallowing and speech disorders
Difficulty swallowing (dysphagia) and voice complaints have been observed and reported in patients with TMJ and whiplash associated disorders. Our specialists help to improve and restore speech and swallowing functions, such as:
- correct respiratory path and air consumption,
- rest position of the tongue, lips and mandible,
- biting and chewing,
- swallowing.
Barbara Jamróz,
MD, PhD
Joanna Chmielewska-Walczak,
MD, PhD
The above functions are crucial for:
- the formation of craniofacial structures,
- proper functioning of the temporomandibular joint (TMJ),
- the effectiveness of the orthodontic and prosthetic treatment,
- normal head position,
- the balance of the orofacial muscles.
The abnormalities of the above functions may cause: malocclusion, laryngophoniatric disorders, TMD, speech defects, and obstructive sleep apnea.
Dysphagia (difficulty swallowing)
Dysphagia is a medical term for difficulty in swallowing. People with dysphagia may be completely unable to swallow or may have trouble swallowing saliva, liquids or food.
Dysphagia can be classified into two types, based on the location of the swallowing impairment: oropharyngeal and esophageal. The first occurs if you have problems with moving the food or liquid to the back of your mouth, i.e. to the pharynx (or throat). The latter type (esophageal) occurs if there is difficulty with the passage of the solid or liquid matter through the esophagus. It may create a sensation of food sticking to the sternum, chest pain, a feeling that food or liquid got stuck in your throat.
Causes of dysphagia
Swallowing is a complex process and it happens in three stages: oral, pharyngeal, and esophageal. During the oral stage the tongue collects the food and liquid and makes it ready to swallow. The pharyngeal stage begins when the tongue pushes the food or liquid to the end of the mouth. Then, during the esophageal stage, the food or liquid enters the esophagus (the tube that carries the solid or liquid matter to the stomach). The first stage is voluntary, whereas the last two are involuntary (independent events).
Dysphagia has many possible causes and they depend on the location of the swallowing impairment:
Oropharyngeal causes:
- structural abnormalities,
- neuromuscular disorders.
Esophageal causes:
- esophageal stricture (abnormal tightening of the esophagus),
- esophageal motor disorders,
- esophageal disorders.
Symptoms of dysphagia
The symptoms of dysphagia (difficulty swallowing) are characteristic and easy to observe.
Patients with oropharyngeal dysphagia may have problems with transforming solid food into bolus that can be swallowed safely. In addition they may have problems with moving food to the end of the mouth. These problems might be accompanied by: coughing, choking, or bringing food back up through the nose. Other symptoms include: itchy throat, sneezing, lachrymation (the flow of tears), hacking cough while eating.
Esophageal dysphagia involves problems with the throat and esophagus and includes the following symptoms: a sensation of food getting stuck in the throat, pain in the chest or behind the breastbone (sternum), chest discomfort, vomiting, regurgitation (food coming back up), coughing up.
Treatment of dysphagia
Dysphagia may be a symptom of serious health conditions or it may be a direct result of some injuries. Therefore, the first step in the treatment of dysphagia is to identify the cause of the problem. If we cure the condition that caused dysphagia, then the swallowing function should improve. If dysphagia is caused by TMJ disorders and cervical spine dysfunctions, then it is vital to start physiotherapy as soon as possible.