Audiology - Communication Research E-ISSN: 2317-6431 [email protected] Academia Brasileira de Audiologia Brasil Yoshida, Fabio Shigueru; Mituuti, Cláudia Tiemi; Totta, Tatiane; Berretin-Felix, Giédre Influence of the masticatory function on the swallowing in the healthy elderly Audiology - Communication Research, vol. 20, núm. 2, abril-junio, 2015, pp. 161-166 Academia Brasileira de Audiologia São Paulo, Brasil Available in: http://www.redalyc.org/articulo.oa?id=391544062013 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative http://dx.doi.org/10.1590/S2317-64312015000200001433 Original Article Influence of the masticatory function on the swallowing in the healthy elderly A influência da função mastigatória na deglutição orofaríngea em idosos saudáveis Fabio Shigueru Yoshida1, Cláudia Tiemi Mituuti2, Tatiane Totta3, Giédre Berretin-Felix4 ABSTRACT RESUMO Purpose: Verify if the masticatory characteristics influence the findings Objetivo: Verificar se as características da mastigação influenciam os of the oropharyngeal swallowing in the elderly. Methods: Data from achados da deglutição orofaríngea em idosos. Métodos: Foram analisa- 47 healthy elderly subjects (29 female and 18 male) were analyzed and dos os dados de 47 idosos saudáveis - 29 mulheres e 18 homens - avalia- evaluated by the application of the mastication clinical protocol and the dos por meio da aplicação do protocolo clínico da mastigação e exame functional clinical examination of the oropharyngeal swallowing. The clínico funcional da deglutição orofaríngea. A avaliação da mastigação mastication evaluation was recorded in video; the mastication type, the foi registrada em vídeo, tendo sido analisado o tipo mastigatório, a for- bolus formation, and the mastication time were analyzed. During the mação do bolo alimentar e o tempo mastigatório. Durante a avaliação clinical evaluation of the swallowing, patients` performance was verified clínica da deglutição foi verificado o desempenho dos pacientes quando when food with different consistencies was tested. After this evaluation, testados alimentos de diferentes consistências, sendo que, após a reali- subjects were classified according to the dysphagia level. Data was zação da avaliação clínica, os indivíduos foram classificados quanto ao analyzed in a descriptive way using comparison and correlation statis- grau de disfunção da deglutição orofaríngea. Os dados foram analisados tical tests. Results: The average mastication time was 32.45 seconds. de modo descritivo e utilizando-se testes estatísticos de comparação e Most subjects presented bilateral mastication (62%), adequate bolus correlação. Resultados: A média do tempo mastigatório foi de 32,45 se- formation (75%) and about half (47%) had moderate oropharyngeal gundos. A maioria dos indivíduos apresentou tipo mastigatório bilateral dysphagia. According to the statistic analysis, there was no correlation (62%), formação do bolo alimentar adequada (75%) e cerca de metade among the level of swallowing dysfunction, the mastication type and the (47%), quadro de disfagia orofaríngea de grau moderado. De acordo com bolus formation. However, there was a statistically significant moderate a análise estatística, não houve correlação entre o grau da disfunção da positive correlation between the level of swallowing dysfunction and deglutição e o tipo mastigatório e a formação do bolo alimentar, porém, the mastication time. Conclusion: It was verified that a relationship houve correlação positiva moderada entre o grau da disfunção da deglu- between the mastication time and the dysphagia level exists. However, tição e o tempo de mastigação. Conclusão: Para os idosos deste estudo, no influence of mastication type and bolus formation on the swallowing o tempo mastigatório influenciou o grau de disfunção da deglutição, não of the elderly was found in this study. tendo sido encontrada relação para o tipo mastigatório e formação do bolo alimentar quanto aos achados da deglutição orofaríngea. Keywords: Deglutition; Mastication; Deglutition disorders; Aged; Aging Descritores: Deglutição; Mastigação; Transtornos de deglutição; Idoso; Envelhecimento A study carried out in the Speech-Language Pathology Course, Bauru School of Dentistry, Universidade de São Paulo – USP – Bauru (SP), Brazil. (1) Multiprofessional Residency Program, Hospital for the Rehabilitation of Craniofacial Anomalies, Universidade de São Paulo – USP – Bauru (SP), Brazil. (2) Postgraduate Program (Doctorate) in Applied Dental Sciences, Bauru School of Dentistry, Universidade de São Paulo – USP – Bauru (SP), Brazil. (3) Postgraduate Program (Doctorate) in Rehabilitation Sciences, Hospital for the Rehabilitation of Craniofacial Anomalies, Universidade de São Paulo – USP – Bauru (SP), Brazil. (4) Speech-Language Pathology Course, Bauru School of Dentistry, Universidade de São Paulo – USP – Bauru (SP), Brazil. Conflict of interests: No Authors’ contribution: FSY main researcher, elaboration of the schedule, literature survey, data analysis, writing of the article, article submission and procedures; CTM joint adviser, data collection and analysis, literature survey, correction of the article; TT researcher, research development, literature survey, data collection; GBF adviser, research development, correction of the article, approval of the article final version. Correspondence address: Giédre Berretin-Felix. Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, Universidade de São Paulo. Al. Dr. Octávio Pinheiro Brisola, 9/75, Vila Universitária, Bauru (SP), Brazil, CEP: 17012-901. E-mail: [email protected] Received on: 6/23/2014; Accepted on: 5/14/2015 Audiol Commun Res. 2015;20(2):161-6 161 Yoshida FS, Mituuti CT, Totta T, Berretin-Felix G INTRODUCTION and the head movement during swallowing, in adults, in the evaluation of solid chewing(9). On the other hand, through a In Brazil, the growth of the elderly population has arisen questionnaire about the eating process, another study verified the interest of professionals in the development of researches there was a significant influence of the difficulty to chew on on this theme. There has also been a concern for the training the swallowing difficulty and on the presence of cough and of human resources based on gerontological care(1). Thus, food residue(10). the understanding of physiological changes that result from Many studies show the impact of increasing age on mas- the aging process and the association between the different ticatory and swallowing functions. However, observing the stomatognathic functions and the systems have been the focus literature, it is possible to notice that there isn´t a study on of research both in the Speech-Language Pathology area and the influence of the masticatory conditions on the swallowing in the Dentistry area. dysfunction level in the elderly population. The physiological changes, arising from aging, in the swal- Thus, the purpose of this study was to verify whether the lowing provide a high risk of dysphagia(2). Videofluoroscopic characteristics of mastication in the elderly influence on the and radiographic studies in the elderly showed alterations in findings of the oropharyngeal swallowing in order to search for the oral phase such as control difficulties and bolus ingestion; new knowledge about this specific population, enabling future decrease in masticatory force and increase in the amount of actions aimed at the prevention, diagnosis and rehabilitation connective tissue in the tongue. They also showed dysfunc- of masticatory and swallowing disorders, resulting in a better tions in the pharyngeal phase, characterized by bolus retention quality of life. and pharyngeal constrictor paresis, reduction of the laryngeal elevation degree, delay in the onset of the hyolaryngeal METHODS excursion, as well as a modest increase in the pharyngeal transit in women and an increase in the time of pharyngeal Casuistry pressure wave in men. Furthermore, the studies mentioned the need of multiple swallows, a greater occurrence of cough, This study was part of the research project “Voice, Speech polyphasic laryngeal movements and a greater probability and Orofacial Functions of the Elderly Undergoing Different of inspiration after swallowing(3). Regarding the esophageal Oral Prosthetic Rehabilitation Strategies”, which was approved phase, an increase in its length occurs due to the extension of by the Research Ethics Committee of the Bauru School of the relaxation time of the upper esophageal sphincter (UES), Dentistry, Universidade de São Paulo (USP), under the process a decrease in the UES pressure with the preservation of the n. 111/2006. Everybody was informed on the use of the data for response to esophageal distension and abnormalities in the this research and signed the Informed Consent Form, agreeing pharyngoesophageal segment(4). Sometimes, the aging effects in taking part of the study. on the normal function are confused with the findings found A total of 47 elderly subjects were selected, 29 women and in specific diseases or degenerative conditions(5). 18 men, users of removable partial denture prosthesis (RPDP), Observations on the influence of age in the masticatory removable complete denture prosthesis in both dental arches adaptation in the edentulous elderly