Physilogy of

mastication and
deglutition

By: Dr Tanmay
Srivastava
MDS 1ST YEAR
Department of
Prosthodontics
 Definition
The cyclic movement produced by the elevation and
depression of the mandible as food is sheared and formed
into a bolus in preparation for swallowing.

Introduction
 Mastication of food is the initial stage in the process of
digestion

 Large pieces of food are reduced for swallowing

 The food is broken apart and the surface area increased

for the efficient action of digestive enzymes and to
facilitate solubilisation of food substances in saliva to
simulate taste receptors

 In mammals mastication is characterized by large vertical

movements of the lower jaw usually on one side of the
dentition

 in humans teeth are admirably designed for chewing.

 anterior teeth (incisors) for cutting and posterior (molars)

for grinding action.

 force can be exerted as great as

 55 pounds on incisors

 200 pounds on molars

 most of the chewing process is controlled by the nuclei in

the brain stem.

 Much of the chewing process is caused by a chewing

reflex, which may be explained as follows:

Chewing reflex
Presence of bolus causes reflex inhibition of muscles of
mastication causing lower jaw to drop.

The drop in turn initiates a stretch reflex of the jaw muscles

leading to rebound contraction.

This automatically raises the jaw to cause closure of the

teeth compressing the bolus against the linings of mouth.

This inhibits jaw muscles once again allowing the jaw to drop
and rebound another time ; this is repeated again and again.

MASTICATORY MOVEMENTS
• Movements
• chewing stroke
• tooth contact
• forces of mastication
• role of soft tissue
• role of saliva
• Muscle activity
Chewing Stroke
 Rhythmic

 Opening and closing of the jaw is in cyclic movement.

 Controlled by CPG (central pattern generator)

located in brain stem.

 Chewing stroke is divided into

 Opening movement

 Closing movement

a) crushing phase

b) grinding phase

Opening phase
• During opening phase there is initial rotation of the
mandible for the first 20-27mm of interincisal distance.
• Thereafter there is translatory or bodily shift of the
mandible anteriorly and in downward direction.

Closing Phase

1) Crushing phase

• starts when the mandible starts closing.

• At this point buccal cusp of maxillary are under the

buccal cusp of mandibular teeth.

• As the mandible closes the bolus of food is trapped.

2) Grinding phase

• bolus gets trapped between the cusps and is grinded.

• Bolus is trapped by the buccinator bucally and by the

tongue lingually.

TOOTH CONTACT

 In final stages of mastication, just before swallowing

tooth contact occurs during every stroke.

 Two types of contact are there :

Gliding contact

Centric contact

 Average length of time for tooth contact during

mastication is 194 msec.

 Occlusal condition influences the entire chewing stroke .

 Tall cusps and deep fossae promote a predominantly

vertical chewing stroke .

 Flattened or worn teeth encourage a broader chewing

stroke area.

ROLE OF SOFT TISSUE

 LIPS:

◦ Guide

◦ Control intake

◦ Seal off the oral cavity

 ◦ TONGUE:

◦ Maneuvering the food within the oral cavity

◦ Initiates the breaking of food

◦ Pushes food to occlusal surfaces of teeth

During opening phase repositions the crushed food

◦ Divides food into portions that require more

chewing and portions that are to be swallowed

◦ After eating the tongue sweeps the teeth to remove

any food residue that has been trapped in the oral
cavity

MUSCLE ACTIVITY

 Contraction of muscles control the jaw during

mastication.

 The pattern of activity is determined by a number of

factors such as :

◦ Species

◦ Type of food,

◦ Degree of food breakdown,

◦ And individual factors.

 The general pattern of muscle activity during chewing

cycle.

◦ Closing muscles are inactive during jaw opening.

◦ Activity of the jaw closing muscles increases slowly

as the teeth begin to interdigitate or as soon as
food is encountered between the teeth.

◦ The jaw closing muscles are more active then the

jaw opening muscles.

Jaw opening muscles

 Lateral pterygoid

 Suprahyoid muscles

 jaw closing muscles

 Masseter

 Temporalis

 Medial pterygoid

Lateral pterygoid

 Origin

 UPPER head arise from infratemporal surface and

the crest of greater wing of sphenoid bone.

 LOWER head arise from lateral surface of lateral

pterygoid plate.

 Insertion

 on the front of the neck of the mandible and into the

articular capsule

Medial pterygoid

 Origin

 Attached to medial surface of lateral pterygoid plate.

 Its fibers pass downwards laterally and backwards

 Insertion

 to the postero-inferior part of the medial surfaces of the

ramus and the angle of the mandible

Masseter

 Origin

 From the inner and outer aspect of the zygomatic arch.

 Insertion

 Into the lower part of the lateral surface of the ramus of

the mandible.

Temporalis

 Origin

 Arises from whole of temporal fossae.

 It passes through the gap between the zygomatic arch
and the side of the skull

 Insertion

 to medial surface,apex,anterior and posterior border of

coronoid process

BRAIN STEM STRUCTURES THAT CONTROL MASTICATION

 Movements in mastication are integrated activity of a

number of muscles, controlled by

 Trigeminal

 Hypoglossal

 Facial

 Vagus

 Glossopharyngeal

 Coordination of activity in these motor nuclei relies

on sensory input from the oral cavity.

 It also depends upon the nature and amount of food

in the oral cavity.

CONTROL OF MASTICATION

 Basic oscillatory pattern of masticatory movements,

originate in a neural pattern generator located in the
brain stem.

 Up and down movement of the mandible during

mastication originates - within the brainstem.

 These pattern generators also influence other responses

like breathing and swallowing.

 Orofacial reflex is the jaw closing or jaw jerk reflex

which involves the afferent fibers from the
mesencephalic and trigeminal nucleus.

INFLUENCE OF AFFERENT INPUT

 Type , texture and consistency of food in the mouth

result in different chewing patterns
  Once chewing begins rhythmic firing of action potential
occurs with various phases of the chewing cycle.

 This firing of action potentials slowly decreases as the

food gets churned in the oral cavity.

 Sensory input is perceived by the mechanoreceptors

located in the periodontal ligament.

Deglutition
 Consists of a reflex sequence of muscle contraction that
propels ingested materials and pooled saliva from the
mouth to the stomach. (Okeson)

Introduction

 The process occurs smoothly and effortlessly requiring the

coordination of a large number of motor neurons typical of a
complex reflex mechanism.

 The average tooth contact during swallowing lasts about

683msec.

 It is more then three times longer than the duration of

mastication.

SWALLOWING MOVEMENTS

Swallowing is a continuous act but is divided into 4 stages:

1) Preparatory phase

2) Oral phase

3) Pharyngeal phase

4) Esophageal phase

PREPARATORY PHASE

Bolus is prepared

Positioned on the dorsum of the tongue

The tongue tip pressed against the palatal aspect of the

maxillary incisors or against the anterior hard palate
 ↓

Bolus is located in depression of the tongue

Tongue raised laterally against the buccal teeth and palatal

mucosa

Posteriorly the pharyngeal part of the tongue arches up to

meet the soft palate

ORAL PHASE

 Chewed food goes from mouth to pharynx

 voluntary

 collection of chewed food into a bolus by tongue

 bolus pressed against palate

 lips sealed, teeth brought together

 reflex contraction of tongue pushes food backwards

down into pharynx

PHARYNGEAL PHASE

 Food goes from pharynx to esophagus

 pharyngeal muscles contract & push food by peristalsis

 soft palate lifts & seals off nasal passages

 epiglottis blocks entrance to trachea

 pharyngeal muscle activity opens communication with

ears (Eustachian tubes)

ESOPHAGEAL PHASE

 Food travels down esophagus to stomach

 Consists of peristaltic contractions

 Begins as the bolus passes the upper esophageal sphincter

 Contractions begin at cervical level of the esophagus and
take about 8 seconds to reach the lower esophageal sphincter
which opens to admit the entry of the bolus into the stomach

PRESSURE CHANGES

 Food is moved by a positive-pressure wave.

 Developed by the piston type action of the tongue and

peristaltic muscle contractions

 At the start of a swallowing sequence the pressure in the

mouth and pharynx is close to atmospheric pressure but at upper
gastro esophageal sphincter it is 5-10 mm Hg pressure.

 Similarly at the lower gastro esophageal sphincter it is 30

mm Hg pressure.

 This pressure difference propels the food in the stomach.

CONTROL OF SWALLOWING

 Preparatory and oral phases are under voluntary control

 The pharyngeal and esophageal phases are involuntary

 Organization of the swallowing motor sequence depends on

the activity of brain stem neurons that belong to a functionally
defined swallowing center

Types of Swallowing

 Swallowing can be classified according to how the mandible

is braced:

 Somatic (Adult) swallow

uses the teeth (MI) to stabilize the mandible

 Visceral (Infantile) swallow

mandible is stabilized by tongue pushing forwards

between the arches and against the anterior part of the palate

INFANTILE SWALLOW

 A type of swallowing pattern seen in infants.

 In it tongue is being thrusted between their gum pads to

obtain the seal during swallowing.
 This type of swallowing changes to mature swallowing when
central incisors erupt.

 When this type of swallowing is retained even after teething,

then it is referred to as “retained infantile swallow”

 It is the major cause of malocclusion.

Suckling reflex

 Fetus is capable of suckling and swallowing amniotic fluid in

utero indicating development of motor activities before birth.

 Fetal swallowing takes in episodes 1 to 9 mins at around 20

times/day

 Volume of amniotic fluid swallowed is similar to volume of

milk intake in the neonatal period.

Rooting reflex

 Response of infant to tactile stimulation of the cheek or lips;

causes infant to turn toward the stimulus and open his mouth.

VOMITING

 Nausea and vomiting are biological protective

mechanisms.

 Serve an important defense mechanism.

 Vomiting is the means by which the upper G.I. tract empties

its content when any part of the upper tract becomes excessively
irritated, over distended, or over excitable.

 Occurs with anti peristaltic movement in the the intestine.

UPPER AIRWAY PROTECTIVE REFLEXES:

 Reflexes such as sneezing, coughing, gagging, and choking

serve as protective mechanism.

 Come into action to sweep away the unwanted foreign

particle in the respiratory tract.

 Happens in vigorous bursts combined with help of other

abdominal muscles.

Advances in diagnosis

 Barium swallow
 A fluroscopic, non invasive procedure where the contrast
medium is swallowed by the patient and the die is further
evaluated by radiographs.

 helps to diagnose perforations, achlasia etc.

Importance of swallowing in prosthodontics

 As the process of swallowing completes, it brings the

mandible to its most retruded position and therefore helpful in
recording the centric relation in edentulous patients.

 Immediately after swallowing mandible comes under rest

position, therefore it is important in recording “vertical jaw
relation in rest position”.

 Helpful in maintaining the freeway space during denture

fabrication.

Disorders associated with mastication and swallowing

 TMJ disorders

 Achlasia

 Singultus (hiccups)

 Gastroesophageal reflux disease

 Parotitis

 Pericoronitis

References

 Essentials of Oral physiology-Robert M.Bradely

 Management of temporomandibular disorders and occlusion-

Jeffery P.Okeson (5th edition)

 Textbook of medical physiology- Guyton (10th edition)