Question

Throat Disorders

What is swallowing re-training and when is it used?

A Answers (2)

  • ALinda Lee, MD, Gastroenterology, answered on behalf of Johns Hopkins Medicine

    Sometimes there's no way to remove or reduce whatever is making it difficult to swallow. In that case an expert, called a speech-language pathologist, designs a program to adjust to a specific person's obstacles.

    Among the options this expert may choose:

    • Cutting food into smaller pieces, to make them easier to swallow.
    • Finding ways to reposition the head and/or neck while swallowing
    • Exercises
  • AShari Green, Dental Hygiene, answered

    Dr. Lee has already addressed one aspect of swallow retraining. However, I would love to elaborate more on this topic. One form of swallowing retraining, specifically involving what is known as tongue thrust, is gaining in awareness and popularity. This retraining involves the orofacial musculature; tongue, lip, and jaws, i.e., the oral phase of swallowing specifically.

    Basically, the tongue should rest in the hard palate most of the day and night beyond the age of 4-6. Swallowing (oral phase) should also encompass vertically based patterns. When the tongue rests low, or the swallow is based more horizontally in nature, this is "tongue thrust". Most individuals with tongue thrust rest the tongue low, against the teeth, or push their tongue forward, sideways, or downwards inappropriately during the oral phase of swallowing. Individuals with tongue thrust may complain of bite changes or open gaps where the tongue inappropriately rests, or one may visibly see the tongue protruding at rest, appearing forward and low in nature. In fact, many referrals for this issue originate from dental professionals who have observed changes in their patient's bite!

    These patterns can be retrained in the right individual. Tongue thrust concerns are commonly addressed by Certified Orofacial Myologists. This is accomplished via a series of exercises that are designed to re-establish proper vertically based oral rest postures, and retrain the tongue to lift vertically into the hard palate during the oral swallow phase. With correct guidance, the vast majority of clients with excellent learning skills, proper nasal competence, and a desire to improve can successfully achieve notable improvement in these initiatives.

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