Factors related to swallowing oral phase

Introduction: Efficacy of swallowing oral phase is often impaired in dysphagic patients and may impact on pharyngeal stage, meal consumption, nutritional status and quality of life. However, factors related to oral phase of swallowing have been little studied. Matherial & Methods: Thirty-nine adult patients with dysphagia of different etiology were enrolled. FEES and the Test of Mastication and Swallowing Solids (TOMASS) were performed. The Penetration-Aspiration scale, the Yale Pharyngeal Residue Severity Rating Scale and the Dysphagia Outcome and Severity Scale (DOSS) were used to assess the FEES. Tongue strength was assessed using the Iowa Oral Performance Instrument. Patients completed the Eating Assessment Tool-10. The time the patients needed to consume a meal, the Functional Oral Intake Scale score and the body mass index (BMI) were recorded. Correlations between the TOMASS and other variables were studied using Spearman’s correlation coefficient. TOMASS scores were compared between patients with complete denture and those with partial edentulism through Mann-Whitney test. Results: The number of discrete bites correlated only with the BMI (r=-0.38; p=0.01). Statistically significant correlations were found between the number of masticatory cycles and tongue strength (r=-0.47; p<0.01), pharyngeal residue (r=0.42; p<0.01), DOSS (r=-0.38; p=0.01). The total time of the TOMASS correlated with tongue strength (r=-0.45; p<0.01), pharyngeal residue (r=0.48; p<0.01), time needed to consume a meal (r=0.41; p=0.01) and DOSS (r=-0.36; p=0.02). A significant difference was found between patients with complete denture and patients with partial edentulism for the number of masticatory cycles (p=0.02) and total time (p=0.03). Conclusions: Swallowing oral phase seems to correlate with tongue strength, denture, pharyngeal residue, overall dysphagia severity, duration of meals and BMI. Further studies involving a larger sample size are necessary to confirm present data.