Functional Development

Normal development of the oro-facial region is to a large extent dependent upon normal function. The functions of the oro-facial region include: - Mastication -Swallowing -Respiration -Speech -Facial expression -Maintenance of mandibular position

MASTICATION
Mastication is a complex activity aimed at breaking down and insalivation of food,preparatory to swallowing. In infants,food is takenin first by suckling. This is unlearred or automatic reflex in new born. There is a rhythmic caving in of the cheeks,bobbling of the hyoid bone,snake like movement of the tongue,anterior mandibular thrust,sphincter like activity of lips and an actual nodding of entire head. The infant quickly learns to use his lips primarily to keep the food from bieng forced out of the mouth during peristaltic like action of the tongue . The bolus of the food is mixed with saliva by the action of the tongue and forced between between gum pads or occlusal surface of the teeth.

The mastication of food in an adult occurs in the following six phase as outlined by Murphy:
Preparatory hase Food contact Crushing phase Tooth contact Guiding phase Centric occlusion

Pre-paratory phase In this phase food is ingested and positioned by tongue within the oral cavity. Mandible is moved towards the chewing side. This phase characterised by a momentary hesitation in movement. He interpreted that there is a pause triggered by a sensory receptors concerning the apparent viscosity of food and probable transarticularpressure incident to chewing. it starts with high velocity then slows down as the food is crushed and packed. Food is crushed by the equal activity on both sides of dental arch. according to murphy all reflex adjustment of the musculature for the tooth contact are completed in crushing phase before actual contact is made. During this phase teeth come in contact and signifies end of crushing phase. This coincides with transgression of mandibular molars across there maxillary counterparts.and therefore highly constant from cycle to cycle Messermen termed this phase as terminal functional orbit. Ahlegren noted that during this phase the bilateral muscular discharge becomes unequal .asynchronous, indicating that person is chewing unilaterally. Movement of the teeth comes to a definite and distinct stop.

Food contact-

Crushing phase

Tooth contact

Grinding phase

Centric occlusion

DEGLUTITION
It is important function carried out by stomatognathic system. The swallowing pattern in infants is different from that seen in adults Thus two main forms of swallowing is recognised: 1. Infantile swallow 2. Mature swallow

Moyers lists following characteristic of the infantile swallow as follows:

1. The jaws are apart,with tongue between the gumpads. 2. The mandible is stabilised primarily by contraction of the muscles of the VIIth cranial nerve and the interposed tongue. 3. The swallow is guided and to a great extent controlled by sensory interchange between the lips and the tongue.

 Gum pads are not usually in contact during the act of swallowing. Milk is directed continuously to pharynx by an automatic peristaltic movement of the tongue and mylohyoid muscle. During this process regular breathing continues. The milk passes between the faucial pillars and the lateral channels of the pharynx . As the infant begins to eat solid food,there is a distinct change in the swallowing pattern. The tongue is contained with in the dental arches and the mandible is no longer protuded This heralds the onset of the mature swallow.

Mature swallow
Mature swallowing is seen after a year of life. The infantile swallow gradually disappears with the eruption of buccal teeth in the primary dentition Usually ,by 18 months of age,the mature swallow characteristcs listed by moyers are readily available: 1. The teeth are together. 2. The mandible is stabilized by contractions of the mandibular elevators ,which are primarily Vth cranial nerve muscles. 3. The tongue tip is held against the palate ,above and behind the incisors. 4. There are minimal contractions of the lips during the mature swallow.

Fletcher divides the deglutitional cycle into four phases,these are:

1. 2. 3. 4. The Preparatory swallow The oral phase The pharyngeal phase The oesophgeal phase

The pharyngeal swallow: It starts as soon as liquids are taken in, or after the bolus has been masticated the liquid or bolus is thenplaced in a swallow-preparatory position on the dorsum of the tongue. For this teeth are parted a little and the cheek muscle contract. Teeth are then brought in occlusion to stabilize the jaws and to close the oral cavity properly and isolate it from labial vestibule The oral cavity is sealed by lip and tongue. The Oral phase: The softpalate is raised to seal off the nasal cavity and the posterior part of the tongue drops down. These movements create a smooth path for the bolus as it is pushed into the pharynx by the peristaltic action of the tongue. The pharyngeal phase: This phase begins as soon as the food passes through the faucial pillars.

The pharyngeal phase: This phase begins as soon as the food passes through the faucial pillars. As the food reaches the pharyngeal wall,there is a reflex upward movement of the entire pharyngeal complex. When the pharyngeal walls touch the soft palate a peristaltic movement sets up to move the food down. The oesophageal phase: This commences as soon as the food passes the cricopharyngeal sphincter. Peristaltic activity of the oesophageal walls occur to pass the food into the stomach. the tongue and palate return to their original position to start the next cycle.

RESPIRATION
respiration is an inherent reflex activity. The newborn infant is basically a nasal breather. Tongue in proximity to the palate ,obturating the passage way. Both pharynx and the larynx are active during respiration. Normal oro-facial development is to a large extent dependent upon presence of normal respiration. In patients having partial or total nasal obstruction ,nasal breathing may not be possible.these patients breath through mouth. The alteration in breathing pattern brings about a lowered mandibular and tongue position Thus orofacial muscular balance is lost leading to abnormal development of dental arches.

SPEECH
Speech is largely a learned activity which is largely dependent on the maturation of organism.