Relação entre a percepção da posição de língua pelo indivíduo e medidas de força da língua nos dentes / Relationship between perception of tongue position and measures of tongue force on the teeth

RESUMO Objetivo Verificar se existe diferença nos valores de pressão da língua nos dentes entre participantes que percebem a posição de língua adequada e alterada, tanto em repouso como em deglutição. Métodos Avaliou-se a força da língua sobre o dente de 28 participantes hígidos com idades de 19 a 31 anos. Para tal, um sensor resistivo Flexiforce® foi fixado na face palatina do dente incisivo central superior direito e conectado a um circuito amplificador, a uma placa de aquisição de dados e a um computador. Foram realizadas medições em posição habitual e deglutição de saliva. Além disso, o participante foi questionado sobre qual era sua posição habitual de língua e onde o ápice da língua tocava durante a deglutição. Utilizou-se o teste Mann Whitney ao nível de 5% para análise estatística. Resultados Durante a posição habitual, a força da língua no dente foi de 0,00 N, tanto para os participantes que relataram toque da língua nos dentes como para os sem toque. Na deglutição dirigida, a força foi de 0,34 N para o grupo com língua tocando os dentes nesta tarefa e 0,08 N para o grupo sem toque, sendo a diferença significante. Conclusão Não houve diferença nos valores de força de língua sobre os dentes de participantes que apresentavam posição habitual da língua tocando os dentes e os que não apresentavam. Porém, na deglutição dirigida, participantes que relataram anteriorização de língua apresentaram valores maiores de força da língua nos dentes do que aqueles com deglutição sem toque nos dentes superiores.

ABSTRACT Purpose To verify whether there are differences of tongue force on the teeth at rest and during swallowing between individuals who report appropriate tongue position and those who report tongue thrust. Methods Tongue forces on the teeth were evaluated in 28 participants aged 19 to 31 years. To this end, a Flexiforce® resistive sensor was fixed to the palatal surface of the maxillary right central incisor (tooth 8) and was connected to an amplifier circuit, a data acquisition board, and a computer. Measurements were taken at rest and during saliva swallowing. Participants were asked about their habitual tongue position and where the apex of tongue touched when they swallowed. The Mann Whitney test was used for statistical analysis at 5% significance level. Results At habitual position, tongue force on the teeth was 0.00 N both for participants that reported tongue touch and for those who did not. At directed swallowing, tongue force was 0.34 N for the group of individuals whose tongues touch the teeth and 0.08 N for the group of individuals whose tongues do not touch the teeth. This difference was significant. Conclusion No significant difference was found between the tongue forces of participants of both groups at habitual position. However, participants with tongue thrust during directed swallowing presented greater force than those whose tongues do not touch the teeth during this task.

Relationship between perception of tongue position and measures of tongue force on the teeth. / Relação entre a percepção da posição de língua pelo indivíduo e medidas de força da língua nos dentes.

PURPOSE: To verify whether there are differences of tongue force on the teeth at rest and during swallowing between individuals who report appropriate tongue position and those who report tongue thrust. METHODS: Tongue forces on the teeth were evaluated in 28 participants aged 19 to 31 years. To this end, a Flexiforce® resistive sensor was fixed to the palatal surface of the maxillary right central incisor (tooth 8) and was connected to an amplifier circuit, a data acquisition board, and a computer. Measurements were taken at rest and during saliva swallowing. Participants were asked about their habitual tongue position and where the apex of tongue touched when they swallowed. The Mann Whitney test was used for statistical analysis at 5% significance level. RESULTS: At habitual position, tongue force on the teeth was 0.00 N both for participants that reported tongue touch and for those who did not. At directed swallowing, tongue force was 0.34 N for the group of individuals whose tongues touch the teeth and 0.08 N for the group of individuals whose tongues do not touch the teeth. This difference was significant. CONCLUSION: No significant difference was found between the tongue forces of participants of both groups at habitual position. However, participants with tongue thrust during directed swallowing presented greater force than those whose tongues do not touch the teeth during this task.

Evaluation of the force applied by the tongue and lip on the maxillary central incisor tooth.

PURPOSE: To describe the development and testing of a system that measures forces exerted by the tongue and upper lip on a tooth during rest and during swallowing. METHODS: Twenty-eight subjects, aged 19-31 years (mean: 23.2 years) were submitted to measurement of forces exerted by the upper lip and tongue on the maxillary right central incisor tooth. Flexiforce resistive sensors were fixed on the labial and lingual surfaces of the tooth. They were connected to an amplifier circuit and a data acquisition board for processing and transmitting information to a computer. RESULTS: At rest, the tongue force on the tooth was 0.00±0.00 N and the lip force on tooth was 0.02±0.02 N. The difference between them was significant. During swallowing, the values were 0.31±0.38 N and 0.15±0.14 N, for the tongue and lip, respectively. This difference was not significant. CONCLUSION: At rest, the lip exerts a larger force than the tongue on the maxillary right central incisor tooth. During swallowing, there was no difference between lip and tongue force on the tooth.

Evaluation of the force applied by the tongue and lip on the maxillary central incisor tooth

PURPOSE: To describe the development and testing of a system that measures forces exerted by the tongue and upper lip on a tooth during rest and during swallowing. METHODS: Twenty-eight subjects, aged 19-31 years (mean: 23.2 years) were submitted to measurement of forces exerted by the upper lip and tongue on the maxillary right central incisor tooth. Flexiforce resistive sensors were fixed on the labial and lingual surfaces of the tooth. They were connected to an amplifier circuit and a data acquisition board for processing and transmitting information to a computer. RESULTS: At rest, the tongue force on the tooth was 0.00±0.00 N and the lip force on tooth was 0.02±0.02 N. The difference between them was significant. During swallowing, the values were 0.31±0.38 N and 0.15±0.14 N, for the tongue and lip, respectively. This difference was not significant. CONCLUSION: At rest, the lip exerts a larger force than the tongue on the maxillary right central incisor tooth. During swallowing, there was no difference between lip and tongue force on the tooth. .

The impact of speech disorders quality of life: a questionnaire proposal / Impacto dos disturbios da fala na qualidade de vida: proposta de questionario

PURPOSE: To develop a questionnaire to analyze the impact of speech disorders on quality of life and verify its reliability. METHODS: A literature review on instruments that assess the quality-of-life was performed, particularly those concerning communication disorders. The questionnaire was designed with 18 closed questions: one related to speech impairments, another about quality-of-life, and 16 questions covering the physical, emotional, and social domains. The questionnaire was applied to a population of 24 individuals of both sexes, aged between 12 and 50 years; 12 patients (case group) had phonetic speech disorders, and 12 (control group) had no impairment in oral communication. They were paired according to age and sex. To analyze the reliability of the instrument, the internal consistency of the items was assessed through Cronbach's Alpha coefficient. RESULTS: The internal consistency of the 16 questions concerning the domains was á=0.93; for the physical domain, á=0.71; for the emotional domain, á=0.77; and for the social domain, á=0.85. CONCLUSION: The questionnaire showed good reliability in identifying the impact of speech disorders on the individuals' quality of life. .

OBJETIVO: Elaborar um questionário para analisar o impacto dos distúrbios da fala na qualidade de vida e verificar a sua confiabilidade. MÉTODOS: Foi realizada revisão de literatura sobre instrumentos que avaliavam a qualidade de vida, sobretudo nas alterações de comunicação. Foi elaborado questionário com 18 questões fechadas, sendo uma relativa ao comprometimento de fala, outra à qualidade de vida e as demais 16 questões abrangeram os domínios físico, emocional e social. O questionário foi aplicado em 24 sujeitos de ambos os gêneros com idades entre 12 e 50 anos, sendo 12 indivíduos (grupo caso) com distúrbio de fala de origem fonética e 12 (grupo controle) sem comprometimento de comunicação oral, pareados por idade e gênero. Para análise da confiabilidade do questionário, foi analisada a consistência interna dos itens que o compõem por meio do coeficiente Alfa de Cronbach. RESULTADOS: A consistência interna das 16 questões referentes aos domínios foi de á=0,93; para o domínio físico á=0,71, para o emocional á=0,77 e para o social á=0,85. CONCLUSÃO: O questionário apresentou boa confiabilidade para a identificação do impacto do distúrbio da fala na qualidade de vida dos indivíduos. .

Habilidades cognitivo-linguísticas e sua relação com características respiratórias / Cognitive-linguistic skills and their relationship with respiratory characteristics

OBJETIVO: relacionar características respiratórias com o desempenho em habilidades cognitivo-linguísticas de crianças de uma escola pública da grande Belo Horizonte. MÉTODO: estudo transversal, observacional e descritivo. Das 180 crianças recrutadas 131 atenderam aos critérios de inclusão e exclusão. Foram avaliadas 66 crianças da 4ª série e 65 da 3ª série do ensino fundamental, de ambos os gêneros, com idades entre nove e dez anos. Foi utilizado um questionário para investigação das características respiratórias e um protocolo previamente publicado e adaptado a população brasileira para avaliação das habilidades cognitivo-linguísticas. As informações coletadas foram analisadas por meio dos testes de Mann-Whitney e Kruskal Wallis, ao nível de significância de 1%. RESULTADOS: não foi observado valor de p<0,01 na comparação entre as características respiratórias e as pontuações obtidas por cada série no teste das habilidades cognitivo-linguísticas. Observou-se que 59,1% dos alunos apresentaram escores no questionário de pesquisa das características respiratórias entre zero e quatro pontos, indicando pouco comprometimento respiratório. CONCLUSÃO: não foi encontrada relação significante entre o desempenho de habilidades cognitivo-linguísticas e a presença de características respiratórias em escolares de uma escola pública de Belo Horizonte, sendo que as crianças que apresentaram sinais e sintomas de alterações respiratórias não obtiveram desempenho abaixo daquelas sem estas alterações nas habilidades avaliadas.

PURPOSE: to relate respiratory characteristics with cognitive-linguistic skills performance of children from a public school of the region of Belo Horizonte. METHOD: a cross-sectional, observational and descriptive study. From the 180 enrolled children, 131 met the inclusion and exclusion criteria. We evaluated 66 children in the 4th grade and 65 children in the 3rd grade of the elementary education, from both genders, with ages going between nine and ten year old. We utilized a questionnaire for assessment of respiratory characteristics and a previously published protocol and adapted to the Brazilian population in order to assess the cognitive-linguistic skills. Data were analyzed using the Mann-Whitney and Kruskal Wallis test at a significance level of 1%. RESULTS: there was not observed a p-value <0.01 in comparison between the respiratory characteristics and the cognitive-linguistic skills’ score obtained by each series. We observed that 59.1% of students had scores in a questionnaire for assessment of respiratory characteristics between zero and four points, indicating some impairment in respiratory variables studied. We obtained a significant p value for comparisons between the performance in cognitive-linguistic skills and the presence of respiratory disorders in the studied series. CONCLUSION: no significant relationship was found between the performance of cognitive-linguistic skills and the presence of respiratory characteristics in students from the same public school of Belo Horizonte city, and the children who showed respiratory changes didn´t have performance below those without these changes in the assessed skills.

The impact of speech disorders quality of life: a questionnaire proposal.

PURPOSE: To develop a questionnaire to analyze the impact of speech disorders on quality of life and verify its reliability. METHODS: A literature review on instruments that assess the quality-of-life was performed, particularly those concerning communication disorders. The questionnaire was designed with 18 closed questions: one related to speech impairments, another about quality-of-life, and 16 questions covering the physical, emotional, and social domains. The questionnaire was applied to a population of 24 individuals of both sexes, aged between 12 and 50 years; 12 patients (case group) had phonetic speech disorders, and 12 (control group) had no impairment in oral communication. They were paired according to age and sex. To analyze the reliability of the instrument, the internal consistency of the items was assessed through Cronbach's Alpha coefficient. RESULTS: The internal consistency of the 16 questions concerning the domains was α=0.93; for the physical domain, α=0.71; for the emotional domain, α=0.77; and for the social domain, α=0.85. CONCLUSION: The questionnaire showed good reliability in identifying the impact of speech disorders on the individuals' quality of life.

Mouth breathing evaluation: use of Glatzel mirror and peak nasal inspiratory flow.

PURPOSE: To compare the use of the Glatzel mirror and peak nasal inspiratory flow in the evaluation of mouth-breathing participants and to analyze the correlation between these instruments. METHODS: Sixty-four children were evaluated--32 mouth breathers and 32 nasal breathers; the children were aged 4 to 12 years. The mouth breathers were subdivided according to the cause of obstruction by a multidisciplinary team. The Glatzel mirror and peak nasal inspiratory flow were used in both groups to evaluate patency and nasal airflow. Data were then subjected for statistical analysis. RESULTS: The Glatzel mirror allowed us to differentiate the breathing mode considering gender, age, weight, height, and body mass index, but it did not help in identifying the cause of mouth breathing. The peak nasal inspiratory flow did not allow differentiation of the breathing mode and identification of the cause of mouth breathing. In our sample, there was no correlation between the instruments used. CONCLUSION: The Glatzel mirror was reliable in identifying participants with and without nasal obstruction, although it was not possible to differentiate subgroups of mouth breathers using this instrument. The peak nasal inspiratory flow showed differences only between nasal breathers and surgical mouth breathers. Low correlation was found between these two instruments.

Avaliação do respirador oral: uso do espelho de Glatzel e do peak nasal inspiratory flow / Mouth breathing evaluation: use of Glatzel mirror and peak nasal inspiratory flow

OBJETIVO: Comparar o uso do espelho de Glatzel e do peak nasal inspiratory flow na avaliação de indivíduos respiradores orais, bem como analisar a correlação dos dois instrumentos. MÉTODOS: Foram avaliadas 64 crianças, sendo 32 respiradoras orais e 32 respiradoras nasais, na faixa etária de 4 a 12 anos. Os respiradores orais, diagnosticados de acordo com equipe multiprofissional, foram subdivididos de acordo com a causa da obstrução. Foram utilizados o espelho de Glatzel e o peak nasal inspiratory flow nos dois grupos para avaliação da permeabilidade e fluxo aéreo nasal. Os dados foram submetidos à análise estatística. RESULTADOS: O espelho de Glatzel diferenciou o modo respiratório considerando-se os estratos gênero, faixa etária, peso, altura e índice de massa corporal da amostra. Entretanto, não foi capaz de dar indícios sobre a causa da respiração oral. Com o uso do peak nasal inspiratory flow, não foi possível diferenciar o modo respiratório e tampouco a causa da respiração oral. Na amostra pesquisada, não houve correlação entre os instrumentos utilizados. CONCLUSÃO: O espelho de Glatzel mostrou ser capaz de identificar indivíduos com e sem obstrução nasal, embora não tenha sido possível diferenciar os subgrupos de respiradores orais entre si com o uso do instrumento. Já o peak nasal inspiratory flow mostrou-se capaz de diferenciar apenas respiradores nasais de respiradores orais cirúrgicos. Foi encontrada baixa correlação entre os dois instrumentos.

PURPOSE: To compare the use of the Glatzel mirror and peak nasal inspiratory flow in the evaluation of mouth-breathing participants and to analyze the correlation between these instruments. METHODS: Sixty-four children were evaluated - 32 mouth breathers and 32 nasal breathers; the children were aged 4 to 12 years. The mouth breathers were subdivided according to the cause of obstruction by a multidisciplinary team. The Glatzel mirror and peak nasal inspiratory flow were used in both groups to evaluate patency and nasal airflow. Data were then subjected for statistical analysis. RESULTS: The Glatzel mirror allowed us to differentiate the breathing mode considering gender, age, weight, height, and body mass index, but it did not help in identifying the cause of mouth breathing. The peak nasal inspiratory flow did not allow differentiation of the breathing mode and identification of the cause of mouth breathing. In our sample, there was no correlation between the instruments used. CONCLUSION: The Glatzel mirror was reliable in identifying participants with and without nasal obstruction, although it was not possible to differentiate subgroups of mouth breathers using this instrument. The peak nasal inspiratory flow showed differences only between nasal breathers and surgical mouth breathers. Low correlation was found between these two instruments.

Quantitative evaluation of tongue protrusion force.

The tongue plays an important role in the functions of speech, mastication, swallowing, and breathing. The tongue helps in the maintenance of proper dental alignment and arch stability. Adequate strength is essential for the tongue to perform these tasks. Recently the Biomechanical Engineering Group from Universidade Federal de Minas Gerais, Brazil, developed a device to improve tongue strength evaluation. The purpose of this study is to describe and compare the main results obtained in tongue protrusion force measurements in different age groups using this new device. Fifteen healthy subjects were given a qualitative evaluation and determined to have normal tongue strength. They were separated by age in three groups: children, adults and elderly. They were then given a quantitative evaluation. Maximum and average forces were analyzed. The time taken to reach maximum force was also assessed. Higher values of maximum and average tongue force were obtained in the adult group, followed by the elderly group and the group of children. Older subjects had greater tongue force when compared to children. However, there were statistically significant differences in the average force and in the maximum force only between children and adults. Time taken to reach maximal isometric force was longer in the elderly group and shorter in the group of children than in the group of adults although no statistically significant difference was found between groups.

Avaliação objetiva das forças axiais produzidas pela língua de crianças respiradoras orais / Objective evaluation of axial forces produced by the tongue of oral breathing children

OBJETIVO: Quantificar e comparar as forças produzidas pela língua de crianças respiradoras orais pré-cirúrgicas, respiradoras orais em tratamento fonoaudiológico e respiradoras nasais, além de comparar os achados da avaliação objetiva com os dados da avaliação clínica. MÉTODOS: Estudo transversal com 15 crianças, de ambos os gêneros, com idades entre oito e 12 anos, sendo cinco respiradoras orais pré-cirúrgicas (Grupo 1), cinco respiradoras orais em tratamento fonoaudiológico (Grupo 2) e cinco respiradoras nasais (Grupo 3). Foi realizada uma avaliação clínica das características linguais das crianças e, em seguida, uma avaliação objetiva da força axial da língua por meio de equipamento desenvolvido na Universidade Federal de Minas Gerais. Os resultados foram analisados de forma descritiva por meio das medidas de tendência central e dispersão. RESULTADOS: A média dos valores das forças médias encontrada nos Grupos 1, 2 e 3, respectivamente, foi de 5,6, 6,0 e 7,3N. Já a média dos valores de força máxima foi de 8,2, 9,2 e 10,4N. Obtiveram os maiores valores de força média (7,0N) e máxima (10,3N) os indivíduos que apresentaram tensão adequada de língua na avaliação clínica e os valores mais baixos (3,5N e 2,0N) aqueles cuja avaliação subjetiva indicou hipotensão lingual. A análise estatística indicou dados heterogêneos nos Grupos 1 e 2, tendendo a homogêneos no Grupo 1. CONCLUSÕES: A média das forças foi maior nos indivíduos respiradores nasais, seguidos pelos respiradores orais em tratamento fonoaudiológico e, por fim, os respiradores orais pré-cirúrgicos. Houve concordância entre os resultados das avaliações objetiva e clínica.

PURPOSE: To quantify and to compare the forces produced by the tongues of pre-surgical mouth-breathing children, oral-breathing children enrolled in therapy and nasal-breathing children, and also to compare the findings of objective and clinical evaluations. METHODS: Transversal study with 15 children of both genders with ages between eight and 12 years: five pre-surgical mouth breathers (Group 1), five mouth breathers enrolled in speech therapy (Group 2) and five nasal-breathing children (Group 3). A clinical assessment of each child's tongue characteristics was carried out, followed by the objective evaluation of the axial centre line force of the tongue using the instrument created at Federal University of Minas Gerais. The results were descriptively analyzed using measures of central tendency and dispersion. RESULTS: The average of the force values found in Groups 1, 2 and 3, respectively, were 5.6, 6.0 and 7.3N. The average values of maximum force were 8.2, 9.2 and 10.4N. The individuals with adequate tongue tension in the clinical evaluation were the ones with highest values of average (7.0N) and maximum force (10.3N). The lowest values (3.5N and 2.0N) were obtained by the subjects whose subjective evaluation showed hypotension of the tongue. Statistical analysis indicated heterogeneous data in Groups 1 and 2, tending towards homogeneous in Group 1. CONCLUSION The average of the forces was higher for nasal breathers, followed by mouth breathers undergoing speech therapy and, finally, pre-surgical oral-breathing children. There was agreement between the results of objective and clinical evaluations.