Aphasia--the hidden disability.

UNLABELLED: Aphasia is an acquired language disorder due to brain damage and which may include difficulty in producing or comprehending spoken or written language. Stroke is the commonest cause and each year 50,000 new patients develop aphasia. People with aphasia differ in their speech output and in their fluency. Some people communicate reasonably well, while others have very limited powers of expression. This review will describe the neurology of speech and aphasia, and will focus on the role of the speech and language therapist in dealing with people with aphasia. CLINICAL RELEVANCE: Dentists and their staff should be aware that after a stroke some people are unable to talk or have limited powers of expression. Comprehension might be impaired and people with aphasia may be unable to grasp some common language, such as appointment letters and patient information.

The role of the dentist in sleep disorders.

UNLABELLED: Snoring and sleep apnoea are common. The demand for sleep medicine services has increased exponentially since the recognition of sleep apnoea as a disease in the 1960s. The involvement of dentists in the treatment of sleep apnoea has increased. This article provides an overview of the disorders and options for management. CLINICAL RELEVANCE: It is important that dentists are aware of the problem of sleep disorders and the potential they have to help in their management.

Mastication and swallowing: 2. control.

UNLABELLED: In recent years, it has become clear that the neural mechanisms controlling chewing and swallowing emanate from centres in the brainstem. However, these activities may be modulated by conscious processes and by feedback from peripheral nerves.This review relates this knowledge to clinical dentistry and, in particular, to the possible relationship between craniomandibular dysfunctions and impaired control of the masticatory system. CLINICAL RELEVANCE: Dentists should understand the neuromuscular control of the masticatory apparatus as this can be relevant to the general health of patients as well as to craniomandibular disorders involving the jaw muscles and joints.

Mastication and swallowing: 1. Functions, performance and mechanisms.

UNLABELLED: The process of mastication involves movements of the tongue, lips and cheeks as well as the more obvious actions of the teeth and jaws. In recent years there have been significant advances in our knowledge of the relationships between these movements in human beings and of how the processes of mastication are related to the associated events of swallowing. In this, the first of two papers, we review the role of mastication in food processing and nutrition and the effect of tooth loss on masticatory performance.The paper also reviews new information on masticatory and swallowing functions in human beings eating naturally. The review relates this knowledge to clinical dentistry, notably to the relevance of a good dentition to the digestive process and practical considerations in the replacement of missing teeth. CLINICAL RELEVANCE: Dentists should understand the process of mastication because an adequate dentition can facilitate the general health and well-being of their patients.This understanding can also inform the clinical management of patients with a depleted dentition or otherwise impaired masticatory system.