Primary or infantile swallowing is characterized by swallowing by pushing the tongue forward (a movement generally described as an interposition of the tongue between the dental arches), as well as by an absence of dental contact and the contraction of the lips and cheeks.
This technique is perfectly suited to breastfeeding since, in this case, the infant will seek out the nipple and bring it into their mouth. A perfect seal at the level of the orbicularis oris muscle is therefore essential, so that the child can squeeze the nipple and create a vacuum inside the mouth (hence the work of the cheeks) to collect the milk and swallow it.
The transition to secondary or mature swallowing
Once a child has functional incisors and canines, the maturation of swallowing can then take place.
Secondary or mature swallowing is performed with the lips closed but not contracted, the dental arches in occlusion, the tongue between these arches (with its tip resting on the anterior palate, behind the incisors), and the base of the tongue in contact with the soft palate. Swallowing between 1,500 and 2,000 times a day while pushing the tongue vertically helps to shape the palate by widening it, which also enlarges the nasal passages and thus improves nasal breathing.
The widening of the palate, meanwhile, provides the necessary space for the implantation of permanent teeth and for the vertical growth of the lower third of the face (reducing the incidence of orthodontic treatments).
The consequences of persistent primary swallowing
In orofacial growth, two successive phases are observed:
- the orthopedic phase, which occurs from 0 to 10-11 years on average (facial growth);
- the orthodontic phase, from 11 years on average (placement of teeth on the dental arch in a more or less harmonious way).
Since the tongue does not grow on the jaws and dental arches, and form and function are closely linked, persistent primary swallowing can then lead to a growth defect of the maxilla (maxillary hypoplasia).
At the level of the mandible, persistent primary swallowing can induce ATM disorders such as functional retrognathia or prognathia (postural, therefore reducible) which can then cause true retrognathia or true prognathia (structural, therefore reducible by orthopedic or surgical treatment).
What treatments are available for persistent primary swallowing difficulties?
In the context of managing persistent infantile swallowing difficulties, various types of treatment can be considered. Among them is neuromotor reprogramming (NMR), which combines central, postural, and functional approaches (Remillieux-Gerentes ProtocolThis is composed of different care elements:
- speech therapy;
- maxillofacial rehabilitation;
- postural treatment;
- orthodontic treatment;
- a “froggymouth” treatment.
The Allyane method in the management of persistent primary swallowing
The Allyane neuromotor reprogramming method is based on a combination of proprioception, mental imagery, and listening to low-frequency sounds emitted by a patented medical device. Among other benefits, it facilitates the release of central motor inhibitions, particularly in patients with swallowing disorders. Using this method helps patients relearn proper swallowing movements and reflexes as part of the treatment for this type of disorder.
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Authors:
Dr. Philippe Gerentes: Private practice dentist, lecturer at the University of Lyon (prosthodontics), instructor of the Allyane method in specialization (TMJ and swallowing). Franck Remillieux: Physiotherapist, Osteopath, Practitioner and instructor of the Allyane method.
Olivier Bonnet: Physiotherapist, Osteopath, Mental Coach, Practitioner of the Allyane Method
Franck Remillieux: Physiotherapist since 1990 and exclusive osteopath since 1998. He earned a university diploma in perinatal care in 2012 from Paris Diderot University. Since 2018, he has been a certified Allyane practitioner and trainer. Franck is particularly interested in the beneficial effects of neuro-motor reprogramming on various pathologies of the masticatory system (TMJ): teeth clenching and its consequences, atypical swallowing, etc.