CHEW AT THE BACK

Myofunktional Exercise  Collection

Application:

to enlarge klick picture

This is a specialised Exercise for habitual “nibbling” and a protrusive posture of tongue or mandibula to school the heterostereognosis and muscle coordination. (Anatomy: Areal II/b,  Page 20).

Contents:

Pseudomanipulated reflex exercise for the chewing process and swallowing.

Materials:

Sugar free chewing gum.

Procedure:

- Previous exercises: Generally all single exercises to build up the swallowing function – DIMPLE;

especially the extended ,1-2-3’-EXERCISE ( see paragraph “Discussion”).

-Starting position: The chewing gum is chewed into shape.

- Step-by-step-description:

-1 The chewing gum is pushed to the last molar in the row only by mouth movements (not by the tongue tip which will stay at its POINT)

-2 Chew it about ten times, then:

-3 ,1-2-3’-EXERCISE, DIMPLE, TOUCH-THE-BUTTON, ,KA', at

,2’ bite on to the chewing gum with the last molars and keep it fixed, at

,3’ ,KA' – and swallow.

-4 Change side and go to step -1.

-Timing: The training phase will mostly consist of one single, equal sequence and not added up to a series. this single sequence contains one run on one side, change of sides, one run on the new side, change of sides……..

A sequence, so, is running under a frequency which can be filled with ten changes.

Characteristics:

Stereognosis, habituation, motivation, tactile kinaesthesia, orientation, feed-back, function kinesis, reflex, coordination.

Remarks:

At the beginning an intraoral record should reveal the masticatory functionability through the state of the static and dynamic occlusion and the dentition of the patient.

Discussion:

This exercise, positioned in the end phase of the general therapy course, may be set just at the beginning of this phase to monitor consciously the total coordination (by the feed-back signals of the aimed chewing of the gum). In the follow may be started the training with the different food qualities (as liquid, mushy, consistent; see also the paragraph “Discussion” in: EAT-(AND DRINK-)EXERCISE).

It may be placed as the immediate pre-exercise to CRUMB SWALLOW or as a single isolated measure when habitually in a tendency for protrusion of tongue and mandibula the foodstuff will only be “nibbled”, chewed with the front teeth.

In connection with the frequently cited individual steps ,GA' und ,KA' it might be added that these will exercise the movement of the complete tongue body especially its back part with a short pressing motion upwards against the palate as it happens in the last swallow phase preceding the triggering of the visceral  deglutition through a short strong pressure. The musculature previously  was trained by, for example, the SQUEEZE-A-FLAKE.

,GA’ in this case rather includes the deeper pharyngeal muscles.

Instructions:

The chewing of food is done by the molars, the pushing about in the mouth hole by the side rims of the tongue.

Therefore:

Chew a gum to get it “squashy” and the shove it with the margin of one side of the tongue quite way back to the last molar tooth to chew on it about ten times – whereas the tongue tip is staying at its POINT.

Now collect the solved flavour to swallow it with the ,1-2-3’-method. And this will run as follows:

,1’ and collect the flavour in the DIMPLE to deposit it with the tongue tip on the POINT;

,2’ and bite on the gum with the last molar of the chewing side and PUSH THE BUTTON.

,3’ make the ,KA’-movement with the back part of the tongue and  -  swallow.

Then the gum is changed only by the back part of the tongue to the opposite side and everything as before, gum to the last tooth, chew it ten times and so forth…. After that a new change of sides. All that ten times or as often as we agreed upon.