What are processes in oral phase of swallowing relevant to dysphagia?

Updated: Mar 20, 2020
  • Author: Nam-Jong Paik, MD, PhD; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Answer

The oral phase of swallowing is divided into the following 2 parts:

  • Oral preparatory phase: The processing of the bolus to render it swallowable

  • Oral propulsive (or transit) phase: The propelling of food from the oral cavity into the oropharynx

With single swallows of liquid, the entire sequence lasts about 1 second. For swallows of solid foods, a delay of 5-10 seconds may elapse while the bolus accumulates in the oropharynx.

Oral preparatory phase

The process begins with contractions of the tongue and striated muscles of mastication. The muscles work in a coordinated fashion to mix the food bolus with saliva, with the taste, temperature, touch, and proprioception senses required to form a bolus of the right size and consistency. (See image below.)

Oral preparatory phase of normal swallowing. Oral preparatory phase of normal swallowing.

Oral propulsive phase

This segment of the swallowing process involves manipulation of the bolus formed in the preparatory stage in the central portion of the tongue. The bolus is then pushed toward the pharynx posteriorly with a sequential anterior-to-posterior tongue elevation in order to trigger the swallowing reflex as the bolus enters the pharyngeal phase.

This process requires that a labial seal be maintained to prevent food from leaking from the mouth and that there be buccal musculature tension to prevent food from getting into the recess between the mandible and cheek. (See the image below.)

Oral propulsive phase of normal swallowing. Oral propulsive phase of normal swallowing.

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