Tipper and dipper types of oral swallows
Abstract
We characterized the normal patterns relating to the onset of the oral-swallowing phase in patients with normal oral motor function. The main pattern of swallowing was of the tipper type, in which swallowing is initiated with the tip of the tongue against the incisors and the bolus is in a supralingual position. However, a second pattern of a dipper-type swallow occurred, in which part of the bolus initially is positioned beneath the anterior part of the tongue. This circumstance requires that the tongue dip beneath the bolus in order to elevate the bolus above the tongue. Dipper swallows occurred in all age groups, but were more prevalent in subjects 60 years or older. Recognition of this component in normal swallowing patterns is essential for optimal evaluation of normal subjects and patients with an abnormal oral phase of swallowing.
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Early work by Logemann and colleagues demonstrated contributions of oral tongue movement to onset of pharyngeal swallowing dynamics.
“This finding fits with the early work of Logemann and colleagues who demonstrated the contributions of oral tongue movement to the onset of pharyngeal swallowing dynamics [66–69].”
From MBS Measurement Tool for Swallow Impairment—MBSImp: Establishing a Standard (2008) · cites this paper as [66]
Cites
Upper esophageal sphincter function during deglutition
Kahrilas, P. J., Dodds, W. J., Dent, J., Logemann, J. A., & Shaker, R. (1988) · Gastroenterology · doi:10.1016/0016-5085(88)90290-9 · Cited by 389 · see citing works
Self-citationInfluence of bolus volume on swallow-induced hyoid movement in normal subjects
Dodds, W. J., Man, K., Cook, I., Kahrilas, P., Stewart, E., & Kern, M. (1988) · American Journal of Roentgenology · doi:10.2214/ajr.150.6.1307 · Cited by 160 · see citing works
Self-citationTiming in the Normal Pharyngeal Swallow
CURTIS, D. J., Cruess, D. F., Dachman, A. H., & Masó, E. (1984) · Investigative Radiology · doi:10.1097/00004424-198411000-00009 · Cited by 84 · see citing works
Videofluoroscopic identification of two types of swallowing.
Curtis, D. J., & Cruess, D. F. (1984) · Radiology · doi:10.1148/radiology.152.2.6739789 · Cited by 16 · see citing works
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MBS Measurement Tool for Swallow Impairment—MBSImp: Establishing a Standard
Martin-Harris, B., Brodsky, M. B., Michel, Y., Castell, D. O., Schleicher, M., Sandidge, J., Maxwell, R., & Blair, J. (2008) · Dysphagia · doi:10.1007/s00455-008-9185-9 · Cited by 685 · see citing works
Best practices in modified barium swallow studies
Martin-Harris, B., Canon, C. L., Bonilha, H. S., Murray, J., Davidson, K., & Lefton-Greif, M. A. (2020) · American Journal of Speech-Language Pathology · doi:10.1044/2020_ajslp-19-00189 · Cited by 129 · see citing works
- Authors
- Dodds, W., Taylor, A., Stewart, E., Kern, M., Logemann, J., & Cook, I.
- Affiliations
- Department of Radiology, Medical College of Wisconsin, Milwaukee 53226.
- Medical College of Wisconsin (US)
- Venue
- American Journal of Roentgenology
- Publisher
- American Roentgen Ray Society
- Published
- 1989-12-01
- Volume
- 153
- Issue
- 6
- Pages
- 1197-1199
- ISSN
- 0002-9580 (ISSN-L)
- 0361-803X
- 1546-3141
- OpenAlex
- W2166396566
- Cited by
- 122
- References
- 4
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 6 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 5 · 2019: 5 · 2018: 6 · 2017: 9 · 2016: 5 · 2015: 5 · 2014: 4 · 2013: 7 · 2012: 7
- FWCI
- 9.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Roentgenology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (DK 25731)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Medicine › Physiology › Voice and Speech Disorders
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Keywords
- oral phase of swallowing, swallowing patterns, tongue position, normal swallowing, age differences, dysphagia
- MeSH terms
- Barium Sulfate, Deglutition, Female, Humans, Male, Middle Aged, Mouth, Pharynx, Radiography, Tongue
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