Estas pueden considerarse las funciones primordiales por excelencia. El reflejo de succión es un remanente de la bomba bucal, que desencadena un movimiento de degluciónque juega un papel importante en el equilibrio postural del individuo al abrir la trompa de Eustaquio y equilibra las presiones del oído medio e interno. La aparición de los dientes de leche y el posicionamiento de las arcadas dentarias alrededor de los treinta meses traen una nueva fisiología de la degluciónligada a la propiocepción del trigémino.

Desde el nacimiento, el bebé traga haciendo una contracción refleja de los labios y la lengua se apoya en ellos. Para obtener una deglucióncorrecta y fisiológica en la fase adulta, la lengua debe extenderse por todo el paladar y con su punta debe estimular las papilas retroincisivas, zona receptora muy reflexogénica, por lo que los labios ya no necesitan contraerse. Esto sucede una vez que han aparecido todos los dientes temporales. El niño debe adquirir una deglucióncorrecta a la edad de tres años; si esto no ocurre, se puede imaginar una lengua mal posicionada sobre los dientes con el consecuente déficit de estimulación ósea y el consecuente fracaso del maxilar superior para desarrollarse sobre un hueso muy maleable en fase de crecimiento.

La lengua, por tanto, es el verdadero conformador del paladar. Durante las 24 horas, se traga en promedio entre 1500-2000 veces, generalmente cada medio minuto durante la vigilia y cada minuto durante el sueño. La presión que ejerce la punta de la lengua es de aproximadamente un kilo, lo que significa que durante las 24 horas la zona donde se libera el empuje de la lengua debe soportar una presión de unos 2000 kg. Por tanto, podemos fácilmente darnos cuenta de por qué aparece tan a menudo la aparición de daños en el sistema osteo-dental cuando la lengua asume una postura anormal tanto en posición de reposo (sin respetar la mancha) como durante el acto de deglución.

La deglución incorrecta en ortodoncia puede, por tanto, ser considerada la principal causa de maloclusión dental y es el punto de paso de problemas de la boca al interior del cuerpo con alteraciones de la fascia cervical y con afectación de la columna. Una lengua disfuncional, de hecho, puede causar mordidas abiertas anteriores, mordidas abiertas unilaterales y bilaterales, mordidas cruzadas mono y bilaterales, mordidas abiertas totales con contactos solo en los últimos molares, mordidas anteriores inversas, mordidas inversas totales, terceras clases funcionales, resalte elevado, aumento de overbyte, diastema entre dientes y mordidas cubiertas. Además, una deglución anormal asociada a un desequilibrio muscular puede dar lugar a algunas formas de enfermedad periodontal que, incluso en presencia de una buena higiene dental, pueden provocar situaciones como recesiones gingivales, resorción ósea y diseminación dentaria en algunos pacientes. Al evaluar la deglución, también es importante considerar la posible presencia de un frenillo corto y una lengua en postura baja que, en consecuencia, afecta la correcta respiración nasal.

Nasal breathing is one of the main vital functions of our life, as it is necessary to bring oxygen to the tissues and remove carbon dioxide. We breathe about 18,000 times a day, at birth the maxillary sinuses are very small. It is considered that with each nasal breath the inhaled air pneumatizes them and makes them grow. It must be taken into account that the underlying part of the maxilla corresponds to the ceiling of the palate. If this is sufficiently stimulated it will develop sufficiently to create the necessary space for the eruption of permanent teeth up to the age of 12, that is, until the end of skeletal and dental growth.

The nose, with its micro-hair and blood microcirculation system, filters impurities from the air and heats it. This happens only through a physiological and correct nasal breathing. It is also necessary to consider the direct connection between nasal breathing and ear; this through a canal (ear canal) communicates with the back wall of the throat and serves for drainage into the pharynx and mucus secreted from the ear mucosa. If the ear canal is closed, an accumulation of mucus will result, which will be responsible for ear infections, even severe, chronic or acute. Proper nasal breathing allows air to pass close to the auditory duct, thus providing a vacuum suction system. Breathing, therefore, is a consequence of various issues pertaining to the otolaryngologist in both children and adults.

It would be enough to observe that all people who breathe with their mouth have more or less severe dysmorphosis of the same. We can therefore consider that oral breathing is the cause of insufficient growth of the palate with consequent crowding of the teeth, which may also be the cause of deformations and a more or less important incorrect development of the face.

Oral breathing favors the onset of short, superficial, unsatisfactory, in itself anxiogenic breathing, which reduces night rest in quality and quantity, worsens the threshold for waking up with anxiety (to which the phenomenon of nocturnal enuresis is frequently linked), constitutes a critical moment for the life of children, does not allow the nasal filter to be activated and this causes frequent recurrent inflammatory respiratory diseases of the oro-rhino-pharyngeal tract, for which it is necessary to pass as soon as possible to spontaneous physiological nasal breathing. The oral respirator will have a high, clavicular, small amplitude breathing, it will be poorly oxygenated and easily fatigued. Prevailing muscular tensions will appear at the level of the sternocleidomastoid muscles, the trapezius and the first rib.

CHEWING

Chewing begins with the appearance of the teeth following sucking. One of the criteria for recognizing good chewing is having a correct swallowing associated with a balanced mouth with all contacts of the upper and lower teeth on the side where the jaw is moved (right laterality and left laterality). When chewing, the food must be well interposed between the dental arches (jaw-jaw) like a crayon that turns in a mortar. If the mandible is positioned forward with respect to the maxilla, the latter will not have a chance to develop. Another important factor for good and correct chewing is to chew on both sides to keep the temporomandibular joints (TMJ) stable and in balance.

A monolateral chewing will allow over time a decompensation of the anomalous shape of the mandibular branch and mandibular condyle with consequent alterations and dysfunctions of the TMJs and deviation of the midlines, with the mandible deviating from the side where you chew the most. On the same side it will cause wear at the occlusal level, while the upright branch and the condyle will take on a more voluminous anatomical shape and on the contrary, on the opposite side they will refine. To understand well, just imagine walking by jumping on one foot only for a long time. What could be the consequences in terms of decompensation to compensate for this condition?

So chewing only on one side for the whole life will cause a deviation of the mandible and jaw from different sides which will cause different tensions of the neuro-muscular system, craniofacial with increased muscle tone on the chewing side and with inclination on one side of the head for muscle hypertonia. To chew well, therefore, it is necessary to coordinate alternating movements in right and left laterality. It is also necessary to consider the limited lateral movements of the jaw when there is an over-occlusion (deep bite), a condition that makes you unable to chew and grind food and, to prepare the food bolus, thus swallowing the food almost entirely and thus conditioning good digestion.

Over time, the stomach and intestines will have to compensate for the failure to chew food, becoming overloaded. In the mouth there are the taste buds with the two sense organs (taste-smell). To swallow whole food is to skip this stage of taste and smell. Quality chewing is of fundamental importance rather than eating like a robot, a situation that forces the body to compensate for digestion which will cause abnormalities in other organs which, being under stress, will affect the correct functioning of the body.

THE PHONATION

Even speech can be affected by incorrect swallowing and breathing as regards the articulation of sounds. Good swallowing prevents the tongue from getting into the teeth with a good foothold. It also produces a decontraction of the lips and the whole, associated with a good nasal breathing allows a good phonation.

CONCLUSIONS

In all cases of dysmorphosis of the mouth, therefore, an atypical swallowing, oral breathing, abnormal chewing and impaired phonation can be found. All these functions are called autonomic functions and, since one of these functions is somewhat disturbed, so are the others to a different degree.

When a mouth does not work well it is because there are systemic associated autonomic dysfunctions.

In these cases, the use of functional orthodontic devices such as AMCOP Bio-Activators, in association with specific exercises, can be of great help in the treatment of the various imbalances listed with an improvement in correct swallowing, with the relaxation of the facial muscles and nasal breathing.

With Bio-Activators, functional orthodontic devices, it is possible to bring the mouth to a situation of equilibrium, orienting growth towards normality.