The act of swallowing is a complex neuromuscular process that occurs dozens of times every hour, largely without conscious thought, involving nearly 50 pairs of muscles and multiple cranial nerves. Proper swallowing is a mechanical function that supports healthy breathing, speech articulation, and overall oral structure. When this process becomes habitually dysfunctional, it can affect health in ways that extend far beyond a simple mealtime inconvenience.
The Three Phases of Swallowing
The physiological process of moving food or liquid from the mouth to the stomach is divided into three distinct, sequential phases. The initial stage is the oral phase, which is the only part of the process under voluntary control. Food is chewed and mixed with saliva to create a cohesive mass known as a bolus. The tongue then pushes the bolus backward toward the throat to initiate the next step.
As the bolus reaches the back of the mouth, it triggers the pharyngeal phase, a rapid, involuntary reflex. The soft palate elevates to seal off the nasal cavity, and the vocal cords close to cover the trachea, protecting the airway. The larynx simultaneously lifts and moves forward, allowing the epiglottis to fold down and divert the bolus into the esophagus. Breathing is briefly inhibited during the movement of the bolus.
The final stage is the esophageal phase, which is entirely involuntary and transports the bolus down to the stomach. This movement is achieved through peristalsis, a wave-like contraction of the esophageal muscles. The upper esophageal sphincter relaxes to allow the bolus to enter, and then a sequential muscular squeeze pushes the food downward. Once the bolus reaches the bottom of the esophagus, the lower esophageal sphincter opens, delivering the contents into the stomach and completing the swallow.
Signs of Swallowing Dysfunction
When the muscles or coordination involved in these three phases falter, a person may experience noticeable symptoms of swallowing dysfunction, often termed dysphagia. One of the most common signs is frequent coughing or choking during or immediately after eating or drinking, which occurs when food or liquid enters the airway instead of the esophagus.
A person might also report the persistent sensation that food is lodged in their throat or chest, a feeling often referred to as globus sensation. Other subtle indicators of an inefficient swallow include needing to clear the throat often or having a wet, gurgly sound to the voice after swallowing.
Excessive drooling, food leaking from the mouth, or taking an unusually long time to chew and swallow a meal can point to an improper pattern in the oral preparatory phase. Chronic mouth breathing at rest is also a related sign, as it prevents the tongue from resting in the correct position.
Training Proper Swallowing and Tongue Posture
Correcting an improper swallowing pattern often focuses on retraining the muscles of the mouth and face through a discipline called myofunctional therapy. The core concept is establishing a proper resting tongue posture, where the entire tongue rests lightly against the hard palate, rather than sitting low in the mouth or pushing against the front teeth. The front section of the palate, just behind the upper front teeth, is often called the “spot” and serves as the anchor point for the tip of the tongue.
The “spot swallow” technique retrains muscular action during swallowing. To practice, an individual places the tip of the tongue on the “spot” and attempts to swallow while keeping teeth lightly together and lips relaxed. The goal is to initiate the swallow using only the upward and backward movement of the tongue, without involving the cheek or lip muscles. This isolates the correct intra-oral pressure necessary for a mature swallowing pattern.
Tongue Strengthening Exercises
Exercises can be used to build strength and awareness in the tongue.
- Making a clicking or popping sound by powerfully sucking the entire tongue up against the palate and then releasing it.
- Pressing the tongue firmly upward against the palate and holding the tension for several seconds to use gentle resistance.
While these retraining methods are effective for habitual issues, any severe or painful swallowing difficulties should prompt consultation with a specialist like a Speech-Language Pathologist for clinical evaluation.
Long-Term Effects of Swallowing Pattern Issues
A chronically incorrect swallowing pattern, often associated with a low resting tongue posture, can lead to several downstream physical and structural consequences. The most frequently discussed effect is dental misalignment, particularly the development of an open bite where the upper and lower front teeth do not meet. This is primarily caused by the continuous, light pressure of the tongue resting against or between the teeth for hours each day, rather than the brief pressure of the swallow itself.
The habitual forward or low tongue posture can also contribute to a retruded chin or altered vertical facial growth patterns. Incorrect muscle function can lead to increased strain on the jaw muscles, potentially contributing to discomfort or temporomandibular joint (TMJ) disorders later in life. Poor tongue posture is also strongly linked to chronic mouth breathing, which can compromise sleep quality and overall respiratory health.