How does the tongue work as a multifunctional organ. What is the structure and anatomy of the tongue. Why is the tongue’s surface rough. How do the tongue’s muscles enable its diverse movements. What role does the tongue play in taste, speech, and swallowing. How can medications be administered sublingually. Why is the tongue crucial for overall oral health.

The Anatomy of the Tongue: A Muscular Marvel

The tongue is a remarkable organ that plays a crucial role in various bodily functions. But what exactly is the tongue made of? At its core, the tongue is a set of highly movable muscles covered with a specialized mucous membrane. These muscles are arranged in an oblong shape and are encased in a dense layer of connective tissue. The tongue’s root is firmly anchored to the floor of the mouth, while the rest of it can move freely.

How is the tongue connected to other parts of the mouth and throat? Several muscles and ligaments keep the tongue “suspended” within the oral cavity:

• Muscles and ligaments connect it to the hyoid bone in the upper throat
• Attachments to the voice box provide additional support
• The lingual frenulum connects the tongue’s underside to the lower jaw
• Some muscles even extend to the base of the skull

This complex network of connections allows the tongue to perform its diverse range of functions while remaining securely in place.

The Tongue’s Sections: From Tip to Root

To understand the tongue’s structure better, we can divide it into distinct sections. Each part has its own unique characteristics and functions:

Tip and Sides

These areas belong to the movable section of the tongue. They are incredibly flexible and capable of performing complex movements, essential for speech and manipulating food.

Back of the Tongue

The upper surface of the tongue is known as the back. This area is rich in sensory cells responsible for our senses of taste and touch.

Root of the Tongue

Also called the base, this section cannot move freely and is connected to the floor of the mouth. It’s not visible when looking into an open mouth.

The Tongue’s Surface: More Than Meets the Eye

Why does the tongue have a rough, velvety texture? The answer lies in its unique surface structure. The tongue’s surface is covered with small bumps called papillae, which give it its characteristic appearance. These papillae serve different purposes:

Mechanical Papillae

These structures anchor the mucous membrane firmly to the tongue and contain sensory cells that allow us to feel the texture and shape of food in our mouths.

Taste Papillae

These papillae increase the surface area of the tongue, maximizing contact between food particles and taste receptors. This enhanced surface area allows for a more nuanced perception of flavors.

The grooves between papillae, especially in the back third of the tongue, can trap food residue and saliva. This can lead to bacterial growth, resulting in a white film on the tongue and potentially causing bad breath. Regular tongue cleaning is essential for maintaining oral hygiene and preventing these issues.

The Underside of the Tongue: A Gateway for Medication

The area beneath the tongue, known as the sublingual region, has some unique properties. It’s characterized by a shiny surface, with the lingual frenulum and visible veins being the most prominent features. The ducts of the submandibular salivary glands also open into this area.

How can medications be administered through the underside of the tongue? The mucous membrane in this region can absorb certain substances quickly, making it an ideal site for administering medications that need to act rapidly. This method of drug delivery is called sublingual administration.

Why is sublingual administration effective for some medications? When a drug is placed under the tongue, it can enter the bloodstream directly, bypassing the digestive system. This route avoids the first-pass metabolism in the liver, allowing for faster onset of action and higher bioavailability of the drug.

An example of a medication administered sublingually is nitroglycerin spray, used for sudden chest pain caused by reduced blood flow to the heart. The rapid absorption through the sublingual route allows for quick relief of symptoms.

The Tongue’s Unique Musculature: A 3D Movement Machine

What makes the tongue’s range of motion so exceptional? The answer lies in its unique muscular structure. Unlike any other muscle in the human body, the tongue’s muscle fibers are arranged in three dimensions:

• Front to back
• Side to side
• Top to bottom

This three-dimensional arrangement allows the tongue to move in all directions with remarkable precision. It can elongate, shorten, curl, flatten, and perform a wide range of complex movements essential for speech, swallowing, and manipulating food.

The Tongue as a Sensory Powerhouse

Beyond its muscular capabilities, the tongue serves as a critical sensory organ. How does the tongue contribute to our sensory experiences?

Taste Sensation

The tongue is home to thousands of taste buds, each containing specialized receptor cells. These taste buds can detect five primary tastes: sweet, sour, salty, bitter, and umami (savory). The distribution of taste receptors across the tongue’s surface allows for a complex and nuanced perception of flavors.

Touch Sensitivity

The tongue is one of the most sensitive organs for touch in the human body. Its high density of mechanoreceptors allows for precise detection of texture, temperature, and pressure. This sensitivity is crucial for assessing the consistency and safety of food before swallowing.

The Tongue’s Role in Speech and Communication

How does the tongue contribute to human speech? The tongue’s flexibility and precise control are essential for articulating a wide range of sounds. It shapes the oral cavity, directing airflow and creating the distinct phonemes that make up human language.

Different languages require different tongue movements and positions to produce their unique sounds. The tongue’s versatility allows humans to learn and speak multiple languages, each with its own set of phonetic requirements.

Beyond verbal communication, the tongue also plays a role in non-verbal expression. Sticking out the tongue can convey various emotions or cultural meanings, highlighting its importance in body language and social interaction.

The Tongue in Swallowing and Digestion

What role does the tongue play in the process of eating and digestion? The tongue’s functions in this regard are multifaceted:

• Manipulating Food: The tongue moves food around the mouth, positioning it for chewing and mixing it with saliva.
• Bolus Formation: It helps form food into a bolus (a rounded mass) that’s easier to swallow.
• Initiating Swallowing: The tongue pushes the bolus to the back of the throat, triggering the swallowing reflex.
• Taste Assessment: By tasting food, the tongue helps the brain decide whether to swallow or reject it, playing a crucial role in food safety.

These functions highlight the tongue’s importance not just in enjoying food, but in the fundamental process of nutrition and survival.

Tongue Health and Overall Oral Hygiene

Why is maintaining a healthy tongue crucial for overall oral health? The tongue’s surface can harbor bacteria, food particles, and dead cells, which can contribute to bad breath and potentially affect overall oral health. Regular cleaning of the tongue, along with proper dental hygiene, is essential for maintaining a healthy mouth.

How can one maintain good tongue health?

• Regular Brushing: Gently brush the tongue’s surface with a toothbrush or tongue scraper to remove buildup.
• Staying Hydrated: Drinking plenty of water helps wash away bacteria and food particles.
• Balanced Diet: A diet rich in fruits and vegetables can help maintain a healthy oral environment.
• Regular Dental Check-ups: Professional cleaning and examination can identify and address any tongue-related issues early.

By taking care of the tongue, individuals can contribute significantly to their overall oral and general health.

The Tongue in Medical Diagnostics

How can the tongue serve as a diagnostic tool for healthcare professionals? The appearance and condition of the tongue can provide valuable insights into a person’s overall health:

• Color Changes: Abnormal tongue color can indicate various health issues, from nutritional deficiencies to more serious conditions.
• Texture Alterations: Changes in the tongue’s texture, such as smoothness or the appearance of patches, can signal certain medical conditions.
• Size and Shape: Swelling or changes in the tongue’s shape may indicate allergic reactions or other health concerns.
• Coating: The presence and nature of tongue coating can provide clues about digestive health and overall well-being.

These observations make the tongue an important part of physical examinations and can guide healthcare providers in their diagnostic process.

The Tongue’s Role in Taste Perception Beyond Basic Flavors

While the tongue is known for detecting five basic tastes, its role in flavor perception is far more complex. How does the tongue contribute to our overall experience of taste?

The tongue works in conjunction with other sensory systems to create a comprehensive flavor experience:

• Olfactory Integration: The tongue’s taste receptors work closely with the olfactory system, combining taste and smell to create complex flavor profiles.
• Texture Perception: The tongue’s ability to sense texture contributes significantly to how we perceive and enjoy food.
• Temperature Sensing: The tongue can detect temperature, which influences our perception of flavor and enjoyment of food.
• Chemical Irritation: Sensations like the heat of chili peppers or the coolness of mint are detected by the tongue’s nerve endings.

This multifaceted sensory capability allows humans to experience a rich and diverse world of flavors, far beyond the basic taste categories.

The Tongue’s Regenerative Properties

One of the tongue’s remarkable features is its ability to heal quickly. Why does the tongue heal faster than many other parts of the body?

• Rich Blood Supply: The tongue’s extensive network of blood vessels provides ample nutrients and oxygen for rapid healing.
• Fast Cell Turnover: The cells on the tongue’s surface are replaced frequently, aiding in quick recovery from minor injuries.
• Saliva’s Healing Properties: Saliva contains compounds that promote healing and fight infection, benefiting the tongue directly.

These factors combine to make the tongue one of the fastest-healing organs in the human body, allowing it to recover quickly from burns, bites, or other minor injuries.

The Tongue in Different Species: A Comparative Look

How does the human tongue compare to those of other animals? While the basic structure remains similar across many mammalian species, there are fascinating variations:

• Length and Shape: Some animals, like anteaters and giraffes, have extremely long tongues adapted for their specific feeding habits.
• Surface Structure: Cats have rough, barbed tongues that aid in grooming and stripping meat from bones.
• Taste Bud Distribution: Different species have varying numbers and distributions of taste buds, reflecting their dietary needs and preferences.
• Specialized Functions: Some reptiles, like snakes, use their tongues primarily for sensing their environment rather than for taste or manipulation of food.

These variations highlight how the tongue has evolved to serve diverse functions across different species, adapting to various ecological niches and dietary requirements.

The Tongue’s Role in Thermoregulation

While not its primary function in humans, the tongue plays a significant role in thermoregulation for many animals. How does this work?

• Panting: In dogs and many other mammals, rapid breathing with the tongue out helps cool the body through evaporation.
• Surface Area Increase: Extending the tongue increases the surface area for heat exchange with the environment.
• Blood Flow Regulation: The tongue’s rich blood supply allows for efficient heat transfer when exposed to cooler air.

In humans, while less pronounced, the tongue can still contribute to cooling by increasing saliva production and spreading it around the mouth, providing a mild cooling effect.

The Tongue in Culture and Symbolism

Beyond its physiological functions, the tongue holds significant cultural and symbolic meaning in various societies. How is the tongue represented in different cultures?

• Language and Communication: The tongue is often used as a symbol for speech and language itself.
• Expression of Emotions: Sticking out the tongue can convey a range of emotions, from playfulness to defiance, depending on the cultural context.
• Religious Symbolism: In some religions, the tongue represents the power of speech and the responsibility that comes with it.
• Culinary Traditions: Many cultures have dishes that include tongue as an ingredient, reflecting different attitudes towards this organ as food.

These cultural representations highlight the tongue’s importance not just as a physical organ, but as a symbol deeply embedded in human consciousness and social interaction.

The Future of Tongue Research and Medical Applications

What does the future hold for our understanding and utilization of the tongue in medical and scientific fields?

• Bioengineering: Research into creating artificial tongues could lead to advances in taste testing and food industry applications.
• Neural Interfaces: The tongue’s sensitivity and neural connections make it a potential site for developing new types of human-computer interfaces.
• Diagnostic Tools: Advanced imaging and sensing technologies could enhance the tongue’s role in early disease detection and diagnosis.
• Regenerative Medicine: Understanding the tongue’s healing properties could inform new approaches to tissue regeneration and wound healing.

These potential developments underscore the continuing importance of tongue research in advancing our understanding of human physiology and developing new medical technologies.

How does the tongue work? – InformedHealth.org

Created: December 19, 2011; Last Update: August 23, 2016; Next update: 2020.

“Having something on the tip of your tongue,” “biting your tongue” or speaking “tongue-in-cheek” – this set of muscles covered with mucous membrane appears in so many idioms for good reason: the tongue is a true all-rounder. It is not only very movable, which allows us to speak, suck or swallow in a coordinated way. It is also a sensory organ responsible for tasting and the most sensitive place for our sense of touch. In addition, the tongue contains many cells of the body’s defense system, and even plays a major role in body language.

What is the tongue?

The tongue is an extremely movable set of muscles, which is well-supplied with blood and has many nerves. The tongue muscles have an oblong shape and are covered with a dense layer of connective tissue. Above this layer, a special kind of mucous membrane makes up the surface of the tongue.

The root of the tongue is firmly anchored to the floor of the mouth. The other parts of the tongue can move freely. A strip of tissue called the lingual frenulum connects the underside of the tongue to the floor of the mouth. When you close your mouth, the tongue almost fills up the entire cavity of your mouth. Various muscles keep the tongue “suspended” in the throat: Muscles and ligaments connect the tongue to the hyoid bone (or lingual bone) in the upper part of the throat and to the voice box. The lingual frenulum connects the tongue to the lower jaw. Some muscles even connect the tongue to the base of the skull.

Structure of the tongue

Back, tip, root – the sections of the tongue

The tongue can be divided into different sections:

• Tip and sides of the tongue: These are parts of the movable section of the tongue. These areas are very movable and can perform complex movements.

• Back of the tongue: The upper surface of the tongue is called the back of the tongue. It has many sensory cells for our senses of taste and touch.

• Root of the tongue: The root of the tongue cannot move freely and is connected to the floor of the mouth. It is also called base of the tongue and cannot be seen from outside the mouth.

Rough or velvety: the surface of the tongue

If you look at your tongue in the mirror, you usually see a slightly white, matt surface. The back of the tongue is curved outwards slightly, and in the middle it falls towards the groove that divides the tongue in half lengthwise.

The rough surface of the tongue is due to a special feature of the mucous membrane: the papillae, which appear as many small bumps on the tongue. They are formed by cells bulging up from underneath. These papillae have different jobs to do:

Mechanical papillae

These papillae anchor the mucous membrane firmly to the tongue. They also sense touch so that we can feel the form and texture of food in our mouth.

Taste papillae

Taste papillae make the surface of the tongue much larger. This allows the greatest number of sensory cells embedded there to have contact with food particles for tasting.

Saliva and food residue can get stuck in the grooves between the papillae, especially on the last third of the tongue. This can favor the development of putrefactive (rot-causing) bacteria. Then a whitish film covers the tongue, which also causes bad breath. These bacteria mainly live on remains of protein-rich food like fish, cheese or milk.

Underneath the tongue: always ready for absorption

If you stick out the tip of your tongue and move it upwards you can see the shiny surface underneath: The most noticeable part of it is the lingual frenulum and a vein on either side of it, which can be seen as bluish strings underneath the mucous membrane. The two salivary glands of the lower jaw (submandibular glands) have their ducts where the tongue meets the floor of the mouth.

The mucous membrane of the tongue can absorb some substances – for example medications that are to act quickly. The tablet, fluid or spray is put underneath the tongue, but is not meant to be swallowed. This is called sublingual administration (from the Latin: lingua, meaning “tongue” or “language”).

One example is nitroglycerin spray used in sudden chest pain caused by reduced blood flow through the coronary arteries. This spray acts very quickly because it directly enters the bloodstream. If it was swallowed it would have to pass the stomach and bowel to reach the liver. There it would be only partly broken down before being made suitable for use by the body.

Unique to the body: three-dimensional muscle fibers

The tongue has a great ability to move in all directions. The reason for this is the way the muscle fibers are arranged, which is unique in our body. They run in all three directions: from front to back, from the sides to the middle and from top to bottom. This allows the tongue to make the following movements:

• Extending and contracting: The tongue is the only muscle in our body that can actively contract and extend. When the vertical and horizontal fibers contract at the same time, the tongue becomes narrower and longer: we can stick our tongue out.

• Raising and lowering

• Bending backwards

• Advancing and retracting

• Rounding or hollowing

• Making grooves

• Changing its position: Additional muscles can change the position of the tongue: They pull into the tongue from the front (from the lower jaw), from below and behind (from the hyoid bone) and from above and behind (from the base of the skull).

The tongue’s jobs

Eating and drinking

Being extremely movable, the tongue’s main job is helping us eat: It enables us to suck, turns solid food into a mash that can be swallowed (bolus) and starts the act of swallowing. The tongue can also differentiate many tastes and flavors, which helps us tell whether the food is good for us.

Sucking

The tongue is vitally important, particularly for babies when breastfeeding. It works like a piston, with the cavity of the mouth being the cylinder: When then tongue moves backward in the closed mouth it produces low pressure, which sucks in fluid for drinking.

Chewing, grinding, pressing, salivating

When we chew, the tongue and the cheeks work together to constantly move the food between the teeth so that it can be chewed. The tongue presses the crushed food against the palate and moves this bolus, which is then ready to be swallowed, to the throat. The movements of the tongue also massage small glands directly underneath it and squeeze out saliva. This starts pre-digestion of the food, and the bolus can glide down the esophagus more easily.

Swallowing

The tongue presses the bolus into the throat, which starts the process of swallowing.

Tasting

The tongue’s mucous membrane contains many taste receptors to test the things we eat and drink. They are found in the taste buds where they are arranged like orange sections around a fluid-filled funnel. This is where the chemical substances responsible for taste are washed up and recognized by the sensory cells. The sense of taste used to be vital to our survival because it was the only way to test food and tell the difference between good and poisonous or bad food. Many taste stimuli also trigger increased production of saliva and stomach acid to start digestion.

Touching

The tip of the tongue is the part of the body that is most sensitive to touch. This fine sensitivity to touch has two main tasks: On the one hand, it tests the mechanical characteristics of the food. This high level of sensitivity is the reason why small stones, bone splinters or fish bones feel much larger than they really are. This magnifying effect of the tongue protects us. On the other hand, the tongue searches the entire mouth for remaining rests of food after the first bite.

Speaking

Humans also use the tongue’s movability for speaking. Only when tongue, lips and teeth work together do sounds from the throat turn into understandable letters and words. The tongue is extremely agile and quick: It can produce more than 90 words per minute, using more than 20 different movements. The tongue is essential for pronouncing the consonants “t,” “d,” “l” or the rolling “r.” When pronouncing the letter “k” the tongue is slightly narrowed at the back. And when we say “s,” the tip of the tongue moves backwards. If the tip of the tongue remains between the teeth, we hear a typical lisp.

The fact that the tongue is essential for speaking can also be seen in the ability of parrots to imitate human language: Although they only have a very simple organ of speech with fewer muscle groups than humans, they have an extraordinarily thick tongue. This helps them to produce the sounds of human language. They can touch the tip of their tongue to certain points of articulation in their mouth to imitate human words in a deceptively similar way.

Defending

All the defense cells of the tongue are collectively called the lingual tonsil (tonsilla lingualis). It is found in the back of the mouth at the base of the tongue and is part of the lymphatic tonsillar ring. Together with the palatine tonsils and the adenoids, the lingual tonsil is responsible for defending the body against germs that can come in through the mouth.

Sources

• Menche N. (ed.) Biologie Anatomie Physiologie. Munich: Urban & Fischer/ Elsevier; 2012.

• Pschyrembel W. Klinisches Wörterbuch. Berlin: De Gruyter; 2014.

• Schmidt R, Lang F, Heckmann M. Physiologie des Menschen: mit Pathophysiologie. Heidelberg: Springer; 2011.

• IQWiG health information is written with the aim of helping
  people understand the advantages and disadvantages of the main treatment options and health
  care services.

  Because IQWiG is a German institute, some of the information provided here is specific to the
  German health care system. The suitability of any of the described options in an individual
  case can be determined by talking to a doctor. We do not offer individual consultations.

  Our information is based on the results of good-quality studies. It is written by a
  team of
  health care professionals, scientists and editors, and reviewed by external experts. You can
  find a detailed description of how our health information is produced and updated in
  our methods.

Beckman Oral Motor – Impairments: Toung Patterns

Normal Tongue Patterns

Tongue movements are an integral part of the eating process. The following six normal patterns (suckling, simple tongue protrusion, sucking, munching, tongue tip elevation and lateral tongue movements) are presented in order from primitive to more mature patterns.

Suckling

The primary movement in suckling is extension – retraction. The tongue does not extend beyond the lips. Lateral movement is not observed. The tongue may show a semi-bowl shape (cupping). The tongue remains flat and thin. The movement is accomplished with normal tonal changes with rhythmical cycles of extension – retraction. Jaw opening and closing occur in conjunction with tongue movement. This is a normal but primitive pattern.

Simple tongue protrusion

This is a primitive, normal movement associated with the suckling pattern. The tongue extends between the teeth or gums. The tongue remains flat and thin with no abnormal tonal changes. (In the normal population, this may be called tongue thrust, especially by speech pathologists.)

Sucking

The tongue is flat and thin, movement is up and down and is contained within the mouth. The tongue tip elevates to the anterior hard palate. The movement is rhythmical, up-down cycles, with normal tonal changes. This is the primary pattern for adults. The normal rhythm for nutritive sucking is one cycle per second; non-nutritive suck is faster or slower than that rate. A suck occurs with two kinds of pressure: positive pressure and negative pressure. Positive pressure occurs when the jaw elevates, the tongue elevates to the hard palate, and the lips seal. Negative pressure occurs when the jaw drops, the tongue moves away from the hard palate, the posterior cheeks contract, the soft palate elevates, and the lips remained sealed. More coordination is needed for the negative phase of suck.

Tongue tip elevation

This pattern emerges during suck. The anterior one-third of tongue raises upward to contact the upper teeth or alveolar ridge (gums behind upper teeth). It indicates separation of tongue and jaw movement. This movement continues to develop so that the tongue tip can reach the upper lip, even when the jaw is depressed.

Munching

The primary movement of the tongue is up and down with flattening and spreading. Lateral tongue movements are not observed during this pattern. Tongue movements are accompanied by up and down movement of the jaw for chewing and biting. This is a normal tongue pattern observed in early chewing. Food is positioned on the body of the tongue and raised upward to the palate to break up the food prior to swallowing. Soft, lumpy foods, ground meats, and foods that dissolve in saliva (such as crackers), are tolerated with this chewing pattern. All of these patterns are normal, but do not involve any lateral tongue movement. The person cannot move food between molars for chewing. Since this is needed for chewing more viscous foods, s/he fails to move along the continuum of greater variety and separation of tongue, lip, and jaw patterns. The person is limited to a diet which does not require chewing and grinding, such as a pureed diet.

The final tongue movements to consider are:

Lateral tongue movements

The tongue moves to either side, horizontally, to shift food from the center of the mouth to the side. Initially, the tongue may barely shift toward the gum. As skill develops, the tongue will contact the gum or molars. With more control, the tongue will move over the gums or molars. With continued development, the tongue will extend into either cheek. As skills develop, the tongue can move food from one side across the midline to the other side. As movements become more defined, lateral and tongue tip elevations are combined to allow sweeping/cleaning movements of lips, palate, and inside the cheeks. This allows particles of food to be gathered and positioned on the tongue prior to swallowing.

Tongue tremor

Rapid, small movements of the tongue during purposeful activity, such as sucking. A mildly abnormal pattern indicating fatigue. May be observe in nursing infants during sucking.

Exaggerated tongue protrusion

The tongue shows extension (forward movement) beyond the border of the lips which is non-forceful. The movement is a rhythmical extension-retraction pattern. It is similar to a suckle pattern, but is mildly abnormal.

Tongue thrust

The tongue is thickened and bunched. The movement is an outward extension beyond the border of the lips. The movement is forceful, and is associated with an abnormal increase in muscle tone. This may occur as part of a total extension pattern of the body, or with hyperextension of the head and neck. The tongue thrust may make it difficult to insert a utensil into the mouth or may cause food to be ejected during feeding. During drinking, the tongue may thrust into the cup or may protrude in a very tight, bunched fashion beneath the cup.

Tongue retraction

In this abnormal movement, the tongue appears thickened and bunched. The movement is retraction, a strong, pulling back of the tongue into the posterior portion of the oral cavity, associated with abnormal increased muscle tone. The tip of the tongue is not forward and even with the lower lip. It is pulled back toward the middle of the hard palate and may be held firmly against the hard or soft palate. Hard approximation of the tongue with the palate may make insertion of utensils extremely difficult and may make it nearly impossible for any food to be placed on top of the tongue for swallowing. Gagging may be increased for the person with this pattern. Severe tongue retraction can partially block the laryngeal airway contributing to added respiratory problems during feeding. Tongue retraction may be associated with other patterns of retraction or extension in the body (i.e., shoulder retraction or neck extension) or it may be an abnormal pattern used as compensation by a person with poor swallowing patterns. When a person has swallowing difficulties, food which moves rapidly or is very thin may be uncontrollable and life threatening when the tongue is more forward. In such cases, the tongue retracts, resulting in reduction of the size of the pharyngeal opening. This pattern is associated with abnormal increased muscle tone.

Asymmetrical tongue placement or movement

The tongue deviates to one side or the other and may show atrophy on the affected side. It may be accomplished by or associated with abnormal tone in the facial musculature. All movements of the tongue are affected. The tongue deviates, or is pushed toward the weak side. If lateral tongue movement is consistently observed only to one side, it may not be active lateral movement, but rather may be asymmetrical movement toward the weak side.

A Hypotonic tongue

A hypotoic tongue may appear thickened and shows little or no active movement. Fasciculations, small, uncoordinated movements over the body of the tongue, may be observed when the tongue is at rest. These movements may increase during eating, drinking, swallowing and vocalizations.

Dystonic tongue movement

This is a rhythmical, nonfunctional movement of the tongue associated with Parkinson’s or Parkinson’s like symptoms. The ability to interrupt the movement is related to the severity of the disease. With less severe involvement, the pattern can be interrupted during functional activities such as eating or speech, and will not be observed during sleep.

Tongue fasciculations

An abnormal pattern of nonrhythmical, unorganized contraction of individual muscle fibers across the surface of the tongue. May be observed when the tongue is at rest, or following direct stimulation to the tongue. May also be observed during generalized hypertonicity or hypotonicity affecting the whole body. Ankyloglossia – A structural impairment consisting of a shortened lingual frenulum. Body of the tongue is thinned, with the lateral borders elevated. A heart shaped indention may be noted at the front edge of the tongue. Function is limited if the tongue tip can lift less than 1/4″ above the lower incisors. Pseudo Ankyloglossia – A functional impairment in which the body of the tongue is thickened and retracted. The lingual frenulum appears as a prominent white fiber at the center of the tongue tip. The end of the tongue is blunt and thick.

Understanding tongue movement in infants

2 min.

Sept. 2021

This resource is for healthcare professionals

Researchers have used video recording for the first time to see differences in tongue movements between breastfed infants and adults when swallowing.

The tongue is an active muscle and a miracle of coordination. When we drink, the tongue prepares for swallowing by collecting liquid in the mouth, taking the shape of a bowl. It then quickly pushes the liquid back where it is swallowed, while still allowing us to continue breathing.

When we eat, the tongue works by holding the food in the mouth, moving it with saliva and turning it into a lump, which is then pushed back for swallowing. Both adults and infants use a peristaltic type of movement when swallowing.

Language training before birth

Teaching our tongue to do all this work begins in the womb. Before birth, the tongue begins to work by swallowing the amniotic fluid. After the birth of a child, the tongue plays a key role – it helps to squeeze milk out of the mother’s breasts, working in conjunction with the jaws and lips.

When the baby is suckled to the mother’s breast, the nipple and areola are retracted into the mouth so that the nipple reaches the junction of the hard and soft palate. After the baby has sucked well, the tongue begins to work, rhythmically squeezing the nipple with peristaltic movements that squeeze the milk from the mammary gland into the back of the throat, where it is swallowed. Babies naturally coordinate sucking, swallowing, and breathing.

Bottle feeding

This process changes slightly when a baby is bottle fed. The stiffness of the artificial material does not allow the nipple to stretch and take the shape of the baby’s mouth. Peristaltic movements of the tongue are difficult and milk can flow almost without effort on the part of the child.

Parents should remember that during breastfeeding, babies make an effort to get milk. When bottle-feeding, milk often flows very easily and babies can drink the same amount of milk much faster (compared to breastfeeding). This may seem like a good way to save time, but as with many other things in life, slower is often better. If you choose a bottle that works more like a breast, with a slower flow, it allows the baby to stop and pause, the baby enjoys comfortable feeding, and the corresponding satiety signals are developed more slowly.

Research task

Usually everything goes smoothly. But from time to time, babies have difficulty swallowing. This may be due to various problems and they are not always easy to learn and understand.

At the beginning of the atomic era, diagnostics were carried out with the help of X-ray cinematography (filming of X-ray images). For the first time in history, people could see the amazing internal processes in the mouth and observe how the tongue helps to swallow. When concerns arose about the effects of radiation on technicians and patients, the practice was discontinued. Currently, video recording using ultrasound and MRI is often used. However, even with the use of less invasive methods or technologies, scientists still have to find ways to study babies while breastfeeding that do not affect their actions.

Tongue Movement Study

The 2020 study “Quantifying Tongue Movement During Feeding in Infants and Swallowing in Adults” shows patterns. The scientists used ultrasound video to study tongue movements.

“We observed the most organized and rhythmic tongue movements in exclusively breastfed infants, less mobility in those who had conditions that interfere with normal feeding, such as tongue tie, and more “disorganized” movements with bottle feeding than breastfeeding,” the researchers report. “This highlights the key role of tongue movements in breast or bottle sucking.”

Disorganized movements with bottle feeding than with breastfeeding,” researchers report. “This highlights the key role of tongue movements in breast or bottle sucking.” They could also observe differences in tongue mobility before and after treatment in infants with tongue and lip frenulum. And for the first time, pictures of a baby with torticollis during breastfeeding and bottle feeding were obtained. The results showed “slightly less rhythmic sucking than usual during breastfeeding and irregular sucking during bottle feeding.”

Although this study was limited, the use of ultrasound video was effective in obtaining objective information about tongue movements. As more scientists use this technique, we’ll get more information about how language works and we’ll be able to get more accurate information about natural feeding and how to deal with it.

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References

Genna CW, Saperstein Y, Siegel SA, Laine AF, Elad D. Quantitative imaging of tongue kinematics during infant feeding and adult swallowing reveals highly conserved patterns. Physiol Rep. 2021;9:e14685. doi.org/10.14814/phy2.14685

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