2018 Volume 22 Issue 3 Pages 237-248
The purpose of this study was to develop and investigate the use of a new mouthpiece for dysphagia rehabilitation. The concept was designed to effectively improve the swallowing function of patients with dysphagia performing a lingual exercise. The mouthpiece is made up of a hard medical silicone elastomer (MED-6019, NuSil Technology, USA) that has a slope part to properly press on the palate when the tongue lifts up in the oral cavity. The three prototypes with slope parts of 20°, 30°, and 40° angles were created to fit the form of the palate. The effects of using a mouthpiece in a lingual exercise on the swallowing function were investigated. A single-arm study design was performed on 20 ambulatory patients within a period of 3 months. The measurement points were pre-post exercise on the first day, 1 month, and 3 months later. The subjects wore the mouthpiece for 15 min per day at home and performed the lingual exercise for 3 min. The parameters measured included the tongue and lip strength using a tongue pressure measurement device (Orarize®, JMS), oral moisture degree using an oral moisture-checking device (Mucus®, Life), masticatory performance using a gum test, and swallowing frequency using a repetitive saliva swallowing test (RSST). Statistical analysis was carried out using a two-way ANOVA to compare the parameters during the intervention period and the training. Patients under 60 years and dropouts were excluded from the analysis. The data on thirteen elderly patients with mild dysphagia (73.5±6.4 years, 5 males and 8 females) were analyzed and showed that the main effect of the intervention period in the tongue pressure was significant (p＜0.05). The tongue pressure significantly increased 1 month later compared with that at the first day (p＜0.05) of intervention. In addition, an increase in the lip pressure and RSST score were noted after the intervention and after the exercise, respectively. The continuous lingual exercise with the mouthpiece increased the tongue pressure of elderly patients, which showed the potential of improving their swallowing function.
