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PubMed2004

The normal range of mouth opening in an Irish population.

The aims of this study were to estimate the average maximum mouth opening and range of mouth opening in a representative sample of the Irish adult population, to compare mouth opening in patients with and without signs or symptoms of temporomandibular joint (TMJ) dysfunction syndrome and to investigate the association between mouth opening and stature among populations. As part of the Irish National Survey of Adult Oral Health, maximum mouth opening was measured and questionnaire data collected for 1513 adults, aged 16-99 years. The average maximum mouth opening was 43 mm for males and 41 mm for females. Mouth opening was found to reduce with age, independent of gender. No link was found between reduced mouth opening and TMJ dysfunction or between mouth opening and stature in populations.

Adolescent↗
PubMed2004

Execution and observation of bringing a fruit to the mouth affect syllable pronunciation.

Kinematic analysis of lip and voice spectrum analysis were used to assess the influence of both execution and observation of arm-mouth-related actions on speech production. In experiments 1 and 2 participants brought either a cherry or an apple to their mouth and either pronounced the syllable BA (experiment 1) or emitted a nonspeech-related vocalization (experiment 2). In the other three experiments participants observed arm actions performed by the experimenter and pronounced the syllable BA. In experiment 3, they observed the action of bringing the cherry or apple to the mouth. In experiments 4 and 5, they observed a pantomime of the same action performed by the experimenter with his own arm (experiment 4) or with a nonbiological arm (experiment 5). The results showed that the formant 2 of the vowel 'a' increased when participants executed the bringing-to-the-mouth act with the apple or observed its execution or pantomime with the experimenter's arm (experiments 1, 3 and 4). In contrast, no modification in the vowel formants was found during a nonspeech-related vocalization (experiment 2) and during observation of an action with a nonbiological arm (experiment 5). Finally, the opening of the lips was larger when the participant brought the apple rather than the cherry to the mouth and pronounced BA (experiment 1). Taken together, the results of the present study suggest that the execution and observation of the bringing-to-the-mouth action activate a mouth articulation posture (probably due to the act of food manipulation with the mouth) which selectively influences speech production. They support the idea that the system involved in speech production shares and may derive from the neural substrate which is involved in the control of arm-mouth interactions and, in general, of arm actions.

Adult↗
PubMed2001

Grasp with hand and mouth: a kinematic study on healthy subjects.

Neurons involved in grasp preparation with hand and mouth were previously recorded in the premotor cortex of monkey. The aim of the present kinematic study was to determine whether a unique planning underlies the act of grasping with hand and mouth in humans as well. In a set of four experiments, healthy subjects reached and grasped with the hand an object of different size while opening the mouth (experiments 1 and 3), or extending the other forearm (experiment 4), or the fingers of the other hand (experiment 5). In a subsequent set of three experiments, subjects grasped an object of different size with the mouth, while opening the fingers of the right hand (experiments 6-8). The initial kinematics of mouth and finger opening, but not of forearm extension, was affected by the size of the grasped object congruently with the size effect on initial grasp kinematics. This effect was due neither to visual presentation of the object, without the successive grasp motor act (experiment 2) nor to synchronism between finger and mouth opening (experiments 3, 7, and 8). In experiment 9 subjects grasped with the right hand an object of different size while pronouncing a syllable printed on the target. Mouth opening and sound production were affected by the grasped object size. The results of the present study are discussed according to the notion that in an action each motor act is prepared before the beginning of the motor sequence. Double grasp preparation can be used for successive motor acts on the same object as, for example, grasping food with the hand and ingesting it after bringing it to the mouth. We speculate that the circuits involved in double grasp preparation might have been the neural substrate where hand motor patterns used as primitive communication signs were transferred to mouth articulation system. This is in accordance with the hypothesis that Broca's area derives phylogenetically from the monkey premotor area where hand movements are controlled.

Adult↗
PubMed2002

How do data from deepest pocket per quadrant relate to full-mouth scores? Progression of untreated periodontal disease in young Indonesians.

BACKGROUND: When the subgingival presence of periodontal pathogens is studied in groups of patients or populations, mostly a number of the deepest sites is sampled. The mean clinical parameters of these deep sites are also frequently used as a the descriptor of the clinical situation of these subjects. It can be questioned, whether these 4 deep sites are capable of predicting a full-mouth situation. AIM: The purpose of the present retrospective study was to investigate to what extent the experienced progression of periodontitis as measured in the deepest approximal pocket in each quadrant reflects the disease progression at the approximal sites on a full-mouth level. METHODS: A data set of a 7-year longitudinal study of 158 young subjects (69 male, 89 female, 15-25 years of age at baseline) was used. Clinical assessments included plaque index (PI), pocket depth (PD) and attachment loss (AL) at baseline (1987) and follow-up (1994). Measurements were made at the approximal surfaces of all teeth. The deepest pocket in each quadrant was determined at follow-up. Changes of the clinical parameters between baseline and follow-up were calculated both as full-mouth mean scores as well as for these 4 deepest sites. A regression analysis was used to evaluate the relationship between full-mouth score and the 4 test sites. RESULTS: For disease progression between baseline and follow-up, significant correlation coefficients were observed between the 4-site and full-mouth mean changes (PD: 0.80, AL: 0.70, PI: 0.77). Regression coefficients were 0.51 for PD, 0.35 for AL and 0.55 for PI. The precision of the estimate for the full-mouth mean, as predicted by the 4-site mean, is determined by the residual standard deviation. This was for PD 0.31 mm, for AL 0.31 mm and for PI 0.29. Compared to the between-patient standard deviation of the full-mouth means, the residual standard deviations were high. CONCLUSION: In the present population, a reasonable to good correlation between full-mouth and 4-sites data was observed. However, the high residual standard deviation in the regression analysis illustrates the inaccuracy for the 4-sites data when used as a descriptive for changes in the periodontal condition on a full-mouth level. Data evaluating progression of periodontitis based on a limited number of diseased sites should be interpreted cautiously.

Adolescent↗
PubMed2003

Reducing the risk of choking hazards: mouthing behaviour of children aged 1 month to 5 years.

Young children have a natural tendency to mouth items to explore their environment. Mouthing carries mechanical and chemical hazard potential for injury to the child, for example if they swallow an item they may choke, they may cut themselves on sharp items, and certain chemicals are present in plastic items which may pose a risk to children. Few data are available on the time that young children mouth items, how they mouth, and what they mouth. This study gathered data on 236 children aged between 1 month and 5 years to supplement and extend existing data. Findings are presented of estimated average and maximum daily mouthing times for children, how they mouth, what they mouth, and whether the items mouthed were intended to be. A validation study was carried out to determine the accuracy of the parental observation method used to gather the data. The implications of the findings of this study are discussed with respect to reducing the potential for mechanical accidents in the home.

Airway Obstruction↗
PubMed2002

[Burning mouth syndrome and depression: a case report].

We present a 63-year-old male patient with major depression, characterised by prominent somatic symptoms localised especially around the mouth, whose complaints started just after a prostate operation. The symptoms consisting of burning in the mouth, pain, dry mouth (xerostomia), an unpleasant and strange feeling of taste and itching, are all consistent with burning mouth syndrome. Burning mouth syndrome is a common disorder, usually affecting elderly females, characterised by intractable pain and burning in the oral cavity, evident especially in the tongue, together with a normal mouth mucosa. In the scientific literature a variety of terms are used to describe similar symptoms, such as glossodynia, glossopyrosis, stomatodynia and oral dysestesia. Most patients suffer from the syndrome for a long time, ranging from months up to years. The onset was reported to be gradual for most of the subjects, although many patients relate the onset of symptoms to previous dental procedures or to a previous medical illness. Burning mouth syndrome has a multifactorial etiology. Anxiety disorder, hypochondriasis, conversion disorder and especially depression may be considered amongst the psychological factors responsible for this situation. The psychological findings in burning mouth syndrome patients may be either the consequence of the chronic pain condition or its cause. It is well known that those patients had a relatively high percentage of psychiatric or psychological treatment in the past and/or present. After excluding organic factors, depression should be considered in old patients with predominant mouth complaints.

English Abstract↗
PubMed1994

Improving mouth guards.

Mouth guards and materials were tested to provide information for a more protective yet more comfortable product. Ethylene-vinyl acetate copolymer materials varying in thickness and stiffness were tested for their mechanical, thermal, and water-absorption properties. Thickness was measured before and after fabrication of the mouth guard. During fabrication, thicknesses decreased from 25% to 50% for the custom-fabricated mouth guards and 70% to 99% for the mouth-formed (boil-and-bite), off-the-shelf, over-the-counter mouth guards. The thicker the material is, the greater the resulting energy absorption is. It is therefore essential that the thickness in the occlusal portion of the mouth guard remain optimal after fabrication. A mouth guard with a stiffer insert, which softens at a higher temperature in the occlusal portion, is proposed as a more protective mouth guard.

Absorption↗
PubMed1988

Fetal mouth movements during behavioural states 1F and 2F.

The aim of this study was to investigate the characteristics of mouth movements during behavioural states 1F (quiet sleep) and 2F (active sleep) in the near term human fetus. Thirty-six women participated. Fetal heart rate and fetal movements were recorded for 2 hours continuously. Videotapes with enclosed periods 1F and 2F were replayed to record fetal mouth movements in detail. During 1F, regular mouthing movements dominated (present in 74%), while jaw opening, yawn and grimace were only observed in 5 to 16% of the recordings. Tongue protrusion was not observed in 1F. In all 2F periods jaw opening was present (100%), while tongue protrusion, yawn and grimace were also frequently observed. Regular mouthing was observed in 2F in only two fetuses. For regular mouthing and sucking, onset-to-onset intervals of clusters, cluster duration, and number and frequency of movements within clusters were calculated. In all aspects the differences between these two types of movement were statistically significant. Within the clusters of regular mouthing a decline in the mouthing frequency was found. The data on fetal regular mouthing correspond with observations in the neonate.

Female↗
PubMed2000

Face and mouth inversion effects on visual and audiovisual speech perception.

Three experiments examined whether image manipulations known to disrupt face perception also disrupt visual speech perception. Research has shown that an upright face with an inverted mouth looks strikingly grotesque whereas an inverted face and an inverted face containing an upright mouth look relatively normal. The current study examined whether a similar sensitivity to upright facial context plays a role in visual speech perception. Visual and audiovisual syllable identification tasks were tested under 4 presentation conditions: upright face-upright mouth, inverted face-inverted mouth, inverted face-upright mouth, and upright face-inverted mouth. Results revealed that for some visual syllables only the upright face-inverted mouth image disrupted identification. These results suggest that upright facial context can play a role in visual speech perception. A follow-up experiment testing isolated mouths supported this conclusion.

Adult↗
PubMed2003

Mirror neurons responding to the observation of ingestive and communicative mouth actions in the monkey ventral premotor cortex.

In the ventral premotor cortex (area F5) of the monkey there are neurons that discharge both when the monkey performs specific motor actions and when it observes another individual performing a similar action (mirror neurons). Previous studies on mirror neurons concerned hand actions. Here, we describe the mirror responses of F5 neurons that motorically code mouth actions. The results showed that about one-third of mouth motor neurons also discharge when the monkey observes another individual performing mouth actions. The majority of these 'mouth mirror neurons' become active during the execution and observation of mouth actions related to ingestive functions such as grasping, sucking or breaking food. Another population of mouth mirror neurons also discharges during the execution of ingestive actions, but the most effective visual stimuli in triggering them are communicative mouth gestures (e.g. lip smacking). Some also fire when the monkey makes communicative gestures. These findings extend the notion of mirror system from hand to mouth action and suggest that area F5, the area considered to be the homologue of human Broca's area, is also involved in communicative functions.

Action Potentials↗
PubMed2003

The influence of working cast residual moisture and temperature on the fit of vacuum-forming athletic mouth guards.

STATEMENT OF PROBLEM: The comfort and effectiveness of athletic mouth guards are believed to depend on their degree of fit to oral tissues. Vacuum-forming machines are simpler and less expensive than pressure-forming machines. However, it is thought that vacuum-formed mouth guards often do not exhibit adequate adaptation. PURPOSE: The purpose of this study was to evaluate the effects of cast residual moisture and temperature on the fit of athletic mouth guards made with a vacuum-forming machine. MATERIAL AND METHODS: A metal master model simulating the cross section of the maxillary molar region was used to form 20 working plaster casts. The casts represented 4 (5 specimens each) conditions before the forming of the mouth guard specimens: storing in a wet environment at room temperature and storing in a dry environment at room temperature, 5 degrees C, and 40 degrees C. Mouth guard specimens were fabricated with ethylene vinyl acetate sheets (3.8-mm thick) with the use of a vacuum-forming machine. Test casts were created by pouring hand-mixed type III dental stone into each of the mouth guard specimens. The differences in the sagittal cross-sectional heights at the line angle area of the test casts and the working casts were compared. This was achieved by superimposing their 3-dimensional images scanned by a laser scanner. The air permeability was also measured for the hand-mixed stone casts under wet and dry conditions, the vacuum-mixed stone cast, and the high-strength stone specimen. This was achieved by measuring the volume of transmitted air passing through the specimen in the testing tube. One-way analysis of variance with the Scheffé post hoc test (P <.05) was applied to determine the conditions of the working cast required to achieve the best fit. RESULTS: With regard to the fit of the mouth guard specimens to the working cast, those with dry and heated working casts showed a significantly better fit than those with wet working casts (P<.05). A significantly larger volume of transmitted air was found in the dry stone specimen (P<.05) followed by the dry high-strength stone cast and then the wet stone cast. CONCLUSION: Within the limitations of this study, residual moisture in the working cast was the most critical factor in determining the fit of the mouth guard made by vacuum-forming machines. The best fit was achieved when the working cast was thoroughly dried and its surface temperature was elevated.

Air↗
PubMed2005

A test of mouth-opening and hyoid-depression mechanisms during prey capture in a catfish using high-speed cineradiography.

Detailed morphological analyses have identified a number of different mechanical pathways by which the morphologically complex cranial system of fishes can achieve mouth opening and hyoid depression. However, many of these proposed mechanisms remain untested. Furthermore, very little is known about the precise timing of activity of each of these mechanisms, and about the magnitude of each mechanism's total contribution to its proposed function. In the present study, all mouth opening and hyoid depression mechanisms described for Clarias gariepinus, an air-breathing catfish, are analysed. High-speed X-ray videos were recorded during prey capture of three catfish implanted with small, radio-opaque markers in the cranial elements potentially involved. A kinematic analysis was performed from which data were used as input in planar four-bar models. This analysis shows that the opercular mouth-opening mechanism initiates mouth opening, but is not able to cause the complete mouth openings as observed on the X-ray videos. The latter is accomplished through the protractor hyoidei muscles, which couple hyoid depression to lower jaw depression in a four-bar system and also reinforce lower jaw depression by shortening during the final stage of mouth opening. Although the angulo-ceratohyal ligament was previously hypothesised to play a part in mouth opening, our results show that it probably does not, but rather functions as a hyoid-elevator during mouth closure. Finally, hyoid depression is exclusively achieved by the four-bar mechanism involving neurocranial elevation and pectoral girdle retraction, generally without any reinforcement by shortening of the sternohyoideus muscle. In contrast to the results from a recent analysis on sunfish, the catfish's sternohyoideus gradually elongates during hyoid depression.

Animals↗
PubMed1991

Mouth lesions in broiler chickens caused by scirpenol mycotoxins.

Dietary scirpentriol (STO), triacetoxyscirpenol (TAS), monoacetoxyscirpenol (MAS), and diacetoxyscirpenol (DAS), mycotoxins produced by Fusarium species, were compared for their ability to cause mouth lesions when graded dietary levels (0, 1, 2, 4, and 8 micrograms STO or TAS/g; 0, .5, 1, 2, and 4 micrograms MAS or DAS/g) were fed to male broiler chickens for 21 days after hatching. The mouth lesions provoked by each scirpenol were dose-related. The minimum effective doses (MED) were 4, 2, 1, and .5 micrograms/g for TAS, STO, DAS, and MAS, respectively, whether the number of affected birds or the number of affected mouth parts (angles, upper beak, lower beak, and tongue) was the measured response. Lesion sites in the mouth varied with the toxin. The rank orders from greatest to least affected sites were angles, upper beak, lower beak, and tongue for TAS and STO, upper beak, lower beak, angles, and tongue for MAS, and upper beak, lower beak, tongue, and angles for DAS. Mouth lesions were clearly visible with each toxin after feeding for 1 wk and the numbers of affected mouth parts almost tripled after 2 wk exposure. During Week 3 of exposure, only the increase caused by MAS was significant (P less than .05). The MED for growth inhibition were 2, 2, 2, and 8 micrograms/g for STO, MAS, DAS, and TAS, respectively. Thus, mouth lesions were of equal or greater sensitivity than growth inhibition as an indicator of scirpenol toxicity. It would appear that the discovery of mouth lesions in birds justifies a mold and mycotoxin control program.

Acetylation↗
PubMed1997

["Forced mouth opening reaction" associated with corticobasal degeneration].

Corticobasal degeneration (CBD) is a slowly progressive disorder characterized by an asymmetrical akinetic-rigid syndrome, supranuclear ophthalmoplegia, dystonia, often accompanied by involuntary movements, particularly myoclonus, and associated with lateralized cortical signs such as alien limb behavior and apraxia. Computerized tomography demonstrates asymmetrical frontoparietal cortical atrophy in the later stages of the illness. Neuropathological examination reveals neuronal loss, gliosis and swollen achromatic neurons within the frontal and temporal cortices, and the substantia nigra. We discuss here a unique phenomenon not described so far in three patients with clinical features of CBD, one with subsequent autopsy observations. When awake, they all showed a common behavior, their mouth opened constantly and immediately, when a tongue-depresser was approached in front of it by the examiner. In two of them, their mouth also opened when its corner was stroked by a tongue-depressor. They could not control these phenomena at all, even they were asked not to open their mouth. We would like to call these phenomena "forced mouth opening reactions" because they were uncontrollable voluntarily. They may be divided into two groups, i.e. visual and tactile "forced mouth opening reactions". In all the patients the neurological, neuro-imaging and neuropathological data showed that the frontal lobes were damaged. Additionally, they had some frontal lobe release signs such as forced grasping, forced groping, or alien limb sign. We would like to apply the mechanism for these release signs to the "forced mouth opening reactions". Thus, we speculate that the frontal lobe contains a higher motor control mechanism for normal mouth opening movement, and the "forced mouth opening reactions" result from impairment of this control.

Basal Ganglia Diseases↗
PubMed2000

Immunoperoxidase detection of polycyclic aromatic hydrocarbon-DNA adducts in mouth floor and buccal mucosa cells of smokers and nonsmokers.

Tobacco smoking is a major risk factor for oral cancer; mouth floor and buccal mucosa are among the most and least cancer-prone subsites, respectively, in the oral cavity. We investigated the applicability of immunohistochemistry of smoking-induced DNA adducts in oral cells for assessing the exposure to carcinogens, and estimating the risk for oral cancer. Polycyclic aromatic hydrocarbon (PAH)-DNA adducts were measured in mouth floor and buccal mucosa cells of smokers (n = 26) and nonsmokers (n = 22) by means of a semiquantitative immunoperoxidase assay. Smokers had elevated levels of PAH-DNA adducts compared to nonsmokers in their mouth floor cells (0.045 +/- 0.022 versus 0.022 +/- 0.016, P = 0.0008 arbitrary units of immunohistochemistry) as well as in their buccal mucosa cells (0.058 +/- 0.028 versus 0.028 +/- 0.012, P = 0.001). Also, there was a correlation between the levels of PAH-DNA adducts in mouth floor cells and those in buccal mucosa cells (r = 0.4, P = 0.01). Furthermore, PAH-DNA adduct levels in both mouth floor and buccal mucosa cells were significantly related to current smoking indices (amount of tar and number of cigarettes consumed per day). Expectedly, the levels of PAH-DNA adducts neither in mouth floor cells nor in buccal mucosa cells, both being short-lived cells, were related to smoking history index (pack years). The levels of PAH-DNA adducts, however, in mouth floor cells as the cancer prone cells were lower than those in buccal mucosa cells (0.037 +/- 0.023 versus 0.044 +/- 0.026, P = 0.04). We conclude that immunohistochemistry of PAH-DNA adducts in oral cells can be used for exposure assessment of tobacco-related carcinogens, however, it cannot be used for oral cancer risk estimation.

Adult↗
PubMed2005

Comparison of dry mouth in women treated with extended-release formulations of oxybutynin or tolterodine for overactive bladder.

The incidence, severity and tolerability of dry mouth was compared in 790 women with overactive bladder who were treated with extended-release oxybutynin chloride 10 mg/day or extended-release tolterodine tartrate 4 mg/day for 12 weeks in a multicenter, double-blind, parallel-group study. Dry mouth was the most common adverse event associated with treatment, with an incidence rate of 28.1% in the oxybutynin group and 21.6% in the tolterodine group (P = 0.039). The majority of dry mouth events were mild in both treatment groups. Severe dry mouth occurred in 1.5% and 0.5% of patients in the oxybutynin and tolterodine groups, respectively (P = 0.173). Seven patients on extended-release oxybutynin and 4 patients on extended-release tolterodine discontinued treatment due to dry mouth (P = 0.380). The results of this analysis showed that dry mouth was common with both treatments, but most events were mild; there was no difference in the rate of severe dry mouth or in the rate of withdrawal due to dry mouth.

Adolescent↗
PubMed2002

Effects of mouth dryness on drinking behavior and beverage acceptability.

In humans, the association between mouth dryness and thirst has been examined in a variety of contexts. Typically, drinking behavior produces a concomitant reduction in unpleasant dry mouth sensations. Evidence is reviewed for a mechanism that influences the termination of drinking behavior by metering this change. Drinking behavior causes a progressive increase in parotid saliva flow. Thus, one possibility is that satiety results from a decrease in the reward associated with mouth wetting during a drinking episode. Beverages can differ in their satiating ability. This variability may be related to their mouth-wetting characteristic, and may be reflected in a shift in their acceptability when the mouth becomes dry. Physically drying the mouth appears to increase the acceptability of beverages that are either cold or acidic. It may be significant that two important determinants of mouth wetting are temperature and acidity. Cold or acidic beverages are also likely to be regarded as 'thirst-quenching.' Thus, shifts in acceptability, 'thirst quenching' and satiety may all be related to the mouth-wetting properties of a beverage. The extent to which this coincidence is meaningful warrants further investigation. However, if a common underlying process exists, then this may help to elucidate reasons for voluntary dehydration and aberrant drinking behavior in the elderly.

Animals↗
PubMed2002

A critical analysis of the philosophy, knowledge and theory underpinning mouth care practice for the intensive care unit patient.

In the provision of high quality mouth care practice for the intensive care unit (ICU) patient, the nurse draws on philosophy, knowledge and theory. The complexity of mouth care for the ICU patient is compounded by their medical or surgical condition and the psychological effects of mouth care problems. Effective mouth care practice includes proactive prediction and prevention of complications, and prompt and skilled intervention in the problems arising. Therefore, critical analysis of the philosophy, knowledge and theory relevant to mouth care practice is important. The philosophical approach to mouth care requires the nurse to view the practice from different perspectives. Nursing knowledge has inextricable links with nursing practice that challenges the nurse in her/his everyday work. This application of knowledge to practice is conceptualised as ways of thinking, which is also based on what the nurse might know. Therefore, the judicious use of theory and the necessary skills are essential to provide high quality and effective mouth care practice. The purpose of this paper is to illustrate the ways in which philosophy, knowledge and theory all have an impact on the practice of mouth care for the ICU patient.

Humans↗