Swallowing reflex

One contributor to this risk of fluorosis in children is the lack of control in the swallowing reflex, particularly in children younger than 3 years of age [96], Children are also known to like the taste of toothpaste, and hence to swallow it deliberately. A small toothbrush of the size appropriate for use by a child holds in the region of 0.75-1.0 g of toothpaste, which means that an individual blob of toothpaste provides between 0.75 and 1.0 mg of fluoride. It has been estimated that children below the age of six swallow a mean of 0.3 of toothpaste per brushing and this may be sufficient to lead to ingestion of enough fluoride to cause the mottling associated with fluorosis [97]. 

Some topical anesthetic preparations are marketed in spray containers. These containers make it difficult to control the amount of material expelled and to confirm the agent was applied to the desired site. If these agents are applied to the posterior part of the mouth, a patient may inhale enough of the aerosol spray to provoke a toxic reaction. Use of topical anesthetics on the posterior pharynx may alter the swallowing reflex. 

A client s gag and swallowing reflexes are assessed postoperatively for the client who has had general anesthesia. 

A delayed triggering of the swallowing reflex, mainly in elderly people, predisposes to aspiration pneumonia. To improve dysphagia, two different approaches using essential oils have been tried with success. 

Ebihara, T., S. Ebihara, A. Watando, et al., 2006b. Effects of menthol on the triggering of the swallowing reflex in elderly patients with dysphagia. Br. J. Clin. Pharmacol., 62 3 69-371. 

The patient is supine with the head in neutral position. A pillow is placed across the shoulders to allow the head to be slightly hyper-extended. This facilitates the recognition of the thyroid and the cricoid cartilages. The skin covering the space between the thyroid and the cricoid cartilage is anesthetized with 1% xylocaine. This permits the patient to feel less pain which in turn decreases the tension in the patient and the tendency to evoke the swallowing reflex. For purposes of introducing the electrode, the patient s larynx should be steady. 

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