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January 19, 1979

Influence of Chew on Swallow

JAMA. 1979;241(3):238. doi:10.1001/jama.1979.03290290012005

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To the Editor.—  The report "Esophageal Mythology" (240:44,1978) fails to mention the influence of chew on swallow. Experience with patients whose esophageal spasm was resolved by equilibration of their dentition prompts me to comment to the physician about the value of consultation with a dentist competent in treating malfunctions of chew.Aberrant patterns of chewing caused by malocclusion or neuromotor abnormalities can lead to considerable confusion at the terminus of chew and the start of swallow. This interface within the pattern of eating involves the transfer of the bolus from the complex neuromotor system of mastication to that of the swallow reflex. The concomitant involvement of the vagus nerve encumbered by a confused trigger signal sets up the mischief of abnormal esophageal function. This syndrome may also be the precursor of café coronary.