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RESEARCH ARTICLE
Effect of changes in the breathing mode and body position on
tongue pressure with respiratory-related oscillations
Shigeki Takahashi, DDS,a Takashi Ono, DDS, PhD,b Yasuo Ishiwata, DDS, PhD,c and
Takayuki Kuroda, DDS, PhDd
Tokyo, Japan
The purpose of this study was to examine whether tongue pressure on the lingual surface of the mandibular
incisors shows respiratory-related changes, with particular attention paid to its relationship to genioglossus
electromyographic activity, and to determine the effect of changes in the mode of breathing and body
position on tongue pressure. Tongue pressure was recorded with a miniature pressure sensor incorporated
in a custom-made intraoral appliance in nine male subjects in different breathing modes and body positions.
Electromyographic activity of the genioglossus muscle and respiratory-related movement were recorded
simultaneously. Tongue pressure showed respiratory-related cyclic oscillations, with a maximum value
during expiration and a minimum value during inspiration. In contrast, the activity of the genioglossus
muscle showed a maximum amplitude during inspiration and a minimum amplitude during expiration. The
maximum tongue pressure during oral breathing was significantly greater (P < .01) than during nasal
breathing in both the upright and supine positions. Changes in body position significantly affected the
maximum tongue pressure during oral breathing. The activity of the genioglossus muscle changed
significantly with different breathing modes and body positions. Changes in the position of the hyoid bone
produced by changes in the breathing mode and body position appear to have a critical role in determining
tongue pressure. (Am J Orthod Dentofacial Orthop 1999;115:239-46)
S
oft tissues in the orofacial region exert
weak but consistent forces on the teeth according to the
classical equilibrium theory,1 which has been reevaluated.2,3 Tongue pressure is considered to be a particularly important factor in the diagnosis and prognosis of
orthodontic treatment.
The genioglossus (GG) muscle is the main protruder of the tongue, and also acts as an accessory respiratory muscle. Contraction of the GG muscle advances
the base of the tongue and dilates the upper airway.
Rhythmic electromyographic (EMG) activity of the
GG muscle in pace with respiration has been reported
in both animals and human beings.4-7 Therefore, we
would expect that tongue pressure should show respiratory-related changes. In addition, increased GG EMG
From the Faculty of Dentistry, Tokyo Medical and Dental University, Tokyo,
Japan.
This work was supported by Grants-in-Aid for Scientific Research Projects,
(07407060 and 09470467) from the Japanese Ministry of Education, Science
and Culture.
aGraduate student, Department of Maxillo-Facial Orthognathics, Division of
Life Science of Maxillo-Facial Systems, Graduate School of Dentistry.
bAssistant Professor, Second Department of Orthodontics.
cPart-time lecturer, Second Department of Orthodontics.
dProfessor and Head, Second Department of Orthodontics.
Reprint requests to: Shigeki Takahashi, DDS, Second Department of Orthodontics, Tokyo Medical and Dental University, 5-45 Yushima 1-chome, Bunkyo-ku,
Tokyo, 113-8549 Japan; E-mail, s=takahashi.ort2@dent.tmd.ac.jp
Copyright © 1999 by the American Association of Orthodontists.
0889-5406/99/$8.00 + 0 8/1/91723
activity in the supine body position has been reported
in human beings.8,9 Considering these functional characteristics, respiratory-related changes in GG EMG
activity may contribute to changes in tongue pressure
on the lingual surface of the mandibular incisors. Consequently, tongue pressure may depend on the breathing mode and body position.
The effects of changes in the head position and
mode of breathing on intraoral pressure have been
investigated in several previous studies.10-12 Archer
and Vig11 reported that the tongue pressure on the lingual surface of the mandibular incisors tended to
decrease with head extension and to increase with head
flexion in subjects with Class I malocclusions. They
pointed out that the tongue played an important role in
producing skeletodental morphologic variation associated with altered head position. Hellsing and L’Estrange12 showed changes in lip pressure during extension and flexion of the head and changes in the mode
of breathing and predicted that intraoral pressure could
affect the inclination and position of the incisors. However, there has been no report of the possible effect of
rhythmic changes in intraoral pressure associated with
respiration.
The purpose of this study was twofold: (1) to examine whether tongue pressure on the lingual surface of
the mandibular incisors showed respiratory-related
changes, with particular attention to its relationship
239
240 Takahashi et al
Fig 1. Occlusal view of a custom pressure-recording
appliance on a plaster model. Thickness of the appliance at pressure sensor is approximately 1 mm. Arrow
indicates surface of pressure sensor.
with GG EMG activity, and (2) to determine the effect
of changes in the mode of breathing and body position
on tongue pressure.
MATERIAL AND METHODS
Subjects
This study was carried out in 10 skeletal Class I
men with a mean age of 27.3 ± 1.9 (mean ± standard
deviation [SD]) years. Subjects with an ongoing respiratory infection or who were taking any medication
known to affect muscle activity were excluded from the
study. All of the subjects had complete dentition with
the exception of the third molars. Each subject had a
normal overjet and overbite. Informed consent was
obtained from each subject before the study.
Methods
Pressure from the tongue on the lingual surface of
the lower anterior teeth was measured with a pressure
sensor (PS-A type, Kyowa Co., Tokyo, Japan) incorporated in a lingual flange of a custom-made intraoral
appliance (Fig 1) made of silicon rubber impression
paste (Exafine putty type, GC Co., Tokyo, Japan). Temperature effect on output of the transducer is 0.1%/°C.
The thickness (ca 1 mm) of the appliance13,14 and the
location of the transducers were carefully standardized.
The sensitivity of the sensor was calibrated before and
after each experimental session.
The EMG activity of the right GG muscle was
recorded monopolarly with a stainless steel fine-wire
electrode inserted through the lingual sulcus following
the method of Sauerland and Harper.8 A neutral electrode was placed on the right ear lobe. The wire elec-
American Journal of Orthodontics and Dentofacial Orthopedics
March 1999
Fig 2. A, Typical simultaneous recording of chest wall
movement; B, GG EMG activity; C, integrated GG EMG
activity; and D, tongue pressure on lingual surface of
mandibular incisors in supine subject during oral
breathing. Vertical bar represents 50 µV for raw GG
EMG activity, and 5 g/cm2 for tongue pressure (insp,
inspiration; exp, expiration).
trodes were 0.03 mm in diameter and insulated with
urethane. The tip of the electrode was bared approximately 2 mm. The EMG activity of the GG muscle was
identified by (1) tonic burst activity during tongue protrusion and (2) rhythmic phasic activity coinciding
with inspiration. Respiratory movement of the chest
wall was simultaneously recorded by an inductance
band (TR-751T, Nihon-Kohden, Tokyo, Japan). Before
each experimental session, EMG activities of the
suprahyoid muscles and the anterior temporal muscle
were recorded with surface electrodes; one subject who
showed respiratory-related EMG activity in the anterior temporal muscle was excluded. If the respiratoryrelated EMG activity was found in the anterior temporal muscle, it would be considered that the jaw position
is changed.15 Thus, the final study group consisted of
nine subjects.
Protocol
The subjects sat in a reclining chair with a headrest
in an upright position; they were instructed to remain
awake with both eyes open. At least 5 minutes after setting up the intraoral appliance and electrodes, respiratory movement, tongue pressure, and GG EMG activity were recorded simultaneously over 20 respiratory
cycles during quiet breathing through the nose with the
mouth shut. Recordings were then repeated while the
subject quietly breathed through the mouth with the
nose completely occluded with a clip. The chair was
Takahashi et al 241
American Journal of Orthodontics and Dentofacial Orthopedics
Volume 115, Number 3
Fig 3. Temporal relationship between peak inspiratory
effort (abscissa) and maximum tongue pressure (ordinate). Straight lines indicate regression lines along with
equations for four subjects.
then reclined, and the subject lay down in a supine
position. After at least 5 minutes, the protocol was
repeated. EMG signals were amplified and band-pass
filtered at 30 Hz to 1 kHz. After conversion of the signals through an A/D converter (Maclab/8S, ADinstruments, Castle Hill, Australia), they were stored in a personal computer (Macintosh Performa 5270, Apple
Computer, Cupertino, Calif) for data analysis. Signals
from the pressure sensor were amplified with preadjusted and calibrated gains and stored in the same manner as EMG signals.
Data Analysis
Time lags (Fig 2) between the maximum tongue
pressure and the peak inspiratory effort were measured
and plotted for five consecutive respiratory phases that
were randomly selected in four subjects while they were
breathing through the mouth in the supine position.
We tested correlation between the timing of the peak
inspiratory effort and that of maximum tongue pressure
with a linear regression analysis in four subjects randomly selected from nine subjects.
In each subject, five respiratory phases were randomly selected during breathing through the mouth and
nose in both the upright and supine positions. The maximum values of tongue pressure were measured and
averaged. GG EMG signals that had been stored in the
personal computer in selected phases were integrated
Fig 4. Comparisons of maximum tongue pressure
among different breathing modes and body positions.
(UPNB, nasal breathing in the upright position; UPOB,
oral breathing in the upright position; SUPNB, nasal
breathing in the supine position; SUPOB, oral breathing
in the supine position; **P < .01)
with a time constant of 200 ms; the maximum and minimum EMG amplitudes in each phase were measured
and averaged. The average EMG amplitude in each subject was normalized to the mean expiratory EMG amplitude during nasal breathing in an upright position. A
one-way repeated analysis of variance (ANOVA) and
Contrasts were used to compare the maximum values of
tongue pressure and GG EMG activity among the different breathing modes and body positions.
RESULTS
Inspiratory activation of the GG muscle was
observed in five subjects during nasal and oral breathing in both the upright and supine positions. Fig 2
shows a typical simultaneous recording of chest wall
movement, GG EMG activity, and tongue pressure on
the lingual surface of the mandibular incisors in a subject during oral breathing in the supine position.
Tongue pressure showed respiratory-related cyclic
oscillation, with a maximum value during expiration
and a minimum value during inspiration. On the other
hand, GG EMG activity showed a maximum value during inspiration and a minimum value during expiration.
This cyclic oscillation in tongue pressure was observed
in all nine subjects. Fig 3 shows a strong correlation
between the timing of the peak inspiratory effort and
that of the maximum tongue pressure in all of the four
subjects tested. Thus, the oscillation in tongue pressure
is respiratory related.
242 Takahashi et al
Fig 5. Comparisons of GG EMG activity during inspiration among different breathing modes and body positions. (UPNB, nasal breathing in the upright position;
UPOB, oral breathing in the upright position; SUPNB,
nasal breathing in the supine position; SUPOB, oral
breathing in the supine position; *P < .05).
Note: GG EMG activities were normalized to the expiratory GG EMG activity during nasal breathing in the
upright position.
In eight of the nine subjects, negative pressure was
recorded during nasal breathing. These negative values
were regarded as 0 g/cm2 for the data analysis, because
the tip of the tongue does not touch the surface of the
pressure sensor when negative pressure occurs.
The maximum tongue pressure in different breathing modes and body positions is illustrated in Fig 4.
Significant differences were found between nasal
breathing in the upright position and both oral breathing in the upright position (P < .01) and oral breathing
in the supine position (P < .01). Significant differences
were also found between oral breathing in the upright
and supine positions (P < .01) and between nasal and
oral breathing in the supine position (P < .01). Thus,
the maximum tongue pressure during oral breathing
was significantly greater than that during nasal breathing in either body position. In addition, changes in
body position had a significant effect on the maximum
tongue pressure during oral breathing.
GG EMG activity during inspiration in different
breathing modes and body positions is illustrated in Fig
5. Significant differences were found between nasal
breathing in the upright position and oral breathing in
the supine position (P < .05), and between nasal and
oral breathing in the supine position (P < .05).
American Journal of Orthodontics and Dentofacial Orthopedics
March 1999
Fig 6. Comparisons of GG EMG activity during expiration among different breathing modes and body positions. (UPNB, nasal breathing in the upright position;
UPOB, oral breathing in the upright position; SUPNB,
nasal breathing in the supine position; SUPOB, oral
breathing in the supine position; *P < .05).
Note: GG EMG activities were normalized to the expiratory GG EMG activity during nasal breathing in the
upright position.
GG EMG activity during expiration in different
breathing modes and body positions is illustrated in Fig
6. Significant differences were found between nasal
breathing in the upright position and oral breathing in
the supine position (P < .05) and between nasal breathing in the upright and supine positions (P < .05).
The reproducibility of maximum tongue pressure in
different breathing modes and body positions was
examined in three subjects on different days (Table I).
The values during oral breathing consistently tended to
be greater than those during nasal breathing in the
upright position, whereas values during oral breathing
were greater than those during nasal breathing in the
supine position.
DISCUSSION
Method Considerations
Although several researchers have emphasized the
importance of intraoral pressure,10-14,16-23 tongue pressure has been studied less than pressure exerted by the
lip and cheek. The tongue pressure on the lingual surface of the mandibular incisors in the present study
ranged between 0.35 g/cm2 during nasal breathing in
the upright position and 8.88 g/cm2 during oral breathing in the supine position. Proffit et al16 reported a
tongue pressure of 5.9 g/cm2 on the mandibular
incisors. However, they did not define the mandibular
Takahashi et al 243
American Journal of Orthodontics and Dentofacial Orthopedics
Volume 115, Number 3
Table I. Means
and standard deviations of the maximum tongue pressure in three subjects on different days
Nasal breathing
Subject
Upright
Supine
1
2
3
1
2
3
Oral breathing
Day l
Day 2
Day l
Day 2
0.00 ± 0.00
1.69 ± 0.47
1.73 ± 0.53
0.00 ± 0.00
0.00 ± 0.00
0.36 ± 0.73
0.00 ± 0.00
0.98 ± 0.54
1.72 ± 1.12
0.10 ± 0.23
0.00 ± 0.00
0.10 ± 0.14
4.83 ± 1.33
3.91 ± 0.51
2.91 ± 0.28
7.68 ± 0.53
6.48 ± 1.81
6.78 ± 0.33
5.36 ± 0.44
3.99 ± 1.22
3.26 ± 0.53
7.20 ± 1.77
6.85 ± 2.24
7.26 ± 0.53
Unit: g/cm2.
position and their appliances that carried transducers
were thicker than ours. The thickness of appliance has
substantial effects on intraoral pressure measurement.
Lear et al20 reported that even a 1.5 mm thickness of
the transducer caused an appreciable increase in mean
forces. Gould and Picton13,14 studied the distance
between the surface of teeth and the pressure sensor,
and they concluded that the distance should be less
than 1 mm to measure correct pressure. The spatial
relationship between the lingual surface of mandibular
incisors and the pressure sensor that was incorporated
in our appliance satisfied with their postulation. Fröhlich et al17 measured a tongue pressure of –0.1 g/cm2
on the mandibular incisors with a device based on an
extraoral pressure transducer incorporated in a waterfilled system to neglect the inevitable effect of the
thickness of the transducer. We also recorded negative
pressures in the present study. However, because the
pressure transducer in the present study cannot accurately measure negative pressure, absolute values were
not completely comparable.
Kato et al18 and other investigators20-23 discussed
the effect of temperature on the intraoral pressure measured by strain gauges. Because the pressure sensor in
the present study incorporates a strain gauge, it is possible that changes in temperature coinciding with respiration could affect the measurement of tongue pressure. Lear et al20 reported that temperature variations
during speech were slight and their effects on the measurement were negligible. Temperature variations in
the present study in which subjects breathed quietly
would be less than theirs. If a change in temperature
did occur, the temperature on the pressure sensor during expiration would be higher than that during inspiration because of the difference in temperature between
the air in the lung and that in the experimental room.20
However, the pressure decreased during inspiration
when the temperature on the surface of the pressure
sensor increased. Therefore, we conclude that changes
in temperature coinciding with respiration did not
affect the measurement of tongue pressure in the present study.
The Maximum Tongue Pressure
We hypothesized that the tongue pressure on the
lingual surface of the mandibular incisors would
change coinciding with respiratory-related activity of
the GG muscle. We also hypothesized that tongue
pressure shows its maximum value during inspiration
because GG EMG activity shows its maximum amplitude during inspiration. However, the timing of the
peak GG EMG activity corresponded with the minimum tongue pressure rather than with the maximum
value. This suggests that respiratory-related GG EMG
activity does not have a substantial effect on tongue
pressure. The GG muscle exhibits phasic inspiratory
activity that is superimposed on a ubiquitous tonic
activity. The physiologic function of enhanced GG
EMG activity during inspiration is to maintain the
efficiency of the upper airway against respiratoryrelated collapse. Nakagawa et al24 used cineradiography to demonstrate that the anterior wall of the upper
airway and the hyoid bone were positioned posteriorly in the inspiratory phase during quiet nasal breathing. This indicates that the base of the tongue moves
posteriorly because of negative intraluminal pressure
during inspiration even though increased GG EMG
activity would be expected to pull the tongue forward.
Kobayashi et al25 used video x-ray fluoroscopy and
found in laryngectomized subjects that forward movement of the tongue was observed concomitant with
augmented GG EMG activity during inspiration.
However, because laryngectomized subjects were
evaluated in their study, changes in intraluminal pressure that might affect upper airway patency did not
occur, indicating that the tongue base moved forward
solely due to contraction of the GG muscle during
inspiration. Thus, it is likely that posterior movement
of the tongue base during inspiration is accompanied
by posterior migration of the tongue tip, which subse-
244 Takahashi et al
Fig 7. Speculative schematic illustration of factors that
may affect tongue pressure during inspiration (A) and
expiration (B) in the upright position. During inspiration,
vector sum of negative intraluminal pressure (a) and
phasic GG EMG activity (b) may induce posterior movement of the tongue accompanied by posterior migration
of the tongue tip (c), resulting in a decrease in tongue
pressure. In contrast, the vector sum of tonic expiratory
GG EMG activity (b’) and positive intraluminal pressure
(a’) may induce anterior movement of the tongue
accompanied by anterior migration of the tongue tip (c’),
resulting in an increase in tongue pressure.
quently decreases tongue pressure on the lingual surface of the mandibular incisors (Fig 7A). There is less
GG EMG activity during expiration than during inspiration, and the two values are almost equal in subjects
who do not show phasic activity. However, intraluminal pressure is positive during expiration and negative
during inspiration.26 This suggests that the tongue
base is positioned more anteriorly during expiration
than during inspiration by positive intraluminal pressure and GG EMG activity, resulting in an increased
tongue pressure (Fig 7B).
Altered Breathing Mode and Tongue Pressure
We hypothesized that changes in GG EMG activity
in association with changes in breathing mode would
affect the maximum tongue pressure. Because tongue
pressure shows its maximum value in the expiratory
phase, GG EMG activity during expiration may be
related to the maximum tongue pressure. However, significant differences in expiratory GG EMG activity
were only found between nasal breathing in the upright
position and oral breathing in the supine position, and
between nasal breathing in the upright and supine positions in the present study (Fig 6). Likewise, Douglas et
al4 demonstrated that the breathing mode had no significant effect on GG EMG activity during expiration.
Thus, expiratory GG EMG activity by itself cannot
explain the change in the maximum tongue pressure.
Previous studies have dealt with the relationship
between the breathing mode and the position of the
hyoid bone. Meurice et al27 reported that opening of
the mouth induced a reduction in the distance between
American Journal of Orthodontics and Dentofacial Orthopedics
March 1999
Fig 8. Speculative schematic illustration of factors that
may affect tongue pressure during nasal breathing (A)
and oral breathing (B) in the upright position, and during nasal breathing (C) and oral breathing (D) in the
supine position. Contraction of the GG muscle (b1) may
be involved in tongue pressure during nasal breathing
in the upright position (A). In addition to contraction of
the GG muscle (b2), anterior movement of the hyoid
bone (h2) may occur during oral breathing in the upright
position (B). The sum of b2 and h2 may be greater than
b1. During nasal breathing in the supine position (C),
contraction of the GG muscle (b4) and anterior movement of the hyoid bone (h4) may overcome gravity (G).
The sum of b4 and h4 may be greater than the sum of
b3 and h3.
the mandibular plane and the hyoid bone even in the
absence of oral airflow. Miller et al28 found that geniohyoid EMG activity increased during oral breathing in
the rhesus monkey, but they did not study the change in
the position of the hyoid bone. This augmented geniohyoid EMG activity28 would pull the hyoid bone anteriorly. Because the tongue is attached to the hyoid
bone, forward movement of the hyoid bone would pull
the tongue anteriorly en masse, leading to an increase
in tongue pressure. As shown in Fig 8, we believe that
changes in the position of the hyoid bone with changes
in the breathing mode play an important role in determining the maximum tongue pressure. In the upright
position, the tongue pressure during nasal breathing
may be affected by expiratory GG activity. Tongue
pressure during oral breathing may be affected by anterior movement of the tongue that accompanies forward
movement of the hyoid bone (Fig 8A and B).
Body Position and Tongue Pressure
Douglas et al4 demonstrated that GG EMG activity during both inspiration and expiration in the supine
Takahashi et al 245
American Journal of Orthodontics and Dentofacial Orthopedics
Volume 115, Number 3
position was greater than that in the upright position.
Although the breathing mode was not defined, Pae et
al10 reported that tongue pressure on the mandibular
incisors tended to be lower in the supine position than
in the upright position despite a significant increase
in tonic GG EMG activity. In the present study, expiratory GG EMG activity during nasal breathing significantly increased when the body position changed from
upright to supine (Fig 6). In contrast, the tongue pressure during nasal breathing in the supine position was
not significantly different from that in the upright position (Fig 4). On the other hand, the tongue pressure
during oral breathing in the supine position was significantly greater than that in the upright position,
although expiratory GG EMG activity during oral
breathing was not significantly different in the upright
and supine positions. Therefore it is not possible to
explain the effect of changes in body position on
tongue pressure by changes in GG EMG activity alone.
Pae et al10 showed that tongue pressure tended to
decrease with changes in body position from upright to
supine. They suggested that the inferior movement of
the tongue occurred as a result of gravity. On the other
hand, Yildirim et al29 and Pae et al10,30 reported that the
hyoid bone moved anteriorly when the body position
changed from upright to supine. Moreover, Pae et al10
reported that suprahyoid EMG activity tended to
increase when the subject moved from the upright to
supine body position, indicating anterior movement of
the hyoid bone. We speculate that changes in the position of the hyoid bone associated with changes in body
position may be an important determinant of the maximum tongue pressure, as well as changes in the breathing mode (Fig 8C and D). Gravity would pull the
tongue posteriorly with changes in body position from
upright to supine. During nasal breathing, this posterior movement of the tongue by gravity may be counteracted by increased GG EMG activity and anterior
movement of the hyoid bone, resulting in no significant
changes in tongue pressure. During oral breathing in
the supine position, posterior movement of the tongue
because of gravity may be overcome by increased GG
activity and anterior movement of the hyoid bone,
resulting in a significant increase in tongue pressure.
CLINICAL IMPLICATIONS
During oral breathing, the subjects in the present
study breathed through the mouth with the nose completely occluded with a clip. Warren et al31 reported
that only 2 of 116 otolaryngologically symptomatic
and dental patients were total mouth breathers. Thus,
most so-called mouth breathers generally do not
breathe entirely through the mouth. Therefore findings
with respect to oral breathing in the present study do
not necessarily account for mouth breathers in a clinical sense. In the present study, tongue pressure during
oral breathing was significantly greater than that during nasal breathing. Moreover, tongue pressure during
oral breathing in the supine position was significantly
greater than that during nasal breathing. It has also
been suggested that mouth breathers may compensate
for nasal impairment by positioning the tongue forward.31,32 If so, tongue pressure would increase and
lead to changes in dentofacial patterns in growing children. Tallgren and Solow33 reported that the position of
the hyoid bone is strongly associated with facial morphology. Given that changes in tongue pressure are
related to changes in the position of the hyoid bone,
this would affect facial morphologic characteristics by
means of neuromuscular compensations over the long
term.
We have not examined the effect of changes in the
breathing mode and body position on tongue pressure
in subjects with skeletal Class II and III malocclusions.
We think, however, that the trend of the changes in
tongue pressure associated with alterations in the
breathing mode and body position would be the same
in skeletal Class I subjects because similar fundamental changes in upper airway patency would occur
regardless of skeletal patterns. Yoo et al34 reported that
no significant differences were found in the tongue volume between skeletal Class I and III subjects, indicating that the tongue volume was invariable. Therefore
differences in the size of oral cavity among different
skeletal patterns may affect the maximum value of
tongue pressure, although differences in the tongue
volume between skeletal Class I and II subjects were
unknown.
Proffit16 has shown that the labial and lingual
forces on the lower incisors are not equal. But the
lower incisors are considered to be in a state of equilibrium, because it is probable that the lips provide a
constant lingual force and the tongue offers more
heavy force intermittently that prevents the teeth from
moving lingually. It is not clear whether tongue pressure with respiratory-related oscillations accounts for
positions of teeth. Further research on lip pressure is
needed.
CONCLUSIONS
The present study investigated respiratory-related
changes in tongue pressure on the lingual surface of the
mandibular incisors and the relationships among
tongue pressure, breathing mode, and body position.
We demonstrated that (1) tongue pressure showed respiratory-related oscillations with a maximum value
246 Takahashi et al
during expiration and a minimum value during inspiration, and (2) changes in the breathing mode and body
position significantly affected tongue pressure.
We are grateful to Dr. Yoshio Nakamura, Dr. Nobuo
Katakura and Dr. Yoshiyuki Kato for their valuable
suggestions.
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