Modulation of Tongue Pressure According to Liquid Flow Properties in Healthy Swallowing

J Speech Lang Hear Res. 2019 Jan 30;62(1):22-33. doi: 10.1044/2018_JSLHR-S-18-0229.


Purpose During swallowing, the tongue generates the primary propulsive forces that transport material through the oral cavity toward the pharynx. Previous literature suggests that higher tongue pressure amplitudes are generated for extremely thick liquids compared with thin liquids. The purpose of this study was to collect detailed information about the modulation of tongue pressure amplitude and timing across the range from thin to moderately thick liquids. Method Tongue pressure patterns were measured in 38 healthy adults (aged under 60 years) during swallowing with 4 levels of progressively thicker liquid consistency (International Dysphagia Diet Standardisation Initiative, Levels 0 = thin, 1 = slightly thick, 2 = mildly thick, and 3 = moderately thick). Stimuli with matching gravity flow (measured using the International Dysphagia Diet Standardisation Initiative Flow Test; Cichero et al., 2017 ; Hanson, 2016 ) were prepared both with/without barium (20% weight per volume concentration) and thickened with starch and xanthan gum thickeners. Results After controlling for variations in sip volume, thicker liquids were found to elicit significantly higher amplitudes of peak tongue pressure and a pattern of higher (i.e., steeper) pressure rise and decay slopes (change in pressure per unit time). Explorations across stimuli with similar flow but prepared with different thickeners and with/without barium revealed very few differences in tongue pressure, with the exception of significantly higher pressure amplitudes and rise slopes for nonbarium, starch-thickened slightly and mildly thick liquids. Conclusions There was no evidence that the addition of barium led to systematic differences in tongue pressure parameters across liquids with closely matched gravity flow. Additionally, no significant differences in tongue pressure parameters were found across thickening agents. Supplemental Material

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Barium
  • Deglutition / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Polysaccharides, Bacterial
  • Pressure
  • Tongue / physiology*
  • Viscosity
  • Young Adult


  • Polysaccharides, Bacterial
  • Barium
  • xanthan gum