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Dysphagia and Oral Health

Yıl 2019, Cilt: 19 Sayı: 4, 789 - 795, 28.11.2019
https://doi.org/10.17098/amj.652021

Öz

Chewing, transfer of nutrients and swallowing are continuous events. Chewing function covers the coordinated movement of teeth, chewing muscles, temporomandibular joints, tongue, cheeks and lips. Swallowing is a dynamic and complex movement with a widespread sensory motor neural network, requiring coordinated work of lips, tongue, palate, pharynx, larynx and esophageal muscles. In case of dysphagia, defined as deterioration at any stage of the swallowing sequence, the safety, efficiency or adequacy of food intake may be impaired. Patients with dysphagia are known to be at greater risk of developing aspiration pneumonia Diagnosis and treatment of these patients often requires a multidisciplinary approach. It is critical for an impaired oral and dental health condition and oral infections, especially for aspiration and related conditions. In order to prevent such infections, patients with swallowing dysfunction should care to oral and dental health, and they should be trained to provide oral hygiene. In these patients, it will be possible to contribute to the chewing function and indirectly to swallow problems by completing the oral and dental treatments and providing a good occlusion.

Kaynakça

  • T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü Aile Hekimliği Dairesi Başkanlığı. [İnternet]; Available from: https://hsgm.saglik.gov.tr/tr/ailehekimligi/aile-hekiminin-tan%C4%B1m%C4%B1.html (Erişim tarihi: 18.09.2019).
  • World health organization. [İnternet]; Available from: https://www.who.int/news-room/fact-sheets/detail/oral-health (Erişim tarihi 9.07.2019).
  • Coster S, Schwarz WJD. Rheology and the swallow-safe bolus. Dysphagia 1987;1:113-8.
  • Dodrill P, Gosa MMJAoN, Metabolism. Pediatric dysphagia: physiology, assessment, and management. 2015;66:24-31.
  • Saitoh E, Shibata S, Matsuo K, Baba M, Fujii W, Palmer JBJD. Chewing and food consistency: effects on bolus transport and swallow initiation. 2007;22:100-7.
  • Rommel N, Hamdy SJNRG, Hepatology. Oropharyngeal dysphagia: manifestations and diagnosis. 2016;13:49.
  • Clavé P, Terre Rd, De Kraa M, Serra MJREdED. Approaching oropharyngeal dysphagia. 2004;96:119-31.
  • Logemann JAJBp, gastroenterology rC. Swallowing disorders. 2007;21:563-73.
  • Forsell M, Kullberg E, Hoogstraate J, Johansson O, Sjögren PJNeip. An evidence-based oral hygiene education program for nursing staff. 2011;11:256-9.
  • Hutcheson KA, Lewin JSJCor. Functional outcomes after chemoradiotherapy of laryngeal and pharyngeal cancers. 2012;14:158-65.
  • Coppens CH, van den Engel-Hoek L, Scharbatke H, de Groot SA, Draaisma JMJEjop. Dysphagia in children with repaired oesophageal atresia. 2016;175:1209-17.
  • Calis EA, Veugelers R, Sheppard JJ, Tibboel D, Evenhuis HM, Penning CJDM, et al. Dysphagia in children with severe generalized cerebral palsy and intellectual disability. 2008;50:625-30.
  • Groher ME, Crary MA. Dysphagia: clinical management in adults and children: Elsevier Health Sciences; 2015.
  • Arvedson JC, Brodsky L, Lefton-Greif MA. Pediatric swallowing and feeding: Assessment and management: Plural Publishing;2019.
  • Poels B, Brinkman-Zijlker H, Dijkstra P, Postema KJD, rehabilitation. Malnutrition, eating difficulties and feeding dependence in a stroke rehabilitation centre. 2006;28:637- 43.
  • Martino R, Beaton D, Diamant NEJD. Perceptions of psychological issues related to dysphagia differ in acute and chronic patients. 2010;25:26-34.
  • Tada A, Miura H. Prevention of aspiration pneumonia (AP) with oral care. Arch Gerontol Geriatr. 2012;55:16-21.
  • Lefton‐Greif MA, Carroll JL, Loughlin GMJPp. Long‐term follow‐up of oropharyngeal dysphagia in children without apparent risk factors. 2006;41:1040-8.
  • Inglis TJ, Sherratt MJ, Sproat LJ, Gibson JS, Hawkey PM. Gastroduodenal dysfunction and bacterial colonisation of the ventilated lung. Lancet. 1993;341:911-3.
  • Furuta M, Yamashita YJCpm, reports r. Oral health and swallowing problems. 2013;1:216-22.
  • Macht M, Wimbish T, Clark BJ, Benson AB, Burnham EL, Williams A, et al. Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. 2011;15:231.
  • Heckathorn D-E, Speyer R, Taylor J, Cordier RJD. Systematic review: non-instrumental swallowing and feeding assessments in pediatrics. 2016;31:1-23.
  • Pedersen AML, Sørensen CE, Proctor G, Carpenter GJOd. Salivary functions in mastication, taste and textural perception, swallowing and initial digestion. 2018;24:1399- 416.
  • Samnieng P, Ueno M, Shinada K, Zaitsu T, Wright FA, Kawaguchi Y. Association of hyposalivation with oral function, nutrition and oral health in community-dwelling elderly Thai. Community Dent Health. 2012;29:117-23.
  • Samnieng P. Association of Hyposalivation with Oral Function, Nutrition, and Oral Health in Visual Impaired Patient. Int J Clin Prev Dent 2015;11:15-20.
  • Linas N, Peyron MA, Hennequin M, Eschevins C, Nicolas E, Delfosse C, et al. Masticatory behavior for different solid foods in preschool children according to their oral state. Journal of texture studies. 2019;50(3):224-36.
  • Montes ABM, de Oliveira TM, Gavião MBD, de Souza Barbosa TJCoi. Occlusal, chewing, and tasting characteristics associated with orofacial dysfunctions in children with unilateral cleft lip and palate: a case-control study. 2018;22:941-50.
  • Psoter W, Gebrian B, Prophete S, Reid B, Katz RJCd, epidemiology o. Effect of early childhood malnutrition on tooth eruption in Haitian adolescents. 2008;36:179-89.
  • Psoter WJ, Reid BC, Katz RVJCr. Malnutrition and dental caries: a review of the literature. 2005;39:441-7.
  • Barrera LM, Buschang PH, Throckmorton GS, Roldán SIJAJoO, Orthopedics D. Mixed longitudinal evaluation of masticatory performance in children 6 to 17 years of age. 2011;139:e427-e34.
  • Soares MEC, Ramos-Jorge ML, de Alencar BM, Marques LS, Pereira LJ, Ramos-Jorge JJCoi. Factors associated with masticatory performance among preschool children. 2017;21:159-66.
  • Hama Y, Hosoda A, Komagamine Y, Gotoh S, Kubota C, Kanazawa M, et al. Masticatory performance-related factors in preschool children: establishing a method to assess masticatory performance in preschool children using colour-changeable chewing gum. Journal of oral rehabilitation. 2017;44:948-56.
  • Fujita Y, Ichikawa M, Hamaguchi A, Maki K. Comparison of masticatory performance and tongue pressure between children and young adults. Clinical and experimental dental research. 2018;4:52-8.
  • Okabe Y, Takeuchi K, Izumi M, Furuta M, Takeshita T, Shibata Y, et al. Posterior teeth occlusion and dysphagia risk in older nursing home residents: a cross‐sectional observational study. 2017;44:89-95.
  • Furuta M, Komiya-Nonaka M, Akifusa S, Shimazaki Y, Adachi M, Kinoshita T, et al. Interrelationship of oral health status, swallowing function, nutritional status, and cognitive ability with activities of daily living in Japanese elderly people receiving home care services due to physical disabilities. Community Dent Oral Epidemiol. 2013;41:173-81.
  • Okabe Y, Furuta M, Akifusa S, Takeuchi K, Adachi M, Kinoshita T, et al. Swallowing Function and Nutritional Status in Japanese Elderly People Receiving Home-care Services: A 1-year Longitudinal Study. J Nutr Health Aging. 2016;20:697-704.
  • Oral care foundation. [İnternet]; Available from: https://oralcancerfoundation.org (Erişim tarihi: 21.09.2019).
  • Chen SC, Huang BS, Hung TM, Chang YL, Lin CY, Chung CY, et al. Swallowing ability and its impact on dysphagia-specific health-related QOL in oral cavity cancer patients post-treatment. Eur J Oncol Nurs. 2018;36:89-94.
  • Chen SC, Huang BS, Chung CY, Lin CY, Fan KH, Chang JT, et al. Effects of a swallowing exercise education program on dysphagia-specific health-related quality of life in oral cavity cancer patients post-treatment: a randomized controlled trial. Support Care Cancer. 2018;26:2919-28.
  • Dougherty NJ. A review of cerebral palsy for the oral health professional. Dent Clin North Am. 2009;53:329-38.
  • Sorensen RT, Rasmussen RS, Overgaard K, Lerche A, Johansen AM, Lindhardt T. Dysphagia screening and intensified oral hygiene reduce pneumonia after stroke. J Neurosci Nurs. 2013;45:139-46.
  • Murray J, Scholten I. An oral hygiene protocol improves oral health for patients in inpatient stroke rehabilitation. Gerodontology. 2018;35:18-24.
  • Yoshikawa H, Furuta K, Ueno M, Egawa M, Yoshino A, Kondo S, et al. Oral symptoms including dental erosion in gastroesophageal reflux disease are associated with decreased salivary flow volume and swallowing function. J Gastroenterol. 2012;47:412-20.
  • Guare RO, Ferreira MC, Leite MF, Rodrigues JA, Lussi A, Santos MT. Dental erosion and salivary flow rate in cerebral palsy individuals with gastroesophageal reflux. J Oral Pathol Med. 2012;41:367-71.
  • Arslan SS, Ilgaz F, Demir N, Karaduman AAJBvDD. Yutma Bozukluğu Olan Serebral Palsili Çocuklarda Büyüme Yetersizliği ve Beslenme Şeklinin Ebeveynlerin Kaygı
  • Durumu Üzerindeki Etkisi. 2017;45:28-34.
  • O'Gara JAJD. Dietary adjustments and nutritional therapy during treatment for oral-pharyngeal dysphagia. 1990;4:209-12.
  • Larsen GLJJoS, Disorders H. Rehabilitation for dysphagia paralytica. 1972;37:187-94.
  • Force NDDT, Association AD. National dysphagia diet: Standardization for optimal care: American Dietetic Associati; 2002.
  • Fortunato JE, Cuffari CJCgr. Outcomes of percutaneous endoscopic gastrostomy in children. 2011;13:293-9.
  • Inoue M. Dysphagia Rehabilitation in Japan. Journal of nutritional science and vitaminology. 2015;61:72-3.
  • Lim M. Basic oral care for patients with dysphagia - A Special Needs Dentistry perspective 2018.
  • Hollaar V, van der Maarel-Wierink C, van der Putten GJ, de Swart B, de Baat C. Effect of daily application of a 0.05% chlorhexidine solution on the incidence of (aspiration) pneumonia in care home residents: design of a multicentre cluster randomised controlled clinical trial. BMJ Open. 2015;5:e007889.
  • van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, Schols JM, de Baat C. Oral health care and aspiration pneumonia in frail older people: a systematic literature review. Gerodontology. 2013;30:3-9.

Yutma Bozukluğu ve Ağız Sağlığı

Yıl 2019, Cilt: 19 Sayı: 4, 789 - 795, 28.11.2019
https://doi.org/10.17098/amj.652021

Öz

Çiğneme, besinlerin transferi ve yutma süreğen olaylardır. Çiğneme fonksiyonu dişlerin, çiğneme kaslarının, temporomandibular eklemin ve dilin, yanakların, dudakların koordineli hareketlerini içerir. Yutma fonksiyonu ise dudaklar, dil, damak, farinks, larinks ve özefagus kaslarının koordine çalışmasını gerektiren, yaygın duyusal motor sinir ağına sahip, dinamik ve karmaşık bir harekettir. Yutma dizisinin herhangi bir aşamasında gerçekleşen bozulma olarak tariflenen disfaji durumunda besin alımının güvenliği, verimliliği veya yeterliliği zarar görebilir. Çoğunlukla disfaji tanı ve tedavisi multidisipliner bir yaklaşım gerektirir. Disfajisi olan hastalar aspirasyon pnömonisi gelişimi açısından büyük risk içindedirler. Bozulmuş bir ağız ve diş sağlığı varlığı ile ortaya çıkan oral kaynaklı enfeksiyonlar, özellikle aspirasyon ve ilişkili enfeksiyonlar için kritiktir. Bu tip enfeksiyonların önüne geçmek için yutma fonksiyon bozukluğu olan hastalar ağız-diş sağlığına önem vermeli, ağız hijyeninin sağlanması için eğitilmelidirler. Bu hastalarda ağız-diş sağlığına yönelik tedavilerin tamamlanması ve iyi bir diş kapanış ilişkisinin sağlanması ile çiğneme fonksiyonuna, dolaylı olarak da yutma problemlerinin giderilmesine katkı sağlanması mümkün olacaktır.

Kaynakça

  • T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü Aile Hekimliği Dairesi Başkanlığı. [İnternet]; Available from: https://hsgm.saglik.gov.tr/tr/ailehekimligi/aile-hekiminin-tan%C4%B1m%C4%B1.html (Erişim tarihi: 18.09.2019).
  • World health organization. [İnternet]; Available from: https://www.who.int/news-room/fact-sheets/detail/oral-health (Erişim tarihi 9.07.2019).
  • Coster S, Schwarz WJD. Rheology and the swallow-safe bolus. Dysphagia 1987;1:113-8.
  • Dodrill P, Gosa MMJAoN, Metabolism. Pediatric dysphagia: physiology, assessment, and management. 2015;66:24-31.
  • Saitoh E, Shibata S, Matsuo K, Baba M, Fujii W, Palmer JBJD. Chewing and food consistency: effects on bolus transport and swallow initiation. 2007;22:100-7.
  • Rommel N, Hamdy SJNRG, Hepatology. Oropharyngeal dysphagia: manifestations and diagnosis. 2016;13:49.
  • Clavé P, Terre Rd, De Kraa M, Serra MJREdED. Approaching oropharyngeal dysphagia. 2004;96:119-31.
  • Logemann JAJBp, gastroenterology rC. Swallowing disorders. 2007;21:563-73.
  • Forsell M, Kullberg E, Hoogstraate J, Johansson O, Sjögren PJNeip. An evidence-based oral hygiene education program for nursing staff. 2011;11:256-9.
  • Hutcheson KA, Lewin JSJCor. Functional outcomes after chemoradiotherapy of laryngeal and pharyngeal cancers. 2012;14:158-65.
  • Coppens CH, van den Engel-Hoek L, Scharbatke H, de Groot SA, Draaisma JMJEjop. Dysphagia in children with repaired oesophageal atresia. 2016;175:1209-17.
  • Calis EA, Veugelers R, Sheppard JJ, Tibboel D, Evenhuis HM, Penning CJDM, et al. Dysphagia in children with severe generalized cerebral palsy and intellectual disability. 2008;50:625-30.
  • Groher ME, Crary MA. Dysphagia: clinical management in adults and children: Elsevier Health Sciences; 2015.
  • Arvedson JC, Brodsky L, Lefton-Greif MA. Pediatric swallowing and feeding: Assessment and management: Plural Publishing;2019.
  • Poels B, Brinkman-Zijlker H, Dijkstra P, Postema KJD, rehabilitation. Malnutrition, eating difficulties and feeding dependence in a stroke rehabilitation centre. 2006;28:637- 43.
  • Martino R, Beaton D, Diamant NEJD. Perceptions of psychological issues related to dysphagia differ in acute and chronic patients. 2010;25:26-34.
  • Tada A, Miura H. Prevention of aspiration pneumonia (AP) with oral care. Arch Gerontol Geriatr. 2012;55:16-21.
  • Lefton‐Greif MA, Carroll JL, Loughlin GMJPp. Long‐term follow‐up of oropharyngeal dysphagia in children without apparent risk factors. 2006;41:1040-8.
  • Inglis TJ, Sherratt MJ, Sproat LJ, Gibson JS, Hawkey PM. Gastroduodenal dysfunction and bacterial colonisation of the ventilated lung. Lancet. 1993;341:911-3.
  • Furuta M, Yamashita YJCpm, reports r. Oral health and swallowing problems. 2013;1:216-22.
  • Macht M, Wimbish T, Clark BJ, Benson AB, Burnham EL, Williams A, et al. Postextubation dysphagia is persistent and associated with poor outcomes in survivors of critical illness. 2011;15:231.
  • Heckathorn D-E, Speyer R, Taylor J, Cordier RJD. Systematic review: non-instrumental swallowing and feeding assessments in pediatrics. 2016;31:1-23.
  • Pedersen AML, Sørensen CE, Proctor G, Carpenter GJOd. Salivary functions in mastication, taste and textural perception, swallowing and initial digestion. 2018;24:1399- 416.
  • Samnieng P, Ueno M, Shinada K, Zaitsu T, Wright FA, Kawaguchi Y. Association of hyposalivation with oral function, nutrition and oral health in community-dwelling elderly Thai. Community Dent Health. 2012;29:117-23.
  • Samnieng P. Association of Hyposalivation with Oral Function, Nutrition, and Oral Health in Visual Impaired Patient. Int J Clin Prev Dent 2015;11:15-20.
  • Linas N, Peyron MA, Hennequin M, Eschevins C, Nicolas E, Delfosse C, et al. Masticatory behavior for different solid foods in preschool children according to their oral state. Journal of texture studies. 2019;50(3):224-36.
  • Montes ABM, de Oliveira TM, Gavião MBD, de Souza Barbosa TJCoi. Occlusal, chewing, and tasting characteristics associated with orofacial dysfunctions in children with unilateral cleft lip and palate: a case-control study. 2018;22:941-50.
  • Psoter W, Gebrian B, Prophete S, Reid B, Katz RJCd, epidemiology o. Effect of early childhood malnutrition on tooth eruption in Haitian adolescents. 2008;36:179-89.
  • Psoter WJ, Reid BC, Katz RVJCr. Malnutrition and dental caries: a review of the literature. 2005;39:441-7.
  • Barrera LM, Buschang PH, Throckmorton GS, Roldán SIJAJoO, Orthopedics D. Mixed longitudinal evaluation of masticatory performance in children 6 to 17 years of age. 2011;139:e427-e34.
  • Soares MEC, Ramos-Jorge ML, de Alencar BM, Marques LS, Pereira LJ, Ramos-Jorge JJCoi. Factors associated with masticatory performance among preschool children. 2017;21:159-66.
  • Hama Y, Hosoda A, Komagamine Y, Gotoh S, Kubota C, Kanazawa M, et al. Masticatory performance-related factors in preschool children: establishing a method to assess masticatory performance in preschool children using colour-changeable chewing gum. Journal of oral rehabilitation. 2017;44:948-56.
  • Fujita Y, Ichikawa M, Hamaguchi A, Maki K. Comparison of masticatory performance and tongue pressure between children and young adults. Clinical and experimental dental research. 2018;4:52-8.
  • Okabe Y, Takeuchi K, Izumi M, Furuta M, Takeshita T, Shibata Y, et al. Posterior teeth occlusion and dysphagia risk in older nursing home residents: a cross‐sectional observational study. 2017;44:89-95.
  • Furuta M, Komiya-Nonaka M, Akifusa S, Shimazaki Y, Adachi M, Kinoshita T, et al. Interrelationship of oral health status, swallowing function, nutritional status, and cognitive ability with activities of daily living in Japanese elderly people receiving home care services due to physical disabilities. Community Dent Oral Epidemiol. 2013;41:173-81.
  • Okabe Y, Furuta M, Akifusa S, Takeuchi K, Adachi M, Kinoshita T, et al. Swallowing Function and Nutritional Status in Japanese Elderly People Receiving Home-care Services: A 1-year Longitudinal Study. J Nutr Health Aging. 2016;20:697-704.
  • Oral care foundation. [İnternet]; Available from: https://oralcancerfoundation.org (Erişim tarihi: 21.09.2019).
  • Chen SC, Huang BS, Hung TM, Chang YL, Lin CY, Chung CY, et al. Swallowing ability and its impact on dysphagia-specific health-related QOL in oral cavity cancer patients post-treatment. Eur J Oncol Nurs. 2018;36:89-94.
  • Chen SC, Huang BS, Chung CY, Lin CY, Fan KH, Chang JT, et al. Effects of a swallowing exercise education program on dysphagia-specific health-related quality of life in oral cavity cancer patients post-treatment: a randomized controlled trial. Support Care Cancer. 2018;26:2919-28.
  • Dougherty NJ. A review of cerebral palsy for the oral health professional. Dent Clin North Am. 2009;53:329-38.
  • Sorensen RT, Rasmussen RS, Overgaard K, Lerche A, Johansen AM, Lindhardt T. Dysphagia screening and intensified oral hygiene reduce pneumonia after stroke. J Neurosci Nurs. 2013;45:139-46.
  • Murray J, Scholten I. An oral hygiene protocol improves oral health for patients in inpatient stroke rehabilitation. Gerodontology. 2018;35:18-24.
  • Yoshikawa H, Furuta K, Ueno M, Egawa M, Yoshino A, Kondo S, et al. Oral symptoms including dental erosion in gastroesophageal reflux disease are associated with decreased salivary flow volume and swallowing function. J Gastroenterol. 2012;47:412-20.
  • Guare RO, Ferreira MC, Leite MF, Rodrigues JA, Lussi A, Santos MT. Dental erosion and salivary flow rate in cerebral palsy individuals with gastroesophageal reflux. J Oral Pathol Med. 2012;41:367-71.
  • Arslan SS, Ilgaz F, Demir N, Karaduman AAJBvDD. Yutma Bozukluğu Olan Serebral Palsili Çocuklarda Büyüme Yetersizliği ve Beslenme Şeklinin Ebeveynlerin Kaygı
  • Durumu Üzerindeki Etkisi. 2017;45:28-34.
  • O'Gara JAJD. Dietary adjustments and nutritional therapy during treatment for oral-pharyngeal dysphagia. 1990;4:209-12.
  • Larsen GLJJoS, Disorders H. Rehabilitation for dysphagia paralytica. 1972;37:187-94.
  • Force NDDT, Association AD. National dysphagia diet: Standardization for optimal care: American Dietetic Associati; 2002.
  • Fortunato JE, Cuffari CJCgr. Outcomes of percutaneous endoscopic gastrostomy in children. 2011;13:293-9.
  • Inoue M. Dysphagia Rehabilitation in Japan. Journal of nutritional science and vitaminology. 2015;61:72-3.
  • Lim M. Basic oral care for patients with dysphagia - A Special Needs Dentistry perspective 2018.
  • Hollaar V, van der Maarel-Wierink C, van der Putten GJ, de Swart B, de Baat C. Effect of daily application of a 0.05% chlorhexidine solution on the incidence of (aspiration) pneumonia in care home residents: design of a multicentre cluster randomised controlled clinical trial. BMJ Open. 2015;5:e007889.
  • van der Maarel-Wierink CD, Vanobbergen JN, Bronkhorst EM, Schols JM, de Baat C. Oral health care and aspiration pneumonia in frail older people: a systematic literature review. Gerodontology. 2013;30:3-9.
Toplam 54 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Derlemeler
Yazarlar

Cansu Ozsin Ozler 0000-0002-9366-3991

Şeyma Öztürk Bu kişi benim 0000-0001-9796-4348

Meryem Uzamıs Tekcıcek Bu kişi benim 0000-0003-1179-7708

Yayımlanma Tarihi 28 Kasım 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 19 Sayı: 4

Kaynak Göster

APA Ozsin Ozler, C., Öztürk, Ş., & Uzamıs Tekcıcek, M. (2019). Yutma Bozukluğu ve Ağız Sağlığı. Ankara Medical Journal, 19(4), 789-795. https://doi.org/10.17098/amj.652021
AMA Ozsin Ozler C, Öztürk Ş, Uzamıs Tekcıcek M. Yutma Bozukluğu ve Ağız Sağlığı. Ankara Med J. Kasım 2019;19(4):789-795. doi:10.17098/amj.652021
Chicago Ozsin Ozler, Cansu, Şeyma Öztürk, ve Meryem Uzamıs Tekcıcek. “Yutma Bozukluğu Ve Ağız Sağlığı”. Ankara Medical Journal 19, sy. 4 (Kasım 2019): 789-95. https://doi.org/10.17098/amj.652021.
EndNote Ozsin Ozler C, Öztürk Ş, Uzamıs Tekcıcek M (01 Kasım 2019) Yutma Bozukluğu ve Ağız Sağlığı. Ankara Medical Journal 19 4 789–795.
IEEE C. Ozsin Ozler, Ş. Öztürk, ve M. Uzamıs Tekcıcek, “Yutma Bozukluğu ve Ağız Sağlığı”, Ankara Med J, c. 19, sy. 4, ss. 789–795, 2019, doi: 10.17098/amj.652021.
ISNAD Ozsin Ozler, Cansu vd. “Yutma Bozukluğu Ve Ağız Sağlığı”. Ankara Medical Journal 19/4 (Kasım 2019), 789-795. https://doi.org/10.17098/amj.652021.
JAMA Ozsin Ozler C, Öztürk Ş, Uzamıs Tekcıcek M. Yutma Bozukluğu ve Ağız Sağlığı. Ankara Med J. 2019;19:789–795.
MLA Ozsin Ozler, Cansu vd. “Yutma Bozukluğu Ve Ağız Sağlığı”. Ankara Medical Journal, c. 19, sy. 4, 2019, ss. 789-95, doi:10.17098/amj.652021.
Vancouver Ozsin Ozler C, Öztürk Ş, Uzamıs Tekcıcek M. Yutma Bozukluğu ve Ağız Sağlığı. Ankara Med J. 2019;19(4):789-95.