Search Results (65)

Background/Objectives: Tongue thrust (TT) occurs when abnormal tongue movements cause anterior tongue placement with pressure and contact against or between the teeth, potentially affecting the oral phase of swallowing, impacting eating, breathing and speaking. There is limited literature on the diagnostic and treatment approaches for TT, as well as involvement of health practitioners in its management. This study aims to examine the current knowledge and practices related to TT diagnosis and treatment among health professionals in Australia. Methods: A two-phase explanatory sequential mixed methods approach was adopted, comprising an online survey that collected participants’ demographic information and details on assessment, diagnosis, management, referral practices, and relevant experience and training. Phase one involved 47 health professionals from various disciplines in Australia who completed an online survey in its entirety. Phase two included in-depth interviews with seven speech-language pathologists (SLPs) to gain further insights into their experiences in managing TT. Survey data were analysed descriptively, and interview data was analysed thematically. Results: Most participants diagnosed TT using clinical assessments, such as general observation and oral motor examinations. Treatment approaches commonly included orofacial myofunctional therapy and the use of myofunctional devices. Interviews with SLPs identified four key themes: tongue thrust as a symptom rather than a diagnosis, facilitators to effective treatment, multidisciplinary approaches to management, and training and education gaps in clinical practice. Conclusions: This study provides valuable insights into how TT is identified, assessed, diagnosed, and managed by health professionals in Australia. It highlights the perspectives of SLPs on treatment approaches, as well as their views on the availability and adequacy of training and education in this field. The findings suggest the need for a broader understanding of TT management, emphasising the importance of multidisciplinary collaboration and professional development. These insights are globally relevant, as they stress the shared challenges and the value of international collaboration in improving TT diagnosis and treatment practices. Full article

An arrangement of Patristic quoted sources translated from Greek into Syriac were used by Peter of Callinicus in his works against Damian of Alexandria within the sixth-century Tritheist Controversy. Exemplifying one useful role for a translator, the quotations have been extracted and saved from inaccessibility in Peter’s very hefty volumes and presented side-by-side, author-by-author in checked and (where necessary) revised English. This not only better clarifies the argumentative thrust of Peter’s diatribes and how he himself translates Greek into a Semitic tongue, but it will serve Patristic scholarship in showing how the thoughts of well-known Greek Fathers are conveyed in Syriac in the contexts of earlier theological debates. A key theme of this presentation is the Tritheist Controversy which broke out more than a hundred years after the acrimonious controversy over the Council of Chalcedon had cooled down. The focus is mainly on the dispute over the doctrine of the Trinity between the so-named miaphysites, the Syrian Patriarch Peter of Callinicus/um (d. 591) and Coptic Pope Damian of Alexandria (d. 605), which, in turn, led to the schism between Alexandria and Antioch lasting about 30 years. It comprises two parts: (i) A brief outline of the origins, narrative, and postlude of the Tritheist controversy of Peter with Damian and its doctrinal issues; (ii) identifying, enlisting and reproducing numerous seminal quotations in English from the works of earlier Church Fathers contained in Peter’s magnum opus in support and in refutation of (or ‘against’) Damian of Alexandria; and (iii) reflection on issues of translating Patristic texts. Full article

Background/Objectives: Multiple factors may contribute to the development of open bite malocclusion, including genetics and environmental factors. Anterior open bite is usually related to the interposition of the tongue between the dental arches during swallowing or at rest. But how important is the role of the tongue in the development of anterior open bite? And how does anterior open bite malocclusion influence tongue behavior? With this study, we would like to offer a better understanding on the importance of tongue function in the context of this malocclusion. Methods: In this narrative review, a comprehensive electronic search was conducted via PubMed, Google Scholar, and ScienceDirect. The inclusion criteria were original research articles published between 2014 and 2024 with full text access. The exclusion criteria were articles older than 10 years and articles with restricted access or without full text access. Results: Out of the initial 1231 articles, 9 articles were found to be eligible for the present study. The tongue is a part of the neutral zone of the oral cavity, together with the lips and cheek musculature, forming a corridor of equilibrium. If this neuromuscular balance is altered, the teeth will move out of the neutral zone, and various malocclusions may develop. Patients with anterior open bite experience difficulties in closing the anterior portion of the oral cavity during swallowing; therefore, adaptative changes occur in an attempt to compensate by changing the dynamics of the tongue. Conclusions: The cause–effect relationship between tongue malfunction and anterior open bite remains controversial. This review article mentions the possible role of the tongue in anterior open bite etiology, but evidence is still needed on this subject, as it is yet unclear whether the influence of the tongue is a primary cause, an influencing factor, or just a consequence of an already-existing vertical occlusal pathology. Full article

Objectives: The aim of this study was to describe the factors that affect the normal dental development of preschool children in Latvia, and to investigate sources that mothers use to get information on children’s oral health. Materials and Methods: A cross-sectional study was performed in two kindergartens in Latvia (cluster sampling). The study sample comprised 141 child–mother pairs of preschool children aged 4–7 years. The dental situation of all children was assessed including evaluation by an orthodontist and a speech therapist, and mothers of children filled out the survey on oral health-related habits and information about it. Statistical analysis: We described individually factors related to orthodontal situations, children’s speech problems, and factors that can affect tongue thrust. We investigated relationships between sources of mothers’ information and oral health-related behaviors using univariate (Kruskal–Wallis test, a chi-squared test, a Fisher test, or Cramer’s V test) and multivariate analyses. We built a multiple logistic regression model adjusted for the demographic and oral health-related factors to investigate the factors associated with tongue thrust. Results of multiple logistic regression were presented with odds ratio (OR) and 95% confidence intervals (CI). Results: In total, 36.9% of children grazed vegetables several times a week, and 61.0% cleaned their teeth twice a day. Of mothers, 12% did not receive any information about child dental care from their general physician, and 23.4% found the received information insufficient. A total of 43.3% of mothers received oral health-related information from friends, and it was significantly related to less carbonated water (p < 0.01), more help during teeth cleaning (p = 0.03), starting cleaning teeth in earlier age (p = 0.03), and more frequent visits to a child dentist (p = 0.03). Conclusions: A lack of knowledge was found to be prominent in mothers of kindergarten children in Latvia, and most of them received information not from official sources such as their general physician. This can be related to some problems in oral health behaviors and oral health-related diseases. Communication among dental health specialists, state authorities, and families is crucial for the improvement of children’s dental situation. Full article

The aim of this systematic review is the assessment of the effect of mouth breathing on the prevalence of tongue thrust. The review was performed according to the PRISMA 2020 checklist guidelines, and the protocol was registered with PROSPERO (CRD42022339527). The inclusion criteria were the following: studies of clinical trials and cross-sectional and longitudinal descriptive studies that evaluate the appearance of tongue thrust in patients with mouth breathing; healthy subjects of any age, race or sex; and studies with a minimum sample group of five cases. The exclusion criteria were the following: studies with syndromic patients, articles from case reports, and letters to the editor and/or publisher. Searches were performed in electronic databases such as The National Library of Medicine (MEDLINE via PUBMED), the Cochrane Central Register of Controlled Trials, Web of Science and Scopus, including studies published until November 2023, without a language filter. The methodological quality of the included case–control studies was assessed using the Newcastle–Ottawa Scale (NOS), and the Joanna Briggs Institute (JBI) tool was used for descriptive cross-sectional studies and cross-sectional prevalence studies. A meta-analysis was conducted on studies that provided data on patients’ classification according to mouth breathing (yes/no) as well as atypical swallowing (yes/no) using Review Manager 5.4. From 424 records, 12 articles were selected, and 4 were eligible for meta-analysis. It was shown that there is no consensus on the diagnostic methods used for mouth breathing and tongue thrust. The pooled risk ratio of atypical swallowing was significantly higher in the patients with mouth breathing (RR: 3.70; 95% CI: 2.06 to 6.66). These studies have several limitations, such as the heterogeneity among the individual studies in relation to the diagnostic tools and criteria for the assessment of mouth breathing and atypical swallowing. Considering the results, this systematic review shows that patients with mouth breathing presented higher risk ratios for atypical swallowing. Full article

This case report describes the camouflage treatment of a patient with an anterior open bite, bimaxillary skeletal protrusion with a mild class II skeletal pattern, reduced periodontium with generalized slight bone loss, localized severe bone loss at the maxillary upper incisors, and a tongue thrust habit. Orthodontic treatment included modifying the resting posture of the tongue and sectionally intruding maxillary posterior teeth while controlling the extrusion of mandibular posterior teeth using temporary anchorage devices (TADs), followed by sectional mechanics at the maxillary arch and continuous arch mechanics at the mandibular arch, along with interpromximal reduction at the mandibular teeth and inter-arch elastics from the mandibular teeth to the maxillary TADs to minimize orthodontic force magnitude and duration specifically applied to periodontally compromised maxillary incisors. The patient’s chief complaint was addressed, and treatment objectives were achieved, with good esthetic and occlusal outcomes. Stability was shown over a 56-month follow-up period. Full article

In orthodontics, understanding the pressure of oral soft tissues on teeth is important to elucidate the cause and establish treatment methods. We developed a small wireless mouthguard (MG)-type device that continuously and unrestrainedly measures pressure, which had previously been unachieved, and evaluated its feasibility in human subjects. First, the optimal device components were considered. Next, the devices were compared with wired-type systems. Subsequently, the devices were fabricated for human testing to measure tongue pressure during swallowing. The highest sensitivity (51–510 g/cm²) with minimum error (CV < 5%) was obtained using an MG device with polyethylene terephthalate glycol and ethylene vinyl acetate for the lower and upper layers, respectively, and with a 4 mm PMMA plate. A high correlation coefficient (0.969) was observed between the wired and wireless devices. In the measurements of tongue pressure on teeth during swallowing, 132.14 ± 21.37 g/cm² for normal and 201.17 ± 38.12 g/cm² for simulated tongue thrust were found to be significantly different using a t-test (n = 50, p = 6.2 × 10⁻¹⁹), which is consistent with the results of a previous study. This device can contribute to assessing tongue thrusting habits. In the future, this device is expected to measure changes in the pressure exerted on teeth during daily life. Full article

Background: Functional Chewing Training (FuCT) was designed as a holistic approach to improve chewing function by providing postural alignment, sensory and motor training, and food and environmental adjustments. The aim of this systematic review was to evaluate the effectiveness of FuCT in improving chewing function and the severity of tongue thrust and drooling in children with cerebral palsy as compared with standard treatment. Methods: We conducted a systematic review of randomized controlled trials. The search was performed between October 2021 and January 2022 using the following databases: PubMed, Scopus, Web of Science, and CINAHL. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: The initial search yielded 56 articles. After reading the studies in full, 3 articles were chosen based on the inclusion criteria. Included participants were people with PCI; the studies reported a sample size ranging from 40–80 individuals, one study was on a pediatric population, while the others on adults. The selected studies were then evaluated using Jadad and PEDro scales. Conclusion: Our study confirmed the value of FuCT in improving chewing function and the severity of tongue thrust and drooling. Our results may be useful in optimizing appropriate therapeutic management. Full article

The normative functioning of the stomatognathic system and masticatory apparatus requires specific coordination between several structures such as teeth with good occlusion, tongue without ankyloglossia or thrusting, and well-balanced facial muscles. This study aimed to evaluate the influence of non-normative primary functions such as breathing, swallowing, biting and chewing on the consonant pronunciation outcome in adults affected with facial skeletal deformities. Moreover, the authors would like to promote a new kind of speech therapy-orthognathic speech therapy. A total of 181 adults affected by skeletal class II and III malocclusion were included, along with the relationship between the malocclusion, speech deficiency (20 phonemes tested) and primary function disorders, in the subjects before and after surgical correction. The impact of surgery on pronunciation and primary function improvement and types of Polish phonemes most often misarticulated by Polish adults were also examined. Patients underwent combined treatment and received a full speech pathology examination. The treatment improved speech (p < 0.05), and primary functions (p < 0.05). Palatal, alveolar (p < 0.05), fricatives (p < 0.05), and labiodental consonant pronunciation (p < 0.05) improved. The surgical correction of malocclusion leads to better oral motor control and articulation of Polish consonants in adults. Full article

The field of myofunctional therapy (MT) is complex, as it covers theoretical and practical information on many topics to effectively assess and treat orofacial myofunctional disorders, also known as myofunctional disorders, including tongue thrust, tongue posture, tongue-tie, orthodontic concepts, oral habits, and more. This review summarizes the strengths and usefulness of the book New Trends in Myofunctional Therapy: Occlusion, Muscles and Posture (Saccomanno & Paskay, 2020). The review informs the audience about various important features of the book, chapter materials, and the overall usefulness of the content for professionals working in MT. Providing cuttingedge information, the book draws substantive support from various interdisciplinary journal articles and clinical textbooks. Overall, the book is beneficial to leading professionals in MT as a resource for assessing and treating orofacial myofunctional disorders. Full article

The nonsuppurative osteomyelitis of the mandible is a rare condition that can occur in children due to low-grade inflammatory processes, dental cavities, periodontal lesions as well as the eruption process of the teeth. We submit a case report involving the orthodontic management of a 9-year-old female patient who presented in our service in the mixed dentition period with diagnosed Garre’s sclerosing osteomyelitis of the entire mandibular body. After a full work-up, the following symptoms and signs were noted: bilateral temporomandibular joint (TMJ) pain, loss of the leeway space, anterior open bite, distalization of the secondary maxillary right canine, nail biting and tongue thrust. Our orthodontic objectives were to relieve the TMJ pain, limit the eruption process of the teeth and to diminish the evolution of the osteomyelitis, reduce the growth of the inferior lower third of the face and to prevent further invasive treatment of the patient. In the first phase of treatment, we established a centric relationship using an orthopedic appliance (occlusal splint) and physiotherapy to deprogram the muscles and the TMJ. Throughout the second phase of treatment, we used orthopedic appliances to inhibit the overeruption of the secondary molars. After another year of treatment, the osteomyelitis lesions were under control with the permanent teeth in final position, good facial esthetic and as a functional result, no root resorption. We can conclude that by using low physiological forces to direct and control the growth pattern, good results could be obtained in stabilizing and controlling the sclerosing osteomyelitis of the mandible. Full article

Rett Syndrome is an x linked developmental disorder which becomes apparent in females after 6 to 18 months of age. It leads to severe impairments including loss of speech, loss of hand movements/manual dexterity, characteristic hand movements such as hang wringing and intellectual disability/learning problems. This systematic review was carried out to identify the dental manifestation of Rett syndrome and to shed light on treatment options available for oral health problems associated with Rett syndrome. A systematic literature search was conducted on the PubMed, Scopus, Biomed, Web of Science, Embase, Google Scholars, Cochrane and CINAHL using the following entries: Rett syndrome (n = 3790), Oral health and Rett syndrome (n = 17), dental health of Rett syndrome patients (n = 13), and the MeSH terms listed below: Rett syndrome and Oral Health (n = 17), Rett syndrome and dentistry (n = 29). The final review included 22 search articles. The most common oral findings was bruxism. Masseteric hypertrophy was also reported. Anterior open bite and non-physiological tooth wear was observed. Other oral manifestations of Rett syndrome included mouth breathing, tongue thrusting, digit/thumb sucking, high arch palate. Increased awareness and dental education amongst dentists and assistants regarding the dental manifestations of Rett syndrome and similar neurodevelopmental disorders is required to improve the level of care and empathy they can provide to these differently able patients. Research on dental aspects of Rett is scarce and this remains a neglected topic. Full article

Atypical swallowing needs treatment in order to eliminate harmful interferences of the tongue, which prevent the harmonious growth of the stomatognathic system. The purpose of this study was to assess the effects of a functional appliance on the presence of atypical swallowing, analyzing the lip strength and the altered facial mimics. The effects of a myofunctional appliance (the Froggy Mouth) were evaluated on 40 children (6 males; 24 females; mean age 9.6 ± 2.17) with atypical swallowing—with tongue thrust diagnosed by an expert orthodontist—before and during a 6 month treatment. Data were analyzed over time with a paired samples t-test for normally distributed data. After 6 months of treatment, 33 children out of 40 achieved clinical correction of atypical swallowing due to their good compliance, even at an early stage. Seven children showed low compliance and did not obtain any result. Lip strength in compliant subjects went from 190.30 ± 86.04 cN to 489.39 ± 123.36 cN (t = p < 0.001). Facial mimics improved in 28 out of 33 compliant subjects, and four children with the initial diagnosis of labial incompetence achieved correction. This observational study demonstrates the short-term efficacy of this myofunctional appliance in the treatment of atypical swallowing, achieving correction of the facial mimics and labial incompetence with a significant improvement of the lip strength. Full article

Down syndrome (DS) has the highest prevalence of any chromosomal abnormality identified in newborns. DS children have specific eating and swallowing difficulties such as poor tongue control, mouth opening, swallowing food without chewing, and both facial and occlusal abnormalities. DS children are also at high risk of aspiration, and swallowing food without chewing is considered to be a factor associated with increased risk of aspiration and eating problems. This study aimed to identify factors preventing the acquisition of masticatory function in DS children. The subjects were 75 outpatient DS children (44 males, age range 12 to 36 month-old, mean age 33.0 ± 7.0 monthold; 31 females, age 12 to 36 month-old, mean age 20.8 ± 8.0 month-old), who had not yet acquired masticatory function, out of 319 who visited the clinic between October 2012 and October 2017. The information necessary for assessment was retrospectively extracted from the medical records of the subjects. The items examined included age, birth weight, nutritional intake, picky eating, tactile hyperesthesia, cognitive development assessed by Ohta stage, gross motor function, occlusal condition by Hellman’s dental age, and tongue thrust/lip closure/mastication while eating. The relationships between the acquisition of masticatory function and these items were investigated after one year of rehabilitation. The revealed age, low birth weight, picky eating, and gross motor function to be relevant factors. Among these, gross motor function was found to be the factor most strongly associated with acquisition of masticatory function. Full article

This study uses real-time (cine) MRI to examine how orofacial myofunctional disorders (OMDs) affect muscle function during speech and horn playing. Dynamic MRI images were captured of an OMD subject and control subjects reciting a speech task and sustaining a note on an MRI-compatible horn. A following visual feedback session allowed the OMD subject to view and react to their (cine) MRI next to the image of an elite subject. Profile lines created in MATLAB allowed analysis of muscle function and changes in oral cavitation between the OMD and control subjects. In both the speech and horn films, the OMD subject consistently utilized maladaptive muscle movements, resulting in low and forward tongue position against the front teeth. Both control subjects had tongue placement free of the front teeth, and the horn control subject could elevate the tongue to narrow the air stream and play higher pitches. The MRI films suggest a connection between speech disorders and compromised horn-playing technique. OMDs limit the ability of the tongue to make the changes in oral cavitation used to play different pitches on the horn. Full article