Incorrect Orofacial functions until 5 years of age and their association with posterior crossbite

Resident: Swan
Title: Incorrect Orofacial Functions Until 5 years of age and their association with posterior crossbite.
Author: Maja Ovsenik
Journal: American Journal of Orthodontics and Dentofacial orthopedics
Major Topic: Habits associated with posterior crossbite
Main Purpose: Investigate the prevalence of posterior crossbite in Slovenian preschoolers at 5 years of age and its relationship to sucking habits, mouth breathing, and atypical swallowing patterns at ages 3,4, and 5.
Methods: 243 Slovenian children were evaluated at ages 3,4, and 5. Sucking habits, irregular orofacial functions, and morphologic malocclusion were all noted. Before the clinical exam, the parents completed a questionnaire regarding the child's sucking habits. Then, the child was evaluated for mouth breathing (compentent lip closure or not) and swallowing pattern (tongue thrust/teeth apart swallowing). "Normal" swallowing pattern was characterized by tooth contact and activity of masseter muscle. Intraorally, posterior crossbite, midline deviation, and transverse relationships were noted.
Results: Posterior crossbite age 5 diagnosed in 15.2 % of children. Majority were unilateral.
The difference of irregular orofacial functions between crossbite and non crossbite groups was significantly significant for mouth breathing and pacifier sucking. At age 3, 50% of the children with crossbite had a pacifier habit, while only 20% of the noncrossbite kids did. Pacifier sucking decreased markedly by age 5 among the kids, while mouth breathing stayed relatively constant. Diagnosed in 40% of kids with CB, 25% without. Atypical swallowing was also significantly related to crossbite, as this habit increased by year in the crossbite group and decreased substantially by year in the non CB group.
Conclusions:
1. To intercept CBs and funct. shifts, the deciduous dentition should be observed closely especially in children with habits from 2-3 years old. Sucking habits have a direct effect on the developing occlusion and an indirect effect by changing the swallowing pattern.
2. each clinical examination in children with sucking habits should include assessment of orofacial functions (esp. swallowing pattern) In this study, atypical swallowing was diagnosed principally by palpating the masseter and temporalis muscles. Atypical swallowing was diagnosed with no masseter activity on swallowing.