Assessment of oral health literacy of principal caregivers and its association with dental caries in Mexican disabled pediatric patients

Open bite can be defined as an absence of occlusion, most frequently located in the anterior region of dental arches and its etiology is multifactorial. We present a clinical case of an 8 years and 10 months child presenting an anterior open bite (AOB) with transverse maxillary deficiency caused by tongue thrust during mixed dentition. The malocclusion was corrected by means of a McNamara expander with a palatal crib jointly with the association of speech therapy for tongue repositioning, and otolaryngology to treat adenoid hypertrophy due to its correlation with AOB. The multidisciplinary approach was effective in correcting the malocclusion with stable results after 2 years post-treatment.

Multidisciplinary approach in the anterior open bite using a McNamara expander with palatal crib during mixed dentition stage: A case report

Open bite can be defined as an absence of occlusion, most frequently located in the anterior region of dental arches and its etiology is multifactorial. We present a clinical case of an 8 years and 10 months child presenting an anterior open bite (AOB) with transverse maxillary deficiency caused by tongue thrust during mixed dentition. The malocclusion was corrected by means of a McNamara expander with a palatal crib jointly with the association of speech therapy for tongue repositioning, and otolaryngology to treat adenoid hypertrophy due to its correlation with AOB. The multidisciplinary approach was effective in correcting the malocclusion with stable results after 2 years post-treatment.

Delayed Neurological Sequelae in an Infant after Carbon Monoxide Intoxication

Delayed neurological sequelae are symptoms that appear over a period of time after an acute event of carbon monoxide poisoning. The incidence of delayed neurological sequelae is lower in children than in adults and is even more uncommon in infants. Here, we present a case of a 4-month-old infant who developed delayed neurological sequelae after carbon monoxide intoxication. She presented with neurologic symptoms, including opisthotonus, athetoid movements, anterior tongue thrust, and opsoclonus. Because these symptoms are starkly different from those of adults, they should be compared with age-appropriate developmental milestones. Because of their faster metabolic rate and presence of fetal hemoglobin, infants with developing brains may be especially vulnerable to carbon monoxide toxicity. Therefore, thorough neurologic examination and prompt treatment are critical for infants who experience carbon monoxide intoxication.

Endogenous Tongue Thrust – Myth?

Anterior open bite cases are very challenging to manage due to the high relapse potential associated with this feature of malocclusion. It is helpful if the aetiology is established before embarking on treatment to ensure that the appropriate treatment modalities are carried out. Determining whether the aetiology of an anterior open bite is caused by an ‘endogenous tongue thrust’ is extremely difficult. In particular, differentiating between an adaptive and endogenous tongue thrust can be extremely challenging. The case study presented explores the clinical considerations when diagnosing and treating anterior open bites. CPD/Clinical Relevance: This report raises the question: is it possible to diagnose an endogenous tongue thrust?

Impact of Oral Myofunctional Therapy on Orofacial Myofunctional Status and Tongue Strength in Patients with Tongue Thrust

<b><i>Introduction:</i></b> Tongue thrust is a frequent clinical condition characterized by abnormal patterns of movements and altered tongue posture on the mouth floor. It might contribute to determining alterations in the maxillofacial morphology and in the development of malocclusion. Several therapeutic options are available for treatment. In particular, the orofacial myofunctional therapy (OMT) is frequently adopted even if only few studies have analyzed its efficacy using validated instruments and no information is available regarding the effect of dentition on the results obtained with OMT. <b><i>Objective:</i></b> To evaluate the effect of OMT through a validated instrument and explore the role of dentition on its efficacy. <b><i>Methods:</i></b> A total of 22 consecutive patients with tongue thrust were enrolled. According to the presence of mixed or complete dentition, the cohort of patients was divided into 2 groups. Each patient underwent OMT according to the Garliner method (10 weekly sessions of 45 min each in hospital and daily exercises at home). The efficacy of OMT was evaluated using the Orofacial Myofunctional Evaluation with Scores (OMES), a validated protocol developed for the assessment of orofacial myofunctional disorders, and the Iowa Oral Performance Instrument (IOPI) to measure the peak isometric pressure exerted by the anterior and posterior part of the tongue. Both OMES and IOPI were administered before and at the end of the treatment. <b><i>Results:</i></b> A significant improvement in the OMES scores was demonstrated after OMT. No significant differences between the patients with intermediate and mixed dentition obtained in both the pre- and post-treatment conditions were demonstrated in the OMES scores. Similarly, a significant increase in the peak isometric tongue pressure in both the anterior and posterior parts of the tongue was demonstrated after OMT in the groups. No differences between the two groups in both the pre- and post-treatment conditions were demonstrated in the IOPI scores. <b><i>Conclusions:</i></b> OMT improves orofacial motricity and tongue strength in patients with tongue thrust regardless of the type of dentition.

Prevalence of malocclusion and occlusal traits of Malay adults (18-23 years) in Shah Alam, Malaysia

Background: The incidence of malocclusion varies among countries, ethnicities, races, and ages. The recognition of malocclusion incidence is an important role in planning public health services. Aims: To assess the occlusal features of Malaysian Malay adults aged 18-23 years. However, few epidemiological studies have been conducted in Malaysia and a little information is available on Malay malocclusion. Methods: A total sample of 191 subjects (73 males and 118 females) was examined to register the occlusal status by using Angle classification as normal occlusion, Class I, Class II/1, Class II/2 and Class III malocclusion. Other variables were recorded such as overbite, over-jet, crowding, spacing, midline diastema, crossbite, scissors bite, midline shifts, canine displacement, missing teeth, supernumerary teeth, traumatically fractured teeth, traumatic gingival contact, tongue thrust and lip coverage. Statistical analysis: Descriptive statistics were used for all measurements and the chi-square test was used for gender differences. Results: Class III was the most predominant with gender significant (P < 0.05). Class II/2 was the lowest incidence (1%). Overall, the anterior crowding was high (75.9%). There was a significant association between crossbite, scissors bite and genders (P < 0.05). The anterior crossbite was more commonly associated with Class III and the antero-posterior unilateral crossbite was found only in subjects with Class III. Conclusion: The incidence of Class III was higher in Malay; therefore, the orthodontic management of Class III would be more common in the clinic so that it is necessary to start a plan to promote the preventive and interceptive orthodontic treatment in Malay population.

Short-Term Effects of a Myofunctional Appliance on Atypical Swallowing and Lip Strength: A Prospective Study

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.

Management of a Skeletal Class II Malocclusion Using 2-Phase Treatment: An Indian Board of Orthodontics Case Report

PK, a 12-year-old female patient, was diagnosed with skeletal Class II due to retrognathic mandible, average growth pattern, Angle’s Class II, Division I malocclusion with Class II canine relation, mild upper anterior spacing, upper anterior proclination, uprighted lower anterior, lingually tipped 35, increased overjet and overbite, scissor bite Irt 24, 25, acute nasolabial angle, tongue thrust habit, incompetent lips, and lower lip trap. The nonextraction approach to orthodontic treatment was involved. The skeletal malocclusion was corrected using the twin-block appliance, followed by upper and lower pre-adjusted edgewise appliances (0.022 × 0.028 slot) with the MBT prescription.