Speech Disorders in Dysgnathic Adult Patients in the Field of Severity of Primary Dysfunction

Anna Lichnowska,Marcin Kozakiewicz

doi:10.3390/app112412084

Abstract

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.

Highlights

The normative functioning of the stomatognathic system and masticatory apparatus requires coordination between several structures such as teeth with good occlusion, tongue without ankyloglossia or thrusting, and well-balanced facial muscles
Oral control of fine motor skills should be established according to modern phonetics and logopaedics by the age of 7–8, which means that both children above that age and adults should not present disorders in primary functions, unless there is some anatomical or physiological obstacle
This study examining adult population describes the associations between human primary function disorders and the quality of articulated consonants

Summary

Introduction

The normative functioning of the stomatognathic system and masticatory apparatus requires coordination between several structures such as teeth with good occlusion, tongue without ankyloglossia or thrusting, and well-balanced facial muscles. The concept of primary function was introduced to Polish logopaedics by Wojciechowska [2] It indicates the significant role of certain basic oral non-speech activities of the cranio- and oro-facial regions in proper pronunciation of the phonemes, especially consonants. These include breathing, swallowing, biting and chewing. D’Onofrio, in her article, lists several aspects that may be fundamental in malocclusion among children: airway obstruction, mouth breathing, abnormal resting postures of jaw, lips and tongue, oral habits, tongue thrust, incorrect chewing and other orofacial myofunctional disorders such as habitual thumb sucking, biting nails or other objects. Even though there is plenty of literature concerning speech difficulties in children seeking orthodontic or orthognathic treatment, there is little research concerning adults

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