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Cleft Palate > Ch. 9 > Flashcards

Ch. 9 Flashcards

0
Q

Dental Anomalies

Children with cleft or craniofacial anomalies commonly have anomalies of the _____ and _____.
Dental and occlusal anomalies can cause obligatory _____ distortion compensatory _____ productions.
Speech-language pathologist must correct the functional modifications in speech that occur as a result of these anomalies.

A

Children with cleft or craniofacial anomalies commonly have anomalies of the teeth and jaws.
Dental and occlusal anomalies can cause obligatory speech distortion compensatory articulation productions.
Speech-language pathologist must correct the _____ modifications in speech that occur as a result of these _____.

The term occlusion means how the upper and lower set of teeth align with each other.

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1
Q

Chapter 9Dental Anomalies

A

*

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2
Q

Normal Dentition

_____ (permanent) teeth number _____ total, ____ teeth in each arch.
_____ and lateral incisors are in _____.
_____ and lateral incisor border the _____ sutures.

A

Succedaneous (permanent) teeth number 32 total, 16 teeth in each arch.
Central and lateral incisors are in premaxilla.
Canine and lateral incisor border the incisive sutures.

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3
Q

Normal Dentition

_____ teeth number _____ total, _____ teeth in each arch.

A

Deciduous teeth number 20 total, 10 teeth in each arch.

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4
Q

Normal Dentition

Number of permanent teeth per arch:
Central incisors: \_\_\_\_\_ 
Lateral incisors: \_\_\_\_\_ 
Canines: \_\_\_\_\_\_ 
Bicuspids: \_\_\_\_\_ 
Molars: \_\_\_\_\_ 
3rd molars/wisdom teeth: \_\_\_\_\_
A 
Number of permanent teeth per arch:
Central incisors: 2 
Lateral incisors: 2 
Canines: 2 
Bicuspids: 4 
Molars: 4 
3rd molars/wisdom teeth: 2
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5
Q

Normal Dentition

Normal relationship of the incisors:
_____ (_____)—______ (or anterior-posterior) relationship between the incisors
______—______ overlap of the upper and lower incisors

A

Normal relationship of the incisors:
Overjet (Labioversion)—horizontal (or anterior-posterior) relationship between the incisors
Overbite—vertical overlap of the upper and lower incisors

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6
Q

Normal Occlusion

_____ occlusion—manner in which the teeth fit together
Normal relationship of the _____ to the ______ teeth is called a Class _____ occlusion.
Normal occlusion is important for:
______
______ and ______
_____

A

Dental occlusion—manner in which the teeth fit together
Normal relationship of the upper to the lower teeth is called a Class I occlusion.
Normal occlusion is important for:
Aesthetics
Biting and chewing
Speech

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7
Q

Normal Occlusion and Speech

_____ incisors overlap _____ teeth.
Tongue rests in mandible, just under _____ _____.
Tongue tip is able to move up and down during speech without dental interference.
_____ and _____ lips are _____ for _____ and _____ sounds.

A

Maxillary incisors overlap mandibular teeth.
Tongue rests in mandible, just under alveolar ridge.
Tongue tip is able to move up and down during speech without dental interference.
Upper and lower lips are approximated for bilabial and labiodental sounds.

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8
Q

Normal Occlusion and Speech

____ (teeth sounds) are not really produced by the teeth.
Closing the teeth is done to elevate the mandible, which positions the tongue tip under the alveolar ridge.
Sibilants are produced by _____ between the _____ ____ and the _____ _____.
Teeth are really not necessary for normal speech.

A

Sibilants (teeth sounds) are not really produced by the teeth.
Closing the teeth is done to elevate the mandible, which positions the tongue tip under the alveolar ridge.
Sibilants are produced by airstream between the tongue tip and the alveolar ridge.
Teeth are really not necessary for normal speech.

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9
Q

Dental Anomalies and Speech

Teeth may cause speech problems by interfering with ____ and _____ movement, affecting _____ or _____ sounds.

Abnormal structure can cause:
_____ _____—articulation placement is normal, but ____ abnormalities interfere with the sound, causing speech distortion
____ ____—articulation is altered to compensate for structural abnormalities, causing a _____ error

A

Teeth may cause speech problems by interfering with lip and tongue movement, affecting bilabial or lingual sounds.
Abnormal structure can cause:
Obligatory distortion—articulation placement is normal, but structural abnormalities interfere with the sound, causing speech distortion
Compensatory error—articulation is altered to compensate for structural abnormalities, causing a substitution error

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10
Q

Dental Anomalies

_____—abnormal when the horizontal relationship between the incisors exceeds ___ mm

A

Overjet—abnormal when the horizontal relationship between the incisors exceeds 2 mm

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11
Q

Dental Anomalies

_____ (anterior crossbite)—a reversal of the normal upper to lower incisor relationships; _____ incisors are _____ lower incisors

A

Underjet (anterior crossbite)—a reversal of the normal upper to lower incisor relationships; upper incisors are inside lower incisors

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12
Q

Dental Anomalies and Speech

Severe overjet may affect bilabial ____ and bilabial ____.
Underjet (anterior crossbite) may cause ____ teeth to interfere with tongue _____ placement for ____.

A

Severe overjet may affect bilabial competence and bilabial sounds.
Underjet (anterior crossbite) may cause maxillary teeth to interfere with tongue tip placement for sibilant.

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13
Q

Dental Anomalies

_____—too much overlap of the upper incisors over the lower incisors
_____ (deep bite)—a _____ overlap of the ____ incisors _____ the _____ incisors

A

Overbite—too much overlap of the upper incisors over the lower incisors
Underbite (deep bite)—a vertical overlap of the lower incisors over the upper incisors

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14
Q

Dental Anomalies and Speech

Both _____ and _____ can shorten _____ dimension of oral cavity during occlusion.
Dental anomalies cause oral cavity _____.
They can affect _____-_____ and ____ sounds.

A

Both overbite and underbite can shorten vertical dimension of oral cavity during occlusion.
Dental anomalies cause oral cavity crowding.
They can affect lingual-alveolar and sibilant sounds.

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15
Q

Dental Anomalies

____ teeth are common in those with cleft lip and alveolus.
Central incisors and lateral incisors (if present) are often rotated _____ the cleft.

A

Rotated teeth are common in those with cleft lip and alveolus.
Central incisors and lateral incisors (if present) are often rotated toward the cleft.

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16
Q

Dental Anomalies

_____ teeth (extra teeth) and _____ teeth (normal teeth that erupt in abnormal positions) often erupt in _____ in line of the cleft.

A

Supernumerary teeth (extra teeth) and ectopic teeth (normal teeth that erupt in abnormal positions) often erupt in palate in line of the cleft.

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17
Q

Dental Anomalies and Speech

Rotated, supernumerary, or ectopic teeth may interfere with tongue ____ movement during speech.
Teeth can divert the airstream _____, causing an obligatory _____ distortion.
Pulling the _____ _____ for compensation also causes lateral distortion.

A

Rotated, supernumerary, or ectopic teeth may interfere with tongue tip movement during speech.
Teeth can divert the airstream laterally, causing an obligatory lateral distortion.
Pulling the tongue back for compensation also causes lateral distortion.

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18
Q

Dental Anomalies

_____ teeth—lateral incisor and/or canine often missing because they border the line of the cleft

A

Missing teeth—lateral incisor and/or canine often missing because they border the line of the cleft

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19
Q

Dental Anomalies

_____ _____—when one or more maxillary teeth fail to occlude with the opposing mandibular teeth. Causes include
_____ teeth
Poor ____ due to _____ or _____ sucking habits
_____ discrepancies

A

Open bite—when one or more maxillary teeth fail to occlude with the opposing mandibular teeth. Causes include
Missing teeth
Poor occlusion due to digit or pacifier sucking habits
Skeletal discrepancies

20
Q

Dental Anomalies and Speech

Missing teeth or open bite only affect speech if there is oral cavity ____.
Tongue may _____ through an ____ opening, causing _____ of _____ or _____-____ sounds.
Tongue may protrude through a _____ opening (due to missing teeth in line of the cleft), causing a _____ distortion.

A

Missing teeth or open bite only affect speech if there is oral cavity crowding.
Tongue may protrude through an anterior opening, causing fronting of sibilants or lingual-alveolar sounds.
Tongue may protrude through a lateral opening (due to missing teeth in line of the cleft), causing a lateral distortion.

21
Q

Dental Anomalies

_____—_____ teeth are _____ the +++++ teeth; common with history of cleft
_____ crossbite—____ incisors positioned _____ the _____ incisors; typical with Class _____ malocclusion and midface _____

A

Crossbite—upper teeth are inside the lower teeth; common with history of cleft
Anterior crossbite—maxillary incisors positioned inside the mandibular incisors; typical with Class III malocclusion and midface retrusion

22
Q

Dental Anomalies and Speech

Anterior crossbite can cause maxillary teeth to articulate ____ tongue during occlusion. This, in turn, can cause:
_____ of _____ (obligatory distortion)
_____ distortion of ____ (compensatory error) if the tongue is brought back to compensate

A

Anterior crossbite can cause maxillary teeth to articulate against tongue during occlusion. This, in turn, can cause:
Fronting of sibilants (obligatory distortion)
Lateral distortion of sibilants (compensatory error) if the tongue is brought back to compensate

23
Q

Dental Anomalies

____ (posterior) ____—affects teeth distal (posterior) to the canines; can be unilateral or bilateral; usually occurs because the _____ is too _____

A

Lateral (posterior) crossbite—affects teeth distal (posterior) to the canines; can be unilateral or bilateral; usually occurs because the maxilla is too narrow

24
Q

Dental Anomalies

_____ _____—entire _____ arch is inside _____ arch

A

Complete crossbite—entire maxillary arch is inside mandibular arch

25
Q

Dental Anomalies and Speech

_____ (posterior) _____ and complete crossbite can restrict oral cavity size.
Dental anomalies cause distorted _____ due to oral cavity _____.

A

Lateral (posterior) crossbite and complete crossbite can restrict oral cavity size.
Dental anomalies cause distorted speech due to oral cavity crowding.

26
Q

Dental Anomalies

_____ _____ is sometimes a problem with _____ complete cleft lip and palate.

A

Protruding premaxilla is sometimes a problem with bilateral complete cleft lip and palate.

27
Q

Dental Anomalies and Speech

A _____ _____ can affect _____ competence at ____ and also during __.
Bilabial sounds may be produced with a _____ placement.

A

A protruding premaxilla can affect bilabial competence at rest and also during speech.
Bilabial sounds may be produced with a labiodental placement.

28
Q

Occlusion and Skeletal Relationships

____—the way the maxillary and mandibular teeth fit together when the jaws are closed
____ _____ ____—describes normal occlusion and three types of malocclusion
_____ _____—the way the jaws (not just the teeth) come together during biting

A

Occlusion—the way the maxillary and mandibular teeth fit together when the jaws are closed
Angle Classification System—describes normal occlusion and three types of malocclusion
Skeletal relationship—the way the jaws (not just the teeth) come together during biting

29
Q

Occlusion and Skeletal Relationships

\_\_\_\_—an abnormal dental or skeletal relationship between the maxillary and mandibular teeth in which the \_\_\_\_ do not \_\_\_\_\_ together normally during biting
The mandible (and thus the tongue) can be positioned too far \_\_\_\_\_ or in \_\_\_\_ of the \_\_\_\_.
This can affect the relationship of tongue tip to \_\_\_\_ \_\_\_\_ or relationship between the \_\_\_\_ and \_\_\_\_ lip.
A 
Malocclusion—an abnormal dental or skeletal relationship between the maxillary and mandibular teeth in which the arches do not close together normally during biting
The mandible (and thus the tongue) can be positioned too far behind or in front of the maxilla.
This can affect the relationship of tongue tip to alveolar ridge or relationship between the upper and lower lip.
30
Q

Angle’s Classification of Occulisons

A

See Ch. 9 PPT and Slide 31

31
Q

Class I Occlusion

Class \_\_\_\_ occlusion—maxillary and mandibular arch relationship is \_\_\_\_\_, although the teeth may be \_\_\_\_
The \_\_\_\_\_ (front outside) \_\_\_\_\_ of the first maxillary molar fits in the \_\_\_\_\_ (outside) groove of the first mandibular molar
A 
Class I occlusion—maxillary and mandibular arch relationship is normal, although the teeth may be misaligned
The mesiobuccal (front outside) cusp of the first maxillary molar fits in the buccal (outside) groove of the first mandibular molar
32
Q

Class II Malocclusion

Class ____ malocclusion—_____ arch is too far in _____ of the _____ arch
The _____ (front outside) cusp of the first maxillary molar is anterior to the _____ (outside) groove of the first mandibular molar.
Class II malocclusion is often associated with _____.

A

Class II malocclusion—maxillary arch is too far in front of the mandibular arch
The mesiobuccal (front outside) cusp of the first maxillary molar is anterior to the buccal (outside) groove of the first mandibular molar.
Class II malocclusion is often associated with micrognathia.

33
Q

Class II Malocclusion and Speech

If severe, Class II causes the _____ to be ____ the _____ arch, rather than the alveolar ridge.
This can cause obligatory distortion of ____ and _____-_____ phonemes.
The individual may compensate by backing ____-____ sounds.

A

If severe, Class II causes the tongue to be under the palatal arch, rather than the alveolar ridge.
This can cause obligatory distortion of sibilants and lingual-alveolar phonemes.
The individual may compensate by backing tongue-tip sounds.

34
Q

Class III Malocclusion

Class ____ malocclusion—maxillary arch is too far ____ the mandibular arch; causes midface _____; common with CLP
The mesiobuccal (front outside) cusp of the first maxillary molar is posterior to the buccal (outside) groove of the first mandibular molar.
It is often associated with _____ _____ and _____ _____.

A

Class III malocclusion—maxillary arch is too far behind the mandibular arch; causes midface retrusion; common with CLP
The mesiobuccal (front outside) cusp of the first maxillary molar is posterior to the buccal (outside) groove of the first mandibular molar.
It is often associated with anterior crossbite and mandibular prognathism.

35
Q

Class III Malocclusion and Speech

Difficulty with _____ and _____-_____ because the tongue ____ is in _____ of the _____ and _____ _____
Can cause _____ (obligatory distortion)
Can cause ____ production, resulting in _____ distortion (compensatory error)
Difficulty with _____ sounds due to _____ discrepancy
Can cause reverse labiodental production for labiodental and bilabial sounds

A

Difficulty with sibilants and lingual-alveolars because the tongue tip is in front of the maxilla and alveolar ridge
Can cause fronting (obligatory distortion)
Can cause dorsal production, resulting in lateral distortion (compensatory error)
Difficulty with labial sounds due to lip discrepancy
Can cause reverse labiodental production for labiodental and bilabial sounds

36
Q

Stages of Dental Development

\_\_\_\_ stage: \_\_\_\_ to \_\_\_\_ months
\_\_\_\_\_ dentition: \_\_\_\_ to \_\_\_\_ years
\_\_\_\_ mixed dentition: \_\_\_\_ to \_\_\_\_\_ years
\_\_\_\_ mixed dentition: \_\_\_\_ to \_\_\_\_ years
\_\_\_\_\_ dentition: \_\_\_\_ to \_\_\_\_ years
A 
Infant stage: 0 to 12 months
Primary dentition: 1 to 6 years
Early mixed dentition: 6 to 9 years
Late mixed dentition: 9 to 12 years
Adolescent dentition: 12 to 18 years
37
Q

Infant Stage (0 to 12 months) Treatment

Premaxillary orthopedics (for bilateral complete clefts)
Done in ____ period
Nonsurgical manipulation of the premaxilla and lateral segments
Makes lip repair easier with better results
Lip and/or palate repair

A

Premaxillary orthopedics (for bilateral complete clefts)
Done in newborn period
Nonsurgical manipulation of the premaxilla and lateral segments
Makes lip repair easier with better results
Lip and/or palate repair

38
Q

Primary Dentition (1 to 6 Years) Treatment

____ expansion
May be started at ____ to ____ years of age
Goal is to create adequate ____ of the maxilla and to correct position of erupting permanent incisors
Can be done within a few months
Retention done with lingual fixed ____

A

Maxillary expansion
May be started at 4 to 5 years of age
Goal is to create adequate width of the maxilla and to correct position of erupting permanent incisors
Can be done within a few months
Retention done with lingual fixed appliance

39
Q

Primary Dentition (1 to 6 Years) Treatment

Maxillary expansion
May result in ____ a preexisting fistula or ____ a new fistula
Fistula can be temporarily obturated if necessary
Fistula is usually closed later with a ____ graft

A

Maxillary expansion
May result in widening a preexisting fistula or opening a new fistula
Fistula can be temporarily obturated if necessary
Fistula is usually closed later with a bone graft

40
Q

Early Mixed Dentition (6 to 9 Years) Treatment

____ pull _____ (or face mask)—a nonsurgical option for correction of ____ ____

A

Reverse pull headgear (or face mask)—a nonsurgical option for correction of maxillary retrusion

41
Q

Early Mixed Dentition (6 to 9 Years) Treatment

____ bone graft
Done at site of cleft in alveolar ridge before eruption of lateral incisor and canine in cleft area
Iliac crest bone is usually used for the graft
Helps to stabilize ____ arch and give bony structure for incisors to erupt through

A

Alveolar bone graft
Done at site of cleft in alveolar ridge before eruption of lateral incisor and canine in cleft area
Iliac crest bone is usually used for the graft
Helps to stabilize maxillary arch and give bony structure for incisors to erupt through

42
Q

Late Mixed Dentition (9 to 12 Years) Treatment

____ to improve dental relationships
____ of missing teeth with _____ plate

A

Orthodontics to improve dental relationships

Replacement of missing teeth with denture plate

43
Q

Adolescent Dentition (12 to 18 Years)

Full _____ treatment to ____ the teeth in the arches
May make occlusion worse until the orthognathic surgery is done

A

Full orthodontic treatment to align the teeth in the arches

May make occlusion worse until the orthognathic surgery is done

44
Q

Adolescent Dentition (12 to 18 Years)

____ surgery or distraction to align the ____
Done after facial growth is complete (girls: age _____ to ____; boys: age ____ to ____)
____ replacement of missing teeth

A

Orthognathic surgery or distraction to align the jaws
Done after facial growth is complete (girls: age 14 to 15; boys: age 18 to 19)
Permanent replacement of missing teeth

45
Q

Summary of Stages of Treatment

\_\_\_\_\_ orthopedics: infant stage
\_\_\_\_ repair: about 3 months
\_\_\_\_\_ repair: about 10 months
\_\_\_\_ expansion:  6 to 9 years
\_\_\_\_ bone graft: 6 to 9 years
\_\_\_\_\_: 12 to 18 years
\_\_\_\_\_ surgery or distraction
A 
Premaxillary orthopedics: infant stage
Lip repair: about 3 months
Palate repair: about 10 months
Maxillary expansion:  6 to 9 years
Alveolar bone graft: 6 to 9 years
Orthodontics: 12 to 18 years
Orthognathic surgery or distraction
46
Q

Summary of Stages of Treatment CONT.

Premaxillary orthopedics: \_\_\_\_ stage
Lip repair: about \_\_\_\_ months
Palate repair: about \_\_\_\_ months
Maxillary expansion:  \_\_\_\_ to \_\_\_\_ years
Alveolar bone graft: \_\_\_\_ to \_\_\_\_ years
Orthodontics: \_\_\_\_ to \_\_\_\_ years
Orthognathic surgery or distraction
A 
Premaxillary orthopedics: infant stage
Lip repair: about 3 months
Palate repair: about 10 months
Maxillary expansion:  6 to 9 years
Alveolar bone graft: 6 to 9 years
Orthodontics: 12 to 18 years
Orthognathic surgery or distraction
47
Q

Role of Speech Therapy

Speech therapy to correct compensatory errors is best.
It’s always best to correct after structure is fixed.
Speech therapy does not correct obligatory errors.

A

Speech therapy to correct ____ ____ is best.
It’s always best to correct ____ structure is ____.
Speech therapy does ____ correct ____ errors.

48
Q

Summary

Children with clefts or other craniofacial anomalies are at risk for ___ and ____ abnormalities.
Most ____ are produced in the ____ portion of the oral cavity.
Abnormalities of the anterior dental arch and of jaw relationships can interfere with movement of the ____ ____ and ____.
It’s important for ____ professionals and speech-language pathologists to work closely together to coordinate care.

A

Children with clefts or other craniofacial anomalies are at risk for dental and occlusal abnormalities.
Most consonants are produced in the anterior portion of the oral cavity.
Abnormalities of the anterior dental arch and of jaw relationships can interfere with movement of the tongue tip and lips.
It’s important for dental professionals and speech-language pathologists to work closely together to coordinate care.

Cleft Palate (7 decks)

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