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Cleft Palate > Chapter Nine > Flashcards

Chapter Nine Flashcards

1
Q

Dental Anomalies

Children with cleft or craniofacial anomalies commonly have anomalies of the ______.

Dental and occlusal anomalies can cause _______and ________productions.

Speech-language pathologist must correct the _______ in speech that occur as a result of these anomalies.

A

teeth and jaws

obligatory speech distortion and compensatory articulation

functional modifications

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2
Q

Normal Dentition

________(permanent) teeth number ___total, __teeth in each arch.

____ and _____are in premaxilla.

Canine and lateral incisor border the ______.

A

Succedaneous; 32; 16

Central and lateral incisors

incisive sutures

IMAGE

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3
Q

Normal Dentition

Deciduous teeth number ___total, __teeth in each arch.

A

20; 10

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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

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:

________-horizontal (or anterior-posterior) relationship between the incisors

______—vertical overlap of the upper and lower incisors

A

Overjet (Labioversion)—

Overbite

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6
Q

Normal Occlusion

Dental occlusion—

Normal relationship of the upper to the lower teeth is called a ______

Normal occlusion is important for:
1.
2.
3.

A

manner in which the teeth fit together

Class I occlusion.

  1. Aesthetics
  2. Biting and chewing
  3. Speech
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7
Q

Normal Occlusion and Speech

____incisors overlap _____teeth.

Tongue rests in ____, just under ______.

Tongue tip is able to move up and down during speech without ______.

Upper and lower lips are approximated for ______and ______sounds.

A

Maxillary; mandibular

mandible; alveolar ridge

dental interference

bilabial AND labiodental

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8
Q

Normal Occlusion and Speech

_____(teeth sounds) are not really produced by the teeth.

_______is done to elevate the mandible, which positions the ______under the alveolar ridge.

Sibilants are produced by …

Teeth are really not necessary for _____.

A

Sibilants

Closing the teeth; tongue tip

airstream between the tongue tip and the alveolar ridge.

normal speech

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9
Q

Dental Anomalies and Speech

Teeth may cause speech problems by interfering with lip and tongue movement, affecting _____or ____sounds.

Abnormal structure can cause:
1.
2.

A

bilabial OR lingual

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

Overjet

A

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

image

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11
Q

Underjet (anterior crossbite)—

A

a reversal of the normal upper to lower incisor relationships; upper incisors are inside lower incisors

image

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12
Q

Dental Anomalies and Speech

Severe overjet may affect ______ and ____sounds.

Underjet (anterior crossbite) may cause ….

A

bilabial competence and bilabial

maxillary teeth to interfere with tongue tip placement for sibilant.

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13
Q

Overbite—

Underbite (deep bite)—

A

too much overlap of the upper incisors over the lower incisors

a vertical overlap of the lower incisors over the upper incisors

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14
Q

Dental Anomalies and Speech

Both overbite and underbite can ________of oral cavity during occlusion.

Dental anomalies cause _______

They can affect ____ and _____sounds.

A

shorten vertical dimension

oral cavity crowding.

lingual-alveolar and sibilant

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15
Q

Dental Anomalies

______are common in those with cleft lip and alveolus.

Central incisors and lateral incisors (if present) are often _______

A

Rotated teeth

rotated toward the cleft.

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16
Q

Dental Anomalies

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

A

Supernumerary teeth; palate

IMAGE

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17
Q

Dental Anomalies and Speech

Rotated, supernumerary, or ectopic teeth may interfere with _________

Teeth can _____the airstream laterally, causing an ______

Pulling the tongue back for compensation also causes ______.

A

tongue tip movement during speech.

divert; obligatory lateral distortion.

lateral distortion

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18
Q

Dental Anomalies

Missing teeth

A

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

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19
Q

Dental Anomalies

Open bite—

Causes include:
1.
2.
3.

A

when one or more maxillary teeth fail to occlude with the opposing mandibular teeth.

  1. Missing teeth
  2. Poor occlusion due to digit or pacifier sucking habits
  3. Skeletal discrepancies
20
Q

Dental Anomalies and Speech

Missing teeth or open bite only affect speech if there is _____

Tongue may ______through an anterior opening, causing _____of sibilants or lingual-alveolar sounds.

Tongue may protrude through a lateral opening (due to missing teeth in line of the cleft), causing a ______

A

oral cavity crowding.

protrude; fronting

lateral distortion.

21
Q

Dental Anomalies

Crossbite—

Anterior crossbite—

A

upper teeth are inside the lower teeth; common with history of cleft

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 _____teeth to articulate against _____during occlusion. This, in turn, can cause:

A

maxillary; tongue

  1. Fronting of sibilants (obligatory distortion)
  2. Lateral distortion of sibilants (compensatory error) if the tongue is brought back to compensate
23
Q

Dental Anomalies

Lateral (posterior) crossbite—

A

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

IMAGE

24
Q

Dental Anomalies

Complete crossbite—

A

entire maxillary arch is inside mandibular arch

image

25
Q

Dental Anomalies and Speech

Lateral (posterior) crossbite and complete crossbite can _______

Dental anomalies cause ______due to oral cavity crowding.

A

restrict oral cavity size.

distorted speech

26
Q

Dental Anomalies

_______is sometimes a problem with bilateral complete cleft lip and palate.

A

Protruding premaxilla

27
Q

Dental Anomalies and Speech

A protruding premaxilla can affect _______at rest and also during speech.

Bilabial sounds may be produced with a _______

A

bilabial competence

labiodental placement.

28
Q

Occlusion and Skeletal Relationships

Occlusion—

Angle Classification
System—

Skeletal relationship—

A

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

29
Q

Occlusion and Skeletal Relationships

Malocclusion—

The mandible (and thus the tongue) can be positioned ….

This can affect the relationship of _____to ____ or relationship between the upper and lower ___.

A

an abnormal dental or skeletal relationship between the maxillary and mandibular teeth in which the arches do not close together normally during biting

too far behind or in front of the maxilla.

tongue tip to alveolar ridge

lip

30
Q

Angle’s Classification of Occlusion**

A

Chart

31
Q

Class I Occlusion:

The mesiobuccal (front outside) cusp of the first maxillary molar fits in the ______of the first mandibular molar

A

occlusion—maxillary and mandibular arch relationship is normal, although the teeth may be misaligned

buccal (outside) groove

32
Q

Class II Malocclusion and Speech

If severe, Class II causes the tongue to …..

This can cause obligatory distortion of ____and ______ phonemes.

The individual may compensate by ______

A

be under the palatal arch, rather than the alveolar ridge.

sibilants and lingual-alveolar

backing tongue-tip sounds.

33
Q

Class III Malocclusion:

The mesiobuccal (front outside) cusp of the first _____is posterior to the buccal (outside) groove of the first mandibular molar.

It is often associated with _____and ______

A

maxillary arch is too far behind the mandibular arch; causes midface retrusion; common with CLP

maxillary molar

anterior crossbite and mandibular prognathism.

34
Q

Class III Malocclusion and Speech

Difficulty with ____and ______because the tongue tip is in front of the maxilla and alveolar ridge

Can cause _____(obligatory distortion)

Can cause _______, resulting in lateral distortion (compensatory error)

Difficulty with ______due to lip discrepancy

Can cause________for labiodental and bilabial sounds

A

sibilants and lingual-alveolars

fronting

dorsal production

labial sounds

reverse labiodental production

35
Q

Stages of Dental Development

Essay Question***

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

36
Q

Infant Stage (______) Treatment

Premaxillary orthopedics (for _______)

Done in ____period

_______manipulation of the premaxilla and lateral segments

Makes _____easier with better results

___and/or ____repair

A

0 to 12 months

bilateral complete clefts

newborn

Nonsurgical

lip repair

Lip and or palate

37
Q

Primary Dentition (______) Treatment

______ expansion

May be started at ______of age

Goal is to create __________ and to_______

Can be done within a _____

Retention done with _______

A

1 to 6 Years

Maxillary

4 to 5 years

adequate width of the maxilla and to correct position of erupting permanent incisors

few months

lingual fixed appliance

38
Q

Maxillary expansion

May result in _______or _____a new fistula

Fistula can be______ if necessary

Fistula is usually closed later with ______

A

widening a preexisting fistula or opening

temporarily obturated

a bone graft

39
Q

Early Mixed Dentition (_______) Treatment

________(or face mask)—a nonsurgical option for correction of maxillary retrusion

A

6 to 9 Years

Reverse pull headgear

40
Q

Early Mixed Dentition (6 to 9 Years) Treatment

_________ graft

Done at site of cleft in _____ before _____ of lateral incisor and canine in cleft area

_______ is usually used for the graft

Helps to _______ and give _______for incisors to erupt through

A

Alveolar bone

alveolar ridge; eruption

Iliac crest bone

stabilize maxillary arch; bony structure

41
Q

Late Mixed Dentition (______) Treatment

Orthodontics to …

Replacement of …

A

9 to 12 Years

improve dental relationships

missing teeth with denture plate

42
Q

Adolescent Dentition(______)

Full ….

May make occlusion …

A

12 to 18 Years

orthodontic treatment to align the teeth in the arches

worse until the orthognathic surgery is done

43
Q

Adolescent Dentition (12 to 18 Years)

Orthognathic surgery or …

Done after _______ (girls: _____; boys: ______)

_______of missing teeth

A

distraction to align the jaws

facial growth is complete

girls: age 14-15
boys: age 18-19

Permanent replacement

44
Q

Summary of Stages of Treatment

Premaxillary orthopedics:

Lip repair:

Palate repair:

Maxillary expansion:

Alveolar bone graft:

Orthodontics:

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

45
Q

Role of Speech Therapy

A

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.

46
Q

Summary

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 (19 decks)

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