Orthodontic-Speech Therapy Coordination in Cleft Lip and Palate: What Should the Orthodontist Know? 

by Rezzonico Angela Alessandra

Orofacial malformations involve, in almost every case, an orofacial muscle compromise and therefore a SMOF with possible compromises in speech articulation, chewing, swallowing and breathing. For this reason the presence of a certain number of professionals is required and it is of great importance that these figures, revolving around CLP, can coordinate their interventions, in order to minimize the load of care for the child. It is essential to identify, as a team, the right timing of intervention for every child and for each type of treatment, thus reducing the burden of care to a minimum. The multidisciplinary team is an indispensable requirement for the care of subjects with craniofacial malformations. In particular, the cooperation between speech therapist and orthodontist in the treatment of children with CLP is of fundamental importance for a good result both from an anatomical and a functional point of view. The synergy of the two disciplines can determine the best treatment decisions. During growth, children with lip and palate malformations can develop alterations in the language area, especially in speech and more precisely in articulatory activity. In case of dental skeletal alterations, children are sometimes induced to use compensatory articulations that affect the quality of communication making the language difficult to understand if decontextualized. The main articulatory praxic acts necessary for the correct production of speech will therefore be examined, in particular those where a correct conformation of the maxillary mandibular relationship can facilitate a correct language articulation. We will also present and explain alterations relating to the compensation that a subject unknowingly implements in order to achieve the target sound he wants to produce. All the alterations described may have different characteristics as age varies, not only as a consequence of the child's neurobiological growth but in consideration of the needs imposed by the clinical status.

Learning Objectives

After this lecture, you will be able to know which phono-articulatory alterations can be affected by skeletal alterations
After this lecture, you will be able to propose personalized interventions, at the right time, based on the orthodontist/speech therapist collaboration
After this lecture, you will be able to understanding when an impaired function can affect orthodontic work