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Chapter 9 Dental Anomalies

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1

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.

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.

2

Normal Dentition

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

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.

3

Normal Dentition

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

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

4

Normal Dentition

Number of permanent teeth per arch:
Central incisors: _____
Lateral incisors: _____
Canines: ______
Bicuspids: _____
Molars: _____
3rd molars/wisdom teeth: _____

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

5

Normal Dentition

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

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

6

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 ______
_____

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

7

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.

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.

8

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.

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.

9

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

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

10

Dental Anomalies

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

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

11

Dental Anomalies

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

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

12

Dental Anomalies and Speech

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

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

13

Dental Anomalies

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

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

14

Dental Anomalies and Speech

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

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.

15

Dental Anomalies

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

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

16

Dental Anomalies

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

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

17

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.

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.

18

Dental Anomalies

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

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

19

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

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

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.

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

Dental Anomalies

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

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

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

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

Dental Anomalies

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

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

24

Dental Anomalies

_____ _____—entire _____ arch is inside _____ arch

Complete crossbite—entire maxillary arch is inside mandibular arch

25

Dental Anomalies and Speech

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

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

26

Dental Anomalies

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

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

27

Dental Anomalies and Speech

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

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

28

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

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

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.

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.