Do oral ankyloglossia impact orofacial, craniofacial development and malocclusion?
The answer is a resounding yes! There is much evidence and scientific basis for this argument.
Do oral brakes impact breastfeeding? The answer is: there are still doubts. That is, a baby, even with ankyloglossia, can be able to suckle at the mother's breast, gain weight and not hurt her nipple. (Pediatricians and happy mothers)
But is it just that? In these cases, is everything ok? NOT.
For those who know the physiology of breastfeeding and are up-to-date with new evidence on the importance of intraoral vacuum for milk extraction during breastfeeding, you know that even when the baby is gaining weight and the mother is comfortable and pain-free, this baby will be extracting milk in an "adapted" way and without proper coordination between breathing, sucking and swallowing functions, impacting their cranium and orofacial development.
We know that these adaptations can impact the establishment of malocclusions, due to changes in sucking, swallowing, breathing, speech and chewing.
Are we all aware of this?
Undoubtedly, breast milk as food is the best we can provide the baby. But this is ONE of the points of the importance of breastfeeding.
We, as pediatric dentists, have to be aware of the physiology of breastfeeding and that all its neuromotor stimuli are being coordinated. And the tongue plays a very important role in this physiology.
From the pediatric dentist's point of view, the movements performed by the tongue and all the muscles involved in milk extraction allow the palate to develop, the mandible to advance and initiate the formation of the temporomandibular joint, which stimulates extremely important centers of craniofacial growth and development. of the baby.
Correct lip sealing stimulates nasal breathing which, in this way, stimulates the growth of the middle third of the face. Sucking and swallowing coordinated with breathing also stimulate posture and development of the cervical spine.
Not to mention breastfeeding from the point of view of speech therapy, osteopathy, occupational therapists, lactation consultants and many other professionals who must be attentive to the development of this “system” that is the baby and its first thousand days of life, and of the mother/baby binomial.
Transdisciplinarity is fundamental, so it is not possible to look at the short lingual frenulum only from ONE point of view.
The mandatory assessment of the lingual frenulum, through a law (questionable or not) raised the issue of lack of training for diagnosis, intervention decision and techniques to be used.
It is not a matter of minimizing the importance of the lingual frenulum or reserving your attention to specific health specialties.
It is about training all professionals involved for the correct diagnosis (which presents validated evaluation protocols) and planned and appropriate interventions for each case.
The management of breastfeeding is undoubtedly very important and can help many cases where we find it difficult to carry out breastfeeding, regardless of the presence of a short lingual frenulum.
However, we still observe professionals who are not trained for this role and many specialties in search of this training.
From my point of view, the pediatric dentist must be able to adjust the orthopedic/orthodontic “device” that breastfeeding represents, allowing all the movements inserted in it to allow the neuromotor development that will provide the harmonious development of the arcades and functional occlusion.
Monitoring craniofacial development since pregnancy should be part of our work. We have to train ourselves for that.
If, in this way, the short lingual frenulum is an impediment factor, we must diagnose it and carry out the necessary interventions in common transdisciplinary agreement (pediatrician, speech therapist, osteopath, family).
The surgical technique will depend on the conditions and diagnosis, performed by trained and qualified professionals.
Remembering the importance of the postoperative period, where the continuity of monitoring will ensure the success of the intervention.
Reference
AS REPERCUSSÕES DO FREIO CURTO E A IMPORTÃNCIA DA LÍNGUA NO DESENVOLVIMENTO OROFACIAL.
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ALEITAMENTO MATERNO E MALOCLUSÃO NA DENTIÇÃO DECÍDUA. MALOCLUSÃO NA DENTIÇÃO DECÍDUA PODE INDICAR RISCO DE MALOCLUSÃO NA DENTIÇÃO PERMANENTE
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Peres KG, Peres MA, Thomson WM, Broadbent J, Hallal PC, Menezes AB. Deciduous-dentition malocclusion predicts orthodontic treatment needs later: fi ndings from a population-based birth cohort study. Am J Orthod Dentofacial Orthop 2015b; 147: 492–98.
TEORIA DO VÁCUO PARA O ALEITAMENTO MATERNO - IMPORTÂNCIA DA LÍNGUA.
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A LÍNGUA E O DESENVOLVIMENTO OROFACIAL
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POSIÇÃO DA LÍNGUA NA CAVIDADE ORAL EM REPOUSO - TESTES VALIDADOS
Martinelli RLC, Marchesan IQ, Berretin-Felix. Posição da língua no repouso em bebês com e sem alteração do frênulo lingual. Anais do 22º Congresso Brasileiro de Fonoaudiologia. 2014. p.5157. [acesso em: 2017 fev. 19]. Disponível em: http://sbfa.org.br/portal/anais2014/trabalhos_exp_select.php?tp=P&id_artigo=5157
Martinelli, R.L.C. Validação Do Protocolo De Avaliação Do Frênulo Da Língua em Bebês. [Dissertação De Mestrado].Bauru :Universidade De São Paulo Faculdade De Odontologia De Bauru; 2015
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