1 and 2 Mouth breathing, a pathological condition,3 may be due to upper airway obstruction, sagging facial muscles, or habit;1 any individual who has exhibited this type of breathing for a minimum of six months should be considered a mouth breather.4 Genetic factors and exposure to obstructive factors, regardless of etiology, can be detrimental to child development. Among the consequences of mouth breathing
are alterations in cranio-orofacial growth, speech, nutrition, GDC-0449 mouse body posture, sleep quality, and school performance.1 Overall, the mouth breather presents alterations in posture, tone, and mobility of lips, tongue and cheeks, resulting in less efficiency in stomatognathic functions: chewing, swallowing and speech, flaccid jaw elevator muscles, anterior head posture, maxillary atresia, and speech disorders.5 and 6 Speech can be altered due to flaccid facial muscles, incorrect positioning of the tongue,7 or structural problems of the oral cavity caused by malocclusion and/or deficiencies in facial growth and development.2 and 8 The most commonly described speech disorders in mouth breathers are: anterior position of tongue during production of lingual dental phonemes,9 imprecision in bilabial (/p/,/b/,/m/) and fricative (/f/,/v/,/s/,/z/,/ʒ/,/∫/) phonemes in Portuguese, frontal lisp (FL), and lateral (LL) lisp.10, 11 and 12 Children
who are mouth-breathers can Akt inhibitor review also have daytime sleepiness,13 and 14 poor brain oxygenation,15 or immature auditory processing. All of these complications can lead to learning disabilities.16 Thus, the aims of this study were to assess the development of speech, the most frequently observed speech alterations, and to correlate them with the etiology of mouth breathing The knowledge of these aspects can help health professionals to prevent or minimize the consequences of mouth breathing. Mouth-breathing children (n = 439) aged 4 to 12 years, enrolled in and regularly attending the Mouth-breather Gefitinib ic50 Center (Centro do Respirador Bucal – CRB) of the Universidade Federal de São Paulo/Escola Paulista de
Medicina (UNIFESP-EPM) from May of 2000 to May of 2011, were evaluated. Patients with genetic syndromes, orofacial malformations, or mental retardation were excluded. Patients were evaluated according to standards established by the CRB. First, patients were evaluated by the otorhinolaryngology specialist and then, by the other specialists of the CRB: allergist, physical therapis, dentist, orthodontist, and speech therapist, always on the same day. Patients with a history of mouth breathing for at least six months, with nasal obstruction, pallid or hyperemic nasal mucosa, with or without hypertrophy of adenoid (volume occupying less than 70% of airway) and tonsils (grade I or II), and nonobstructive nasal septal deviation/turbinate (Brozek et al.5), conditions observed by the otorhinolaryngology specialist during clinical examination and nasal fibroscopy, were included.