Speech therapy

Speech therapy of tongue thrust swallowing in Szeged

It is commonly known phenomenon that children at an early stage of development don’t start to speak clearly, certain sounds are replaced by others or the phonation itself is „baby-like”, they push out their tongue while speaking. This phenomenon is the so called speech with tongue thrust swallowing. This may spread out to numerous sounds, it may have impact on the formation of soundings: sz,z,c,s zs,cs,t,d,n,l,ty,gy,ny.

The distorted or supplementary forming of sounds is collectively called lisping. In the first years of the period of shaping coherent speech and routinous application (3-5 years) this phenomenon may be considered to be of physiological nature. (physiological lisping). The necessity of correction of speech disorders accompanied by speech therapy emerges when at the age of 5 the number of mistaken or incorrectly formed sounds still exceeds 10.

It may occur that lisping is combined with other disorders in this development stage, in such case it is justified to look for a speech therapist for children under 5. It is worth paying attention to the ponits below:

• deviation involving pregnancy and birth process
• previous development disorders, diseases in the family
• deferred or obstructed speech development, previously occured in the family, dyslexia (dygraphia, dyscalculia – i.e. difficulties with reading, writing, counting at school age), left-handedness
• deferred, immaturity or disorder symptoms int he movement development of children
• frequent diseases of the upper respiratory
• allergic diseases
• oddities in social behaviour, communication
• expansion of start of speaking (at the age of 3 or later)
• baby language, double-talk, constant maintenance of self-made words
• suspected disorders in speech attention, speech-orientation, speech perception and understanding
• long remaining double-handedness (no dominance shaped up to 5)
• erratic speech
• left-handedness
• deviations in movement coordination, balance, spatial orientation, attention, activity, biorhytm irregularities

Tongue thrust swallowing

The background of defective artculation has frequently the above mentioned swallowing peculiarity in the background, the so called tongue thrust swallowing. Its subsistance until the change of teeth can be considered as physiologic phenomenon, but later on abnormal. The initial, voluntary stage of the swallowing process takes place within the mouth and for those who produce the abnormal form occurs like this: by swallowing the dentures don’t close and the tongue produces an almost horizontal in-and-out movement (up and down) so sliding between the front or the side teeth, respectively it will push them at all swallowings. From speech therapy aspects this leads to the distorted formation of the already mentioned sounds sz,z,c,s zs,cs,t,d,n,l,ty,gy,ny, the formation occurs in such cases spectacularly between the two dentures making the tip and the front side of the tongue visible. Is is often followed by the open status of the lips at normal breathing, too.

The following factors may play a role in the formation of defective swallowing (sometimes even breathing):

• peculiarities of infants and childhood nutrition (artificial nutrition, use of insuffient sized pacifier, or the too big whole shaped on it).
• By teeth changing the tongue conforms to the changing mouth area anatomy and performs compensation movement and this is not being settled by the existence of the remaining teeth.
• Thumb sucking, prolonged use of pacifier.
• Upper respiratory diseases, because of which the tongue (also its front side) falls forward (increased nose or pharyngeal tonsils, allergic diseases).
• Generally sluggish muscles all over the body, disorder of muscle tone, overall weakness of movement coordination.

Setting up diagnosis as well as indication of the necessary therapy shall be made by a team of specialists including an ear-nose-throat sepcialist, a dentist, an orthodontics specialist (orthodontus), a speech therapist, in some cases a phoniater (if the phonation changes spread out on the tone, too). In the longer period of therapy the speech therapist and the orthodontus have a major role, since both the swallowing and the speech can be shaped to an activity that takes place properly even in spontanous use in the course of a long, practicing-strenthening-automating process.

The mechanical influence of the position of tongue and teeth is often necessary, this is the professional field of the orthodontics specialist who is in charge of deciding what device might promote the shaping of normal denture, biting, tongue position, swallowing. The „tempering” of muscles around the mouth and inside it, the formation of correct resting and speech breathing, the change of speech sounds formation adjusted to the standard, are followed by speech therapist. The expression „follow” is not accidental here; during the succesful outcome of the therapy the motivation of child and parent as well as the regular practicing of trained movements and exercises at home have the same importance as the job of the professional team.

This following, speech correction service became available also in Szeged.

Tooth disorders

• Jam
• Open bite (incisors don’t come together when biting)
• Deep bite (upper incisors overlap or cover the lower incisors)
• Cross bite (e.g. upper teeth bite not before but behind lower teeth)
• Tooth outside or inside teeth arch
• Excessive leaning of teeth in- or outside
• Retarded teeth
• Supernumerery teeth
• Lack of tooth germ

Disordres concerning the jaw

• Underdeveloped or too big jaw
• Underdeveloped or too big upper jaw
• The combination of the above, disproportion between the size and location of jaws
• Open bite
• Deep bite
• Dyssymmetry
• Lips- and palate gaps

Frequent deviations we meet in adulthood

• Overgrown or leaned teeth due to missing teeth, obstructing preparation of prothesis
• Wandering teeth due to periodontal diseases
• Surgery- orthodontics treatments due to jaw deformities
• Disfunctions of mandibular joints (pain, clacking)
• Aesthetic interventions

Why do tooth disorders shape?

1. Genetic reason

• The size and shape of our teeth are genetically determined. However, the size of the jaw is coded by other genes. So it may occur that we inherit too big teeth with small jaw or too small teeth with big jaw resulting jamming or on the contrary gapping.
• A great number of deviations can itself be inherited, for example the protruding, overgrown jaw (bulldog bite) let’s think of the Habsburg family. Family aggregation can be observed in many cases due to lack of germ, supernumerery teeth, or just due to gaps (lips- and palate gap).

2. Outer harms

• Bad habits, functional disorders
• Thumb sucking (children push the upper incisors outside with their thumbs, like a „bracing” device)
• Tongue thrust swallowing (tongue is jamming between the two dentures by swallowing)
• Lips-pressure swallowing (lower lip is jamming behind the upper incisors, so upper incisors lean forward, the lower ones backwards)
• Nail chewing, pencil chewing
• Bruxism (mainly at night, in most cases because of stress)
• Nutrition disorders (baby doesn’t suck, doesn’ chew enough)
• Impaired nasal breathing (when child is sick for longer time, can’t take breath through nose, breathing happens through mouth only. Accordingly, lips are always open, teeth are not supported by the muscle of lips, therefore upper incisors lean outside)
• Premature loss of milk teeth (removal of milk teeth at least one year prior to breaking out the final teeth). Early removal of milk teeth causes a great number of disorders, because the neighbouring teeth start to wander towards the missing space and the later breaking peermanent teeth will find insufficient place, so they will stand inside or outside the denture, in worst case they are unable to grow at all and remain inside the bone. Bite may also sink causing deep bite syndrome. To prevent this phenomenen we prefer keeping teeth, on the other hand, if removal is indispensible, we used to suggest the application of site maintenance. This can be removable or fixed, small size device, doesn’t disturb children.
• Trauma (due to accident of milk teeth the permanent tooth doesn’t break out or breaks out with abnormal poisiton).

Meglepő lehet, de vannak olyan ételek, italok, melyek kifejezetten jót tesznek fogaival. A cukormentes rágógumi jótékony hatását sokan ismerik, de tudta Ön például, hogy a fekete- és zöldtea ill. a hüvelyesek fluor tartalmuknak köszönhetően erősítik a fogzománcot?

A csíkok a fogkrém anyagára utalnak, 3 féle csoportot különböztethetünk meg:

• 100%-ban szintetikus anyagokból készült fogkrémek, ezt fekete vagy kék színnel tüntetik fel a tubuson
• 50-50%-ban tartalmaz vegyi-, illetve szintetikus anyagokat, ezt piros csík jelzi
• 100%-ban csak természetes anyagokból áll, ennek tubusán zöld csík található

A francia Pierre Fauchard-t tartják a fogszabályozás atyjának, aki 1728-ban kiadott könyvében írt a fogászati kezelésekről. Ő vezetett be egy olyan készüléket, mely leginkább egy lópatkóhoz hasonlított, és a fogsor igazításához használták. Az orthodoncia elnevezés azonban Joachim Lefoulon-tól származik, aki 1841-ben megjelent művében írt felfedezéseiről.