Impacts of Skeletal Anterior Open Bite Malocclusion on Speech

Abstract

Introduction: Articulation problems are seen in 80% to 90% of dentofacial deformity (DFD) subjects compared with 5% of the general population, impacting communication and quality of life, but the causal link is unclear. We hypothesize there are both qualitative (perceptual) and quantitative (spectral) differences in properties of stop (/t/ or /k/), fricative (/s/ or /ʃ/), and affricate (/tʃ/) consonant sounds and that severity of anterior open bite (AOB) jaw disharmonies correlates with degree of speech abnormality. Methods: To test our hypotheses, surgical orthodontic records and audio recordings were collected from DFD patients (n = 39 AOB, 62 controls). A speech pathologist evaluated subjects, and recordings were analyzed using spectral moment analysis (SMA) to measure sound frequency distortions. Results: Perceptually, there is a higher prevalence of auditory and visual speech distortions in AOB DFD patients when compared to controls. Quantitatively, a significant ( P < .01) increase in the centroid frequency (M1) was seen in the /k/, /t/, /tʃ/, and /s/ sounds of AOB subjects compared to the controls. Using linear regression, correlations between AOB skeletal severity and spectral distortion were found for /k/ and /t/ sounds. Conclusions: A higher prevalence of qualitative distortions and significant quantitative spectral distortions in consonant sounds were seen in AOB patients compared to controls. Additionally, severity of skeletal AOB is correlated with degree of distortion for consonant sounds. These findings provide insight into how the surgical and/or orthodontic treatment of AOB may impact speech.

Assessment of anterior open bite prevalence in children visiting a dental hospital – A retrospective evaluation

“…The findings of the present investigation are in line with studies by Al-Balkhi Zah-rani and Al-Emran et al .,[ 43 ] which concluded that Class I malocclusion was the most typical type of malocclusion seen in the Saudi population followed by Class II division I and Class III. [ 37 43 44 45 ] According to Abdullah MA, the dental malocclusion which is prevalent in the Saudi population is Angle's Class I, followed by asymmetrical molar relationship in patients with AOBs. A small sample size and the inclusion of only participants who reported to a private dental institution are few limitations of the study.…”

Impacts of Development, Dentofacial Disharmony, and Its Surgical Correction on Speech: A Narrative Review for Dental Professionals

“…An articulation disorder is a type of SSD characterized by “atypical production of speech sounds characterized by substitutions, omissions, additions or distortions that may interfere with intelligibility” [ 10 ]. Articulation disorders are often seen in DFD patients with severe malocclusions and jaw disproportions [ 19 , 26 , 44 ]. Starting at age seven, the American Association of Orthodontics (AAO) recommends that children be referred to an orthodontist for an initial evaluation [ 45 ].…”

“…Severe malocclusion has been implicated as a cause of speech distortion, especially in the pronunciation of sibilants [s] and [z] [ 44 – 46 ]. Linear correlations have been found between the severity of malocclusion and the degree of distortion, suggesting causation between malocclusion and speech distortions [ 19 , 26 , 44 ].…”

“…Common SSDs in the AOB population also include sibilants such as [s] and [z] as well as postalveolar affricate [tʃ] (<ch>) and labiodental fricatives [f] and [v] [ 73 , 74 ]. Keyser et al found a 10-fold increased prevalence of interdental and auditory distortions compared with controls for sequences including /ta/, /la/, /sa/, /si/, and /s I si/ [ 19 , 66 ]. Similarly, sibilants [s] and [z] were aberrant in several studies of AOB patients, with one study identifying articulation problems in 84.4% of children with AOB [ 61 ].…”

“…Similarly, sibilants [s] and [z] were aberrant in several studies of AOB patients, with one study identifying articulation problems in 84.4% of children with AOB [ 61 ]. Linear correlations were also found between open-bite severity and degree of speech distortions [ 19 ].…”