Saturday, 05 February 2011 / Published in Dental Hygienist, Dentists, Orofacial Myologist, Orthodontist, physical therapists, speech languge pathologist, Therapists, Uncategorized

Deep Overbite Impinging

Hi Sandra,

How are you? How is Orlando?

I have a young client (female, age 12) who has a very deep overbite. So deep that her lower teeth touch her alveolar ridge when she is at rest.

She is able to do skinny-fat and make a tip for the football hold and touch tip to the spot when her mouth/jaw is open. She is unable to touch the tip to spot while mouth closed as her bottom teeth are there. She is unable to execute a correct swallow. There is no visible tongue protrusion but she cannot hold water in mouth with her tongue suctioned to roof of mouth.

Does the deep overbite need to be addressed before we can move on to therapy?

Also..I should also mention that this young girl has a long history of speech therapy for articulation and intelligibility. Her speech is much improved but she still needs reminders to speak slowly for intelligibility.

I would love to hear your thoughts.

Thank you very much!

Hi,

Good to hear from you. Orlando is wonderful and the people are friendly, just like in a small town.

In response to your questions about the 12 year girl:

Yes, you’ll recall we talked in class about the possibility of the lower teeth impinging upon the tongue with such a deep overbite. We discussed how it might be necessary in certain cases, to have them move the “spot” back a mm or so if that eliminates the impingement. This is to be done only if the altered position can be maintained comfortably. Considering her difficulty with the water suction exercise, her continued difficulties with articulation through 12 years old, etc., it seems to suggest she might also have a narrow palate. Is she seeing an orthodontist? If not, is her family able to take her to see one?

Have you ruled out ankyloglossia? Does she have any concomitant learning difficulties?

As a side note, you might remember our class discussion about a client’s having to speak slowly to be intelligible….in reality, if form is acceptable and function is operating well, one should not have to speak slowly to be highly intelligible. This young lady needs your help for sure and perhaps the help of some others as well. It sounds like you have maximized her as far as proficiency exam #1 is concerned; if not, be sure to do so. Beyond that, you might be limited and orthodontic intervention might be needed before you can expect further success.

I hope this helps. Your question is excellent and demonstrate how nicely you are thinking and reasoning and questioning.