{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T11:34:11Z","timestamp":1765971251670,"version":"3.48.0"},"reference-count":35,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Introduction: Malocclusion and dysfunctional or atypical swallowing are two conditions that significantly affect the health and well-being of the stomatognathic system, so much so that they often interact, influencing each other, and the presence of one can cause the onset or aggravation of the other. In this regard, over the years studies have been carried out that tried to discover the correlation between atypical swallowing and malocclusion. The aim is to evaluate the prevalence of dysfunctional swallowing in patients with malocclusion, to examine the pathophysiological mechanisms linking malocclusion and dysfunctional swallowing, and above all to investigate what potential risk factors may be. Materials and Methods: A sample of 60 patients aged between 6 and 16 years was analyzed at the Department of Dentistry of the University of L\u2019Aquila. Some characteristics of the subjects\u2019 face and posture were analyzed both from a frontal and lateral point of view. An orthodontic, temporomandibular joint, and masticatory muscle diagnosis was made. In addition, an examination of oral structures and functions was performed that allowed breathing, swallowing, chewing, and phono-articulation to be assessed. Results: It was observed that all the children had atypical swallowing, with significant postural abnormalities of the tongue; in fact, only 5% had a correct posture of the tongue at rest. In the analysis of occlusal characteristics, it emerged that with regard to the transverse plane, 21.67% of subjects have a condition of No Cross, while 10% show a Unilateral Cross. Finally, 68.33% show a Bilateral Cross. As far as the anterior\u2013posterior plane is concerned, most of the subjects, equal to 76.67%, are placed in Class I, while 23.33% are in Class II. Finally, in relation to the vertical plane, 63.33% of subjects have normal occlusion, while 25% suffer from deep bite and 11.67% from open bite. The sample, stratified by presence or absence of alerts, shows significant differences for atypical swallowing (p = 0.031), for the presence of Class II malocclusion (p = 0.002), for low lingual posture, (p &lt; 0.001), and for labial incompetence (p = 0.001). The multivariate logistic regression model showed that the presence of atypical swallowing (OR 1.04, 95% CI 1.04\u20131.07, p = 0.029), open bite malocclusion (OR 1.09, 95% CI 1.01\u20131.18, p = 0.013), low lingual posture (OR 1.11, 95% CI 1.04\u20131.18, p = 0.002), and the presence of labial incompetence (OR 1.06, 95% CI 1.02\u20131.10, p = 0.029) were significant clinical risk factors independently associated with the presence of alerts. Conclusions: The data collected confirm that atypical swallowing is a key element in the development of malocclusions, with a strong impact on posterior crossbite, anterior overjet, and other occlusal discrepancies. Among the data collected in the diagnostic phase, patients who presented at least one significant alert were also considered and atypical swallowing, low lingual posture, open bite malocclusion, and the presence of labial incompetence were statistically significant.<\/jats:p>","DOI":"10.3390\/dj13120607","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T10:41:23Z","timestamp":1765968083000},"page":"607","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cross-Sectional Study of Atypical Swallowing and Occlusal Characteristics in 6\u201316-Year-Old Patients Presenting for Orthodontic Care"],"prefix":"10.3390","volume":"13","author":[{"given":"Sara","family":"Caruso","sequence":"first","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Cipriani","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Development, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Martino","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucilla","family":"Calgani","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Arcangeli","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Gatto","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Caruso","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6420-8116","authenticated-orcid":false,"given":"Antonella","family":"Mattei","sequence":"additional","affiliation":[{"name":"Department of Life, Health and Environmental Sciences, University of L\u2019Aquila, 67100 L\u2019Aquila, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"ref_1","first-page":"33","article-title":"Froggy mouth: A new myofunctional approach to atypical swallowing","volume":"20","author":"Manzini","year":"2019","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_2","unstructured":"De Filippis Cippone, A. (1998). Nuovo Manuale di Logopedia, Erickson."},{"key":"ref_3","unstructured":"Lanteri, C., Vernero, I., and Lanteri, V. (2009). Malocclusioni e Logopedia. Educazione Della Bocca e Correzione Delle Malocclusioni Nell\u2019et\u00e0 Evolutiva, Edizioni Martina."},{"key":"ref_4","first-page":"777","article-title":"Tongue disorders and jaw deformities: Nosological aspects and therapeutic concepts","volume":"14","author":"Dahan","year":"1989","journal-title":"Mondo Ortod."},{"key":"ref_5","first-page":"149","article-title":"Eziopatogenesi e trattamento precoce delle malocclusioni correlate al perdurare della deglutizione atipica","volume":"2","author":"Garattini","year":"1991","journal-title":"Mondo Ortod."},{"key":"ref_6","first-page":"217","article-title":"Atypical swallowing: A review","volume":"63","author":"Maspero","year":"2014","journal-title":"Minerva Stomatol."},{"key":"ref_7","unstructured":"Werlich, E.P. (1962). The Prevalence of Variant Swallowing Patterns in a Group of Seattle School Children. [Master\u2019s Thesis, University of Washington]."},{"key":"ref_8","first-page":"S3649","article-title":"Effect of Orthodontic Treatment on Airway Dimensions in Patients with Obstructive Sleep Apnea: A Prospective Study","volume":"16","author":"Alam","year":"2024","journal-title":"J. Pharm. Bioallied Sci."},{"key":"ref_9","first-page":"18","article-title":"Progetto riabilitativo individuale nella Disfagia: Valutazione funzionale strumentale e revisione della letteratura","volume":"38","author":"Martorana","year":"2022","journal-title":"G. Ital. Med. Riabil."},{"key":"ref_10","unstructured":"Ruoppolo, G., Schindler, A., Amitrano, A., and Genovese, E. (2012). Manuale di Foniatria e Logopedia, Societ\u00e0 Editrice Universo."},{"key":"ref_11","unstructured":"Schindler, O., Ruoppolo, G., and Schindler, A. (2020). Deglutologia, Omega Edizioni. [2nd ed.]."},{"key":"ref_12","unstructured":"Ferrante, A. (2007). Manuale Pratico di Terapia Miofunzionale, Marrapese Editore."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"37","DOI":"10.52010\/ijom.2006.32.1.4","article-title":"Instrumentation and measurement procedures in orofacial myology","volume":"32","year":"2006","journal-title":"Int. J. Orofac. Myol. Myofunct. Ther."},{"key":"ref_14","first-page":"13","article-title":"The diagnostic importance of the Payne technique","volume":"3","year":"1992","journal-title":"J. Gen. Orthod."},{"key":"ref_15","unstructured":"Hanson, M.L., and Mason, R.M. (2003). Orofacial Myology: State of the art in Europe. Orofacial Myology: International Perspectives, CC Thomas."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100639","DOI":"10.1016\/j.ortho.2022.100639","article-title":"Evaluation of the diagnostic accuracy of CBCT based interpretations of maxillary impacted canines compared to those of conventional radiography: An in vitro study","volume":"20","author":"Hajeer","year":"2022","journal-title":"Int. Orthod."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1111\/joor.12826","article-title":"Electromyographic analysis of the oral phase of swallowing in subjects with and without atypical swallowing: A case-control study","volume":"46","author":"Begnoni","year":"2019","journal-title":"J. Oral Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"52","DOI":"10.14295\/bds.2010.v13i1\/2.20","article-title":"Prevalence of malocclusion and its relationship with functional changes in the breathing and in the swallowing","volume":"13","author":"Marcomini","year":"2010","journal-title":"Braz. Dent. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1093\/ejo\/cjt028","article-title":"A 2D ultrasound evaluation of swallowing in children with unilateral posterior crossbite","volume":"36","author":"Ovsenik","year":"2014","journal-title":"Eur. J. Orthod."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1093\/ejo\/1.4.271","article-title":"Sucking habits and their influence on swallowing pattern and prevalence of malocclusion","volume":"1","author":"Melsen","year":"1979","journal-title":"Eur. J. Orthod."},{"key":"ref_21","first-page":"113","article-title":"Relationships between swallowing pattern, mode of respiration, and development of malocclusion","volume":"57","author":"Melsen","year":"1987","journal-title":"Angle Orthod."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/j.ajodo.2008.03.018","article-title":"Incorrect orofacial functions until 5 years of age and their association with posterior crossbite","volume":"136","author":"Ovsenik","year":"2009","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_23","first-page":"321","article-title":"Causal relationship between malocclusion and oral muscles dysfunction: A model of approach","volume":"13","author":"Saccomanno","year":"2012","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/ejo\/26.3.237","article-title":"Prevalence of malocclusions in the early mixed dentition and orthodontic treatment need","volume":"26","author":"Tausche","year":"2004","journal-title":"Eur. J. Orthod."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1067\/mod.2001.118627a","article-title":"Morphological and positional asymmetries of young children with functional unilateral posterior crossbite","volume":"5","author":"Pinto","year":"2001","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1067\/mod.2001.118626","article-title":"Changes in the masticatory cycle following treatment of posterior unilateral crossbite in children","volume":"120","author":"Throckmorton","year":"2001","journal-title":"Am. J. Orthod. Dentofacial. Orthop."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1007\/s00056-007-2606-9","article-title":"Relationship between occlusal findings and orofacial myofunctional status in primary and mixed dentition\u2014Part II: Prevalence of orofacial dysfunctions","volume":"68","author":"Stahl","year":"2007","journal-title":"J. Orofac. Orthop."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"380","DOI":"10.2319\/030708-137.1","article-title":"Posterior crossbite and functional changes. A systematic review","volume":"79","author":"Andrade","year":"2009","journal-title":"Angle Orthod."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1093\/ejo\/cjq042","article-title":"Altered oral sensory perception in tongue thrusters with an anterior open bite","volume":"33","author":"Premkumar","year":"2011","journal-title":"Eur. J. Orthod."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.ortho.2020.12.005","article-title":"Anterior open bite and its relationship with dental arch dimensions and tongue position during swallowing and phonation in individuals aged 8\u201316 years: A retrospective case\u2013control study","volume":"19","author":"Franco","year":"2021","journal-title":"Int. Orthod."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1067\/mod.2000.109494","article-title":"Kinesiographic study of the mandible in young patients with unilateral posterior crossbite","volume":"118","author":"Palma","year":"2000","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_32","first-page":"5","article-title":"Treating the open bite","volume":"8","author":"Pedrazzi","year":"1997","journal-title":"J. Gen. Orthod."},{"key":"ref_33","first-page":"e2221285","article-title":"Association between atypical swallowing and malocclusions: A systematic review","volume":"27","author":"Taveira","year":"2023","journal-title":"Dent. Press J. Orthod."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1590\/S1415-54192005000600012","article-title":"Prevalence of malocclusion and functional changes among students by the Family Health Program in Juazeiro do Norte, Cear\u00e1, Brazil","volume":"10","author":"Suliano","year":"2005","journal-title":"Rev. Dent. Press Ortod. Ortop. Facial"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"14","DOI":"10.22514\/jocpd.2024.100","article-title":"Orthodontic treatment in patients with atypical swallowing and malocclusion: A systematic review","volume":"48","author":"Inchingoglo","year":"2024","journal-title":"J. Clin. Pediatr. 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