Children with Down syndrome: oral development and morphology after use of palatal plates between 6 and 48 months of age.

Objective: The aim of this study was to describe the number of erupted teeth, sucking habits, tongue morphology, facial expression and speech in children with Down syndrome (DS) aged 48 +/- 6 months and treated from 6 months of age with palatal plates in combination with speech and language therapy.

Methods: The research took the form of a multicentre, multidisciplinary, longitudinal study of children with DS followed from the age of 6 months. A total of 37 children with DS were included. One child could not cooperate at all and was excluded from the evaluations. In combination with speech and language intervention provided by speech and language therapists, the children used palatal plates provided by dentists from 6 months of age. In the evaluation, the children in the sample (n = 36) were compared with two similarly aged control groups: one group of children with DS who never had used palatal plates (n = 31) and one group of children with normal development (n = 36). The evaluation of oral parameters was performed by dentists after calibration. Registration of facial expression and speech was done by a speech and language therapist, and the evaluation was done by two speech and language therapists and one phonetician who were calibrated in joint discussions.

Results: In contrast to the children with DS in the control group, the subjects in the study were found to have as many erupted teeth as the children with normal development. The prevalence of sucking habits did not differ between the three groups. Only children with DS sucked their tongue, a toy or other things in addition to a thumb or dummy. The prevalence of tongue diastase in the study group with DS was of the same magnitude as in the evaluation at the age of 18 +/- 3 months. The palatal plates were used by 57-65% of the children without any larger problems. In the study sample, the possible beneficial effects of palatal plate therapy were a lower prevalence of posterior cross-bite, a higher prevalence of frontal cusp-to-cusp relation and a lower prevalence of frontal open bite. Evaluation of facial expression and speech showed a higher score for facial expression and a better communicative capacity in the children in the study group than in the control children with DS.

Conclusions: In children with DS, palatal plate therapy between 6 and 48 months of age in connection with speech and language intervention had a positive effect on occlusion, oral motor function, facial expression and speech. No harmful effects were observed. Although this is a valuable method, however, it must be emphasized that palatal plate therapy puts additional demands on already burdened children and their caretakers.