“STUDY OF OROFACIAL MIOFUNCTIONAL CHARACTERIZATION OF CHILDREN BETWEEN 4 AND 12 YEARS OF AGE WHO

ATTEND THE DENTISTRY CLINIC OF THE UNIVERSITY OF TALCA”

Flga. Orietta San Martín / 2016

OROFACIAL MIOFUNCTIONAL PHONE-AUDIOLOGICAL EVALUATION GUIDELINE

NAME: ______________________ _________________________________________ RUT _____________________________

BIRTH DATE:____ /___ __/_______ __ AGE: ___________ __to ____m EXAM DATE:__ __/ __/_________
SCHOLARSHIP: _____ _______ __

INFORMANT:
COMMUNE: PHONE:

YO. RELEVANT ANAMNESTIC HISTORY

Complete the requested information and/or mark with “X”

Development Background

Prenatal
Pregnancy: Normal_____ Pathological____
Maternal pathology: _________________________________________________________________
Fetal pathology: ____________________________________________________________________
Perinatal
Delivery: Normal ___ Caesarean section
Programmed____ Urgency_______ cause?______________________________________________________________

Gestational age_______ weeks Weight______________g rs. Size_____________cms. APGAR_____ - _____

Postnatal
Postnatal pathology No_____ Yeah____ Which?___________________________________________________________________

Psychomotor development
Head support:_________ months
Sitting: ______________ months
March: _________months
Daytime sphincter control________ night____________

Linguistic Development (in months)

Babbling: _________ Holophrase: ________ Simple sentences: _________

Dietary History ( Best score=0, Worst score=2) Score obtained =(_____)

Breast-feeding
Maternal Breast: No _____ Cause __________________________________________________________________________
Yeah ____ Duration_______________

Bottle: No ____________ Yeah ______ Duration________________

Food consistency
Porridge starting age ____________
Solid start age _________________
Current predominant consistency (0) solid_______ (1) crushing____ (1) porridge ___ (1) liquid______

Current Eating Utensil Use

(1) Baby bottle _____ (0) Transition vessel_______ (0) Mug________

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Oral Habits ( Best score=0, Worst score=6) Score obtained =(__ __)

Suction: (0) No ______ (1)Yes______

(1) Pacifier _____ Duration: _____________________ ____ Frequency: day_____ _ evening____
(1) Digital _____ Duration: ______________________ ____ Frequency: day____ _ evening____
(1) Lipstick____ Duration: ______________________ ____ Frequency: day____ __ evening____
(1. Object_____ Duration: ____________________ What object?________ ________ Frequency: day _____ evening____

Onychophagia: (0) No____ (1)Yes______

ATM ( Best score=0, Worst score=5) Score obtained =(___ __)

Do you grind your teeth? (0) No______ (1)Yes______ When? _________

Recurrent headache (0) No__________ (1)Yes_____
Recurrent ear pain (0) No___________ (1)Yes_____
Recurrent “jumps” during Chewing (0) No___ __ (1)Yes____
Pain (0) No________ (1)Yes____ When? __________

_______________
Hearing

Hearing threshold:
Normal ____ Hearing loss ____ What type? _________________________________________________________________
Hearing aid user No________________ Yeah___
Date of implementation__________________
Auditory pathologies:
Earwax plug No___________ Yeah____
Effusive Otitis Media No_____ Yeah___ Collars? _________
Acute Otitis Media No____ Yeah____ How many episodes in the last 12 months? ____________

Sleep ( Best score=0, Worst score=5) Score obtained =(__ ___)

Quality: (0) Quiet __________ (1) Uneasy ________

Presents:
Oral Respiration (0) No_______
___________________________________(1)Yes__
Snoring (0) No_____ -
(1)Yes__ --
Xyalorrhea (0) No_____ -
(1)Yes_ --
Respiratory Apnea
Health (0) No_____

Recurrent nasal congestion No_____ Yeah______

Recurrent tonsillitis No____ Yeah_______
Recurrent bronchitis No____ Yeah_______

Previous treatments by other professionals

Doctor: No_______ Yeah______

Specialty __________________ ___Indication
Specialty __________________ ________________
___Indication
Specialty __________________ ________________
___Indication
Non-Medical: No______ Yeah______ ________________
Specialty __________________ ___Indication
Specialty __________________ ________________
___Indication
Specialty __________________ ________________
___Indication
________________

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NAME: __________________________________________________________________________RUT___________________
BIRTH DATE:____ /_____/_________ AGE: _____________to________m EXAM DATE:________/____/_________

II. CLINICAL EVALUATION

A) EXTRAORAL OROFACIAL EVALUATION

POSTURE (subject standing in a relaxed position, observe at 2 meters. away)

SIDE Normal Deviated to the right _____ Deviated to the left________ OBS:
FRONT: Normal Anteposition of head________ Shoulder anteposition_____
FACIAL ANALYSIS (carry out observation and measure with a meter foot)
FACIAL INDEX:
Relationship between facial width and
height.
IF = Ophrion-Gnation distance x 100 x100
=
Bizygomatic diameter
---- Euryprosopus (short face): < 97%
---- Leptoprosop (narrow face): >104%
-- Mesoprosopic (middle face): 97-104%

FACIAL SYMMETRY : horizontal comparison of bilateral structures (pupils, lobes, commissures)

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symmetric_
asymmetric to right_______ to the left_______

PROFILE: lateral observation of the glabella-

subnasal-chin line.

concave
plane
convex_
_
NOSE

MIDDLE LINE: Aligned _______ deviated to the right ___ _ deviated to the left________
NOSES: Adequate______ Narrow ________ Spacious______

NASAL PERMEABILITY:
With Glatzel mirror: Normal Altered: to the right______ to the left_______ both nostrils
Rozenthal test: Normal_ Altered: to the right______ to the left_______ both nostrils

LIPS

UPPER LIP: at rest LS should cover two thirds of the buccal surface of the upper incisor
Length : Normal Long_____ Short___
Position : Normal Gotten up Retracted

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 UPPER LABIAL FRENUM: Normal _____ Short____________ Transfixant_______
—--

LOWER LIP: Tonicity : Normal _____ Hypotonic_______

Aspect: Normal_____ parched _____
Position : Normal______ Everted_______

LIP COMPETITION:
Normal _____ Altered ________
Lip closure with Mentalis contraction
—
Lip closure with periorbicular contraction_______

TMJ (kinesiology annex)

Presence of pain_________________________________________________________________________________________

Opening pattern _________________________________________________________________________________________

Vertical range of motion___________________________________________________________________________________

Joint sounds on palpation _________________________________________________________________________________

Patient characteristics ____________________________________________________________________________________

Observations

B) INTRAORAL OROFACIAL EVALUATION

OCCLUSION

INTRAMAXILLARY Evaluation ( Best score=0, Worst score=8) Score obtained =(__ ___)
UPPER ARCH LOWER ARCH
Crowding No____ (0) Yes Crowding
- (1) No ___(0) Yeah____(1)
Supernumerary No_________ (0) Yes Supernumerary
-- (1) no ___(0) Yeah____(1)
Rotation No____ (0) Yes Rotation
- (1) no ___(0) Yeah____(1)
Diastemas No_____ (0) Yes Diastemas
--- (1) no_ ___(0) Yeah____(1)
_

INTERMAXILLARY evaluation (use meter foot) ( Best score=0,

Worst score=2) Score obtained =(__ ___)
SAGITAL SENSE VERTICAL DIRECTION
(Espinoza, A. 2002. N: 3 years = 2.6mm / 5 years = 0mm, adults 2.5mm) (Espinoza, A. 2002. N: 3 years = 2.8mm / 5 years = 0mm, adults 2.5mm)
Horizontal Incisor Relationship (Highlight-Overjet): Vertical Incisor Relationship (Step-Overbite):
Extent: mm
Extent: ____________ mm
Normal _____ (0) Increased_______ (1) Decreased___ (1) Normal_____(0) Increased_ ___ (1) Decreased_ ___(1)

BITE
( Best score=0, Worst score=2) Score obtained =(__ ___)
to. Normal Overbite and Overjet =2.5 0
mm. 7 //
b. Vis a vis Overbite and Overjet 0 ?° / L/ ' t (
0mm ¡\
\
c. Overbite or Overbite 1 V
Overbite greater than 2.5 mm or ICS \J OR
covers more than 1/3 of ICI.
bonde a borce open deck crusade

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d. Open Negative Overbite. 2
and. Inverted Negative Overjet. 2

TRANSVERSAL SENSE
( Best score=0, Worst score=2) Score obtained =(_______)
to. Normal right/left 0 0

b. Vis a Vis right/left 1 1

c. Right/left cross 1 1

d. Right/left vestibuloclusion 1 1

Interincisal midline

Coincident ________ Not matching _________________

OCCLUSION (Angle)
( Best score=0, Worst score=1) Score obtained =(_______)
to. Class I 0
b. Class II.1 1
c. Class II.2 1 6s5 sgh 880
d. Class III 1

LANGUAGE
Aspect
Request lingual protrusion and observe the presence of imprints.
( Best score=0, Worst score=3) Score obtained =(_______)
Normal 0
Side imprints 1
Previous imprints 1
central groove 1

Tongue-Arcade Relationship
Analyze tongue volume based on arches.
( Best score=0, Worst score=1) Score obtained =(_______)
Harmonica ( without imprints and 0
size according to arch)
Disharmonic ( with marks and size 1
not in accordance with the arch)

Resting Position
Observe tongue position immediately after a dry swallow.
( Best score=0, Worst score=2) Score obtained =(_______)
Normal ( In palatoposition) 0
Interposed ( Between incisors) 1
In a low position (on the floor of 2
the mouth)

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 FRENULUM
CLASSIFICATION
(Queiroz, I. 2008)
Request that the lingual apex contact the
palate area at maximum mouth opening.

( Best score=0, Worst score=4)

Score obtained =(____________)
a. Normal 0 t b c
b. Short 1 o
c. With previous insertion 2
d. Short + Insert previous 3
e. Ankyloglossia 4

d a
n

MEASUREMENT (1) Overbite_____mm + ABM ( apert. buccal max.) ____mm = ABM(total)______mm

Use meter foot. Request maximum
mouth opening without and with (2) Overbite_____mm + ABM(with apex) mm =
lingual apex on the palate.

( Best score=0, Worst score=1)

Score obtained =(____________)

ABM(a) ratio of ABM (t) = [ (2) x 100 / (1) ] =

Normal (greater than or equal to 51%)

Altered (less than or equal to 50%)
Lingual mobility at maximum mouth opening
(Duran, J. 2003)
Request that the lingual apex contact the palate area at maximum mouth opening.

( Best score=0, Worst score=3) Score obtained =( )

Level 0 : prior Frenectomy 0

Level 1: apex contacts upper postdental area

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Level 2: apex almost contacts upper postdental area
Level 3: apex reaches half of 1 the distance between upper and lower incisors
Level 4: Apex surpasses 2
slightly to the lower incisors
Level 5: apex does not reach lower incisors 3
PALATE
BONE PALATE:
Normal -
High____
Ogival ______

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Cracked _______
With Fistula ___
---

SOFT PALATE:
Aspect: Normal_____ Cracked______ With Fistula________
Mobility: Normal _____ diminished_________
Symmetry in motion: Symmetrical ___ Asymmetric _______

UVULA
Aspect:
a) Normal
b) Hypoplastic
c) Bifida

TONSILS (Durán, J. 2003)

Visualize tonsils with sustained /a/ emission and the help of tongue depressors. Consider the dimension of one of them in relation to the
total pharyngeal space.
( Best score=0, Worst score=3) Score obtained =(_______)

Level 0: previous tonsillectomy

Level 1: not visible

Level 2: very small (<25% of the pharyngeal

space)

Level 3: 1/3 of the pharyngeal space

Level 4: 2/3 of the pharyngeal space, without

mutual contact.

Level 5: 3/3 of the pharyngeal space, in

mutual contact.

C) FUNCTIONAL EVALUATION

REPOSE
Normal _______ Altered _____________

BREATHING
MODE: Nasal____ Oral _______ Mixed____________
BLEW IT: Enough ________ Insufficient________

SWALLOWING (use of liquid)

Normal____
Atypical : lip sucking__________ cheek sucking_______ lingual interposition______
Adapted _______ cause: _____________________________________________________________________

CHEWING (use of Parafilm sheet)

Laterality: Bilateral______ Unilateral_______

Preference: right____________ left__________
Lips: Closed___________ open_________

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 ORAL MOTOR EXERCISES (L) Achieves (NL) Does not achieve (A) Approximate
LIPSTICK LINGUALS
Protrusion of both lips ____________ Extraoral Lingual Descent ________
Distension of both lips ____________ Extraoral lingual lift ________
Lip Vibration _______ Lateraliz. Lingual apex to right ________
puff out cheeks _______ Lateraliz. Lingual apex to left ________
Lingual apex pushes right cheek ________________
Apex. Lingual pushes left cheek Lingual apex under
lower lip ________
Lingual apex under upper lip ________
Apex Lingual runs through the hard palate ________
Tongue click ________
Lingual vibration ________

JOINT
Performance: (L) Achieves (NL) Does not Achieve / Error type: distorts, substitutes, omits)
allophone Stimulus Performance Error type consonant diphones
/m/ Mother PR meadow P.L. beach
/p/ Dad BR arm B.L. speaks
/b/ Baby FR phrase F.L. skinny
/t/ Tata TR rag T.L. atlas
/d/ Finger D.R. dragon K.L. nail
/n/ Baby K.R. crater G.L. ruler
/l/ Lulu GR fat
/s/ susi Complex words
/F/ Fifi Temperature Artichoke Carabineer
/ch/ Chiche Fridge Noodles Bakery
/and/ Yo-yo Machine gun Greengrocery Little Red Riding
/ñ/ No no Hood
/j/ Juice
/g/ Cat
/k/ Kiko
/r/ Ring
/rr/ Rice
CHARACTERISTICS OF SPONTANEOUS SPEECH
Intelligibility: Normal______ Decreased: ______
Articulatory inaccuracy: No_________ Yeah____
Increased speed: No______ Yeah____
Poor mouth opening: No______ Yeah____

SUMMARY OF EVALUATION RESULTS

OFA:

ORAL MOTOR EXERCISES:

REPOSE:

BREATHING:

SWALLOWING:

CHEWING:

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JOINT:

laryngeal action Articulatory Mode

Stop Fricative Affricate Vibrant Side Nasal

sonorous aphone sonorous aphone sonorous aphone

Spot Bilabial b Q M
Articulatory Labiodental F
Post dental sup d T

Post dental inf Yes

Alveolar R l N
RR
palatal AND CH Ñ
To ensure g K J.

PHONE AUDIOLOGICAL INDICATION:

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