Ultrasound-based diagnostic approach to infantile swallowing in children during the mixed dentition period

Relevance. The tongue is a powerful muscular organ that plays a critical role in the postnatal growth and development of craniofacial structures. Disruptions in tongue posture and function are recognized as significant aetiological factors in the development of dentofacial anomalies and deformities. Clinical diagnosis of tongue dysfunction in children remains challenging due to limited patient cooperation and anatomical limitations of the oral cavity. These limitations underscore the need for improved methodological approaches and diagnostic algorithms for detecting dysfunction of this organ.

Objective. To identify the predominant swallowing pattern in children during the mixed dentition period using ultrasonographic assessment and to evaluate its association with dentofacial morphology.

Materials and methods. A total of 428 children aged 6 to 12 years (mean age 7.9 ± 1.8) were examined using clinical evaluation, electromyography, mandibular kinesiography, and a novel ultrasonographic method developed to identify the predominant swallowing pattern in children during the mixed dentition period (patent application No. 2025107573, submitted 28.03.2025). Associations between swallowing dysfunction and the development of occlusal anomalies were assessed using Pearson’s χ² test with Yates’ correction and Cramér’s V coefficient.

Results. The prevalence of the infantile swallowing pattern (ISP) among children in the mixed dentition period was 57.7% (p < 0.05). The anterior subtype was identified in 67.9% of cases, the lateral subtype in 17.4%, and the combined subtype in 14.7%. Tongue dysfunction in anterior and lateral directions during swallowing was most frequently associated with anterior open bite (34.1%) and combined malocclusion patterns (20.6%) (p < 0.001). Notably, 13.4% of children exhibited physiological occlusion, among whom the anterior subtype of ISP was most frequently observed during spontaneous swallowing under ultrasonographic control, accounting for 19% of cases (p < 0.001).

Conclusion. Abnormal tongue posture and articulation during swallowing are closely associated with the morphological characteristics of the dentofacial complex. Functional assessment of the stomatognathic system in 86% of growing patients revealed asymmetrical mandibular movements and unbalanced muscular activity consistent with the presence of anterior, lateral, or combined ISP subtypes. These findings highlight the importance of continued investigation into the aetiology and pathogenesis of functionally induced malocclusions to clarify the predictive role of tongue dysfunction in dentofacial development during the mixed dentition period. This will help inform and enhance therapeutic, preventive, myofunctional, and speech-language interventions for children affected by this condition.

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