Speech evaluation in children with temporomandibular disorders

Objectives: The aims of this study were to evaluate the influence of temporomandibular disorders (TMD) on speech in children, and to verify the influence of occlusal characteristics. Material and methods: Speech and dental occlusal characteristics were assessed in 152 Brazilian children (78 boys and 74 girls), aged 8 to 12 (mean age 10.05 +/- 1.39 years) with or without TMD signs and symptoms. The clinical signs were evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD) (axis I) and the symptoms were evaluated using a questionnaire. The following groups were formed: Group TMD (n=40), TMD signs and symptoms (Group S and 5, n=68), TMD signs or symptoms (Group S or S, n=33), and without signs and symptoms (Group N, n=11). Articulatory speech disorders were diagnosed during spontaneous speech and repetition of the words using the "Phonological Assessment of Child Speech" for the Portuguese language. It was also applied a list of 40 phonological balanced words, read by the speech pathologist and repeated by the children. Data were analyzed by descriptive statistics, Fisher's exact or Chi-square tests (alpha=0.05). Results: A slight prevalence of articulatory disturbances, such as substitutions, omissions and distortions of the sibilants /s/ and /z/, and no deviations in jaw lateral movements were observed. Reduction of vertical amplitude was found in 10 children, the prevalence being greater in TMD signs and symptoms children than in the normal children. The tongue protrusion in phonemes /t/, /d/, /n/, /I/ and frontal lips in phonemes /s/ and /z/ were the most prevalent visual alterations. There was a high percentage of dental occlusal alterations. Conclusions: There was no association between TMD and speech disorders. Occlusal alterations may be factors of influence, allowing distortions and frontal lisp in phonemes /s/ and /z/ and inadequate tongue position in phonemes /t/; /d/; /n/; /I/.19549349

Anxiety/depression and orofacial myofacial disorders as factors associated with TMD in children

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)The purpose of this study was to evaluate factors associated with temporomandibular disorder (TMD) in children. TMD clinical signs were evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD; axis I), and subjective symptoms were evaluated using a structured questionnaire. Eighty-two children were selected, 40 with TMD (19 boys and 21 girls, mean age 9.84 +/- 1.53 and 9.71 +/- 1.30 years, respectively) and 42 without TMD (21 boys and 21 girls, mean age 10.27 +/- 1.63 and 9.9 +/- 1.37 years, respectively). Intra- and extra-oral examinations were carried out to determine the myofunctional characteristics of the masticatory system. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression. Data were analyzed using descriptive statistics and bivariate analysis followed by multiple logistic regression (alpha = 0.05). In bivariate analysis, the variables of open lips, anxiety, and depression had a p value < 0.15 and were entered into the multivariate logistic regression model. The most significant predictor factors were the presence of open lips (odds ratio = 5.42, p = 0.034) and anxiety (odds ratio = 18.59, p < 0.001). Thus, anxiety levels and open lips were associated with TMD in children. Owing to the cross-sectional design of the present study, the associations observed may have a bidirectional relationship.272156162Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Evaluation of the Effectiveness of a Voice Training Program for Teachers

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Objectives. To investigate the effects of a voice education program to teachers on vocal function exercise and voice hygiene and compare a pre- and post-vocal exercise for the teacher's voice quality. Methods. A random sample of 102 subjects was divided into two groups: experimental group (29 women and seven men) with vocal hygiene and training exercises and control group (52 women and 14 men) with vocal hygiene. Two sessions were held about voice hygiene for the control group and five sessions for the experimental group, one being with reference to the vocal hygiene habit and four vocal exercise sessions. Acoustic analysis of the vowel [i] was made pre- and post-vocal exercise and for the situations of initial and final evaluation of the educational program. Student t test (paired) and Proc MIXED (repeated measures) were used for analyses with level of significance (alpha = 0.05). Results. The training exercises, posture and relaxation cervical, decreased the mean of fundamental frequency (f(0)) for men (P = 0.04), and for the phonation, intensity, and frequency exercises, there was a significant increase for f(0) in woman (P = 0.02) and glottal to noise excitation ratio (P = 0.04). There was no statistically significant difference intergroup evaluations after 3 months. The control group presented increased mean voice intensity in the final evaluation (P = 0.01). Conclusions. Voice training exercises showed a positive and immediate impact on the teacher's quality of voice, but it was not sustained longitudinally, suggesting that actions for this purpose should be continued at schools.275603610Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)FAPESP [2009/01507-6