Palatal Development and Orofacial Function: Possible Effects of Preterm Care

Abstract

Understanding of the impact of disordered palatal and orofacial development on preterm neonatal survivors is increasing. Optimal clinical assessment and management requires neonatologists to have a sound knowledge of: normal palatal development; potential causes for disordered development, including iatrogenic causes; factors to assess on newborn examination; and optimal multidisciplinary follow-up for feeding, orthodontic, and speech-language development. Key findings quantify harmful effects of intubation on palatal shape, tooth eruption/morphology, and speech; further studies are required to delineate the effect on swallowing. The evidence base is discussed for preterm care and palatal and orofacial development in preterm and low-birthweight infants. Current knowledge is limited by lack of uniformity of definition and measurement tools. Guidance is summarized for practical management and follow-up of preterm and low-birthweight infants requiring intubation.Objectives After completing this article, readers should be able to:1. Describe normal palatal development. Describe potential alterations in palatal morphology and orofacial development amongpreterm infants compared with term infants. 3. Discuss the contributing role of oral intubation to palatal development. 4. Manage the functional impact on feeding, tooth development, and speech and language of disordered palatal development.