Orthodontic and speech therapy cooperation in combined orthodontic and surgical treatment Case report

Introduction
Specialists in the field of speech therapy and orthodontics evaluate developmental and functional processes of the stomatognathic system. Joint research projects and practical activities between specialists in these fields are more and more often observed. There are only few literature reports on the treatment of patients with severe skeletal disorders by orthodontic and surgical teams with the cooperation of speech therapists.

Aim
The main aim of the article was to present principles of cooperation between orthodontists and speech therapists based on a case report of a female patient with a skeletal defect and speech defect. Additionally, exercises that are traditionally classified as speech therapy were presented and they can be recommended to adult patients before and after an orthognathic procedure. Exercises were described so as they could be recommended by orthodontists as well, and not only speech therapists.

Material and methods
. The material used included orthodontic and speech therapy documentation prepared on the basis of a case study collected in 2015-2018 at the Outpatient Clinic of Orthodontics, UCS GUMed. Collected empirical material was analysed by two speech therapists and two orthodontists.

Results
Regarding this patient, correlation between orthodontic and surgical treatment and speech therapy was extremely beneficial. An orthodontic and speech therapy team should recommend specifically tailored exercises to help the patient develop functions of proper breathing, swallowing and chewing. In the period before the surgery it is recommended to introduce respiratory exercises, exercises for the motor functions of the mandible, lips, and tongue. After the surgery it is recommended to add exercises to practice biting off, chewing, swallowing and a correct position of the tongue at rest, sometimes exercises to improve articulation.

Conclusions
When a skeletal defect coexists with a speech defect orthodontic treatment correlated with speech therapy is aimed to maintain outcomes of orthodontic treatment and to help recovery of correct performance of physiological functions of the masticatory organ.