Association between atypical swallowing and malocclusions: a systematic review

Abstract

Objective: This systematic review aims to answer the following focus question: “Is there an association between atypical swallowing and malocclusions?”. Methods: Appropriate word combinations were chosen and tailored specifically for each of the following electronic databases: EMBASE, Latin American and Caribbean Literature in Health Sciences (LILACS), LIVIVO, PubMed/Medline, Scopus, Web of Science, and gray literature, without any restrictions, up to February 2021. According to the selection criteria, only cross-sectional studies were includ-ed. The following inclusion criteria were considered: a sample composed of children, adolescents, and adults; patients clinically diagnosed with atypical swallowing; patients with normal swallowing; and outcome of interest of atypical swallowing in patients with malocclusion. The data consisted of study char-acteristics, sample characteristics, results, and conclusion of each study. The risk of bias was assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies, and the certainty of evidence was assessed using the GRADE tool. Results: 4,750 articles were identified. After a two-step selec-tion, four studies were included. A higher frequency of distal occlusion, extreme maxillary overhang, and open bite was re-lated to swallowing disorders; most studies pointed to posterior crossbite as a malocclusion more associated with atypical swallowing. All studies had a moderate to high risk of bias, and the certainty of evidence was very low. Conclusion: The results indicate that atypical swallowing is associated with mal-occlusions and that posterior crossbite is the main maloc-clusion found, but only in the young population (3-11 years). Registration: PROSPERO (42020215203).