Approach to chewing disorders in children

Abstract

Chewing function is the rhythmic oral motor activity required to grind and soften solid foods. Difficulties in transforming solid foods into a soft and cohesive bolus are defined as chewing disorders. Chewing disorders complicate adequate food intake, negatively affect growth and overall health. It also affects family members. In particular, primary caregivers spend more time for preparing foods suitable for child, meal times are prolonged, feeding becomes tiring, interaction between child and caregivers is negatively affected, and quality of life for both child and family is decreasing. Thus, chewing disorders in children should be detected in early period and appropriate intervention program should be determined. The purpose of this review is to describe the steps of approach to chewing disorders in children and provide a guiding reference. A clinical decision-making process is maintained to determine an individual and appropriate approach in children. Evaluation is the first step of the clinical decision making process. Evaluation of chewing disorders include history taken, evaluation of head, neck and trunk control, evaluation of tonus and feeding positions, physical assessment of structures involved in chewing function, and evaluation of chewing function by observational and instrumental techniques. As a result of evaluation, the causes of chewing disorders are determined and a patient-specific rehabilitation program is established. The goal in rehabilitation of chewing disorders is to ensure proper lip, tongue and cheek coordination, improve the effectiveness of grinding function and transform food into bolus. It is also very important to set realistic goals in rehabilitation process, reduce negative experiences and reinforce positive behaviors.