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High-Arched Palate in an Infant

Robert Mason Dmd, Ph.D

August 24, 2009

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Question

I have recently noticed my 9 and half month old son has a very high arched palate - so high that he actually gets food stuck there and he can't get it out. He has said "mum" a few times but other than that doesn't say any other words. He does make diffe

Answer

Please don't worry about the high-arched palate in your son at this time. I'm guessing that he also has a narrow upper dental arch. Generally, the narrower the dental arch, the higher the palatal vault, or, conversely, the wider the dental arch, the flatter the palatal vault.

Over time, your son's palate is expected to grow in width. At the same time, the nasal septum will grow vertically and this may help to flatten out the palatal vault to some extent. The upper dental arch, including the palate, will grow considerably over the next few years. So yes, this should be one of those things that will sort itself out over time.

You also mentioned speech sound productions. The development of speech should not be hampered by a high arched palate. All speech sounds can be made adequately in spite of a high palatal vault.

I hope that these comments will help you relax about your observation of your son's palatal vault.

ADDENDUM - Brief Tutorial for Professionals Regarding Hard Palatal Growth:
The hard palate grows in a very interesting way. It and many other facial and cranial bones, or even parts of bones, grow according to the "V principle". For the palate, envision the V upside down. During growth, bone is added, by deposition, on the inner (or oral) side of the V, with removal, or resorption, taking place on the outer (or nasal) surface. Thus the V moves downward and outward at the same time. This increases the overall dimension and widens the maxillary dental arch because movement is toward the wide end of the V.

Does the nasal septum play a role in the descent of the hard palate? Apparently, very little. An early theory to explain maxillary displacement (the nasal septum theory of Scott) has been disregarded. The current concensus is that the nasal septum supports the roof of the nasal chamber but does not contribute actively to the displacement activities of the hard palate. While I accept this view, the bony and cartilagenous nasal septum is likely to contribute something to overall growth of the nasal capsule and hard palate due to the multifactorial nature of maxillary growth.

Here is the fascinating part of hard palatal growth: As the hard palate remodels and grows inferiorly, there is an exchange of old for new bone and as well, soft tissue coverings. At each level of hard palatal descent, the hard palate actually changes to a different palate. It becomes composed of different bone, connective tissue, epithelia, blood vessels, and nerve extensions. So keep in mind when viewing the hard palate of a newborn or an infant (as in the question above), or even a young child, that the palate at an older age in that same individual is not the same palate at all.

If you are interested in further information on facial growth, I refer you to the source for the growth perspectives provided above in the excellent book: Essentials of Facial Growth, by Donald H. Enlow and Mark G. Hans, W.B. Saunders Co., Philadelphia, 1996.

Robert M. Mason, DMD, Ph.D. is a speech-language pathologist (CCC-ASHA Fellow), a dentist, and orthodontist. He is a Past President of the American Cleft Palate-Craniofacial Association, a professional, interdisciplinary organization specializing in problems associated with facial and oral deformities. Dr. Mason has studied and written extensively about orofacial examination, developmental problems related to the tongue, and the anatomy and physiology of the speech and hearing mechanisms. His reports have appeared in speech, dental, medical, and plastic surgical journals and texts. He is considered to be an expert in tongue thrusting, tongue tie, and other problems related to tongue functions and speech.


Robert Mason Dmd, Ph.D


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