14/10/2021
Let’s chat about narrow, high palate in infants. We get asked this question frequently when working on babies that are having breastfeeding issues or who have had their oral ties revised. Dr Shereen Lim from Sparkle Dental sums up the answer nicely below.
FAQ: What does it mean if my baby has a narrow, high palate?
I see a lot of babies who have had a high arch palate identified, and parents want to know what does this mean?
The photo on the left is a more ideal broad and flat palate.
The other two photos are versions of high arch palate – the one on the right is more “gutter” or high and narrow.
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Normal suction in-utero is associated with the tongue against the palate, and it moulds the palate broad and flat.
A narrow high palate in a baby born without any syndromes reflects altered sucking and swallowing, and reduced strength of tongue suction in-utero.
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A narrow high palate is associated with a narrow nasal floor, reduced cross-sectional area of the nasal passages and increased resistance to nasal breathing.
It is a well-known risk factor for developing snoring and obstructive breathing later in life.
It is also a risk factor for increased ear infections by age one. This is because a narrow palate reduces support for the soft palate. Reduced tension prevents the soft palate from lifting optimally during swallowing. When this doesn’t happen, the eustachian tube doesn’t open properly and the fluid from the middle ear doesn't drain properly.
A deep palate also makes it less likely more normal tongue suction can be restored. And there tends to be a continuous interaction between poor function and poor structural development.
There is a wealth of research to support that palate expansion can help improve nasal breathing and obstructive sleep apnoea.
In addition, some researchers have found that palate expansion can improve eustachian tube dysfunction and conductive hearing loss in children with glue ear. One group even found expansion as effective as grommet placement at improving hearing thresholds in children with glue ear.
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Although we can identify this problem very early on in life, we often can’t do enough to correct this issue in infancy.
But the great news is that by identifying this problem and associated risks early, we can be open to the option of palate expansion as young as age 3-4 years if there are functional problems.
