# Analysis of Tongue Function from the Orthodontist's Point of View: Not Only a Matter of Deglutition
## 4 Discussion  
In the present study, the analysis of the swallowing pattern showed no statistically different results between patients with class III malocclusion and controls. Whereas the altered rest position of the tongue was significant in patients with skeletal class III. The results obtained were in accordance with [PERSON] et al. and [PERSON] et al. [22; 32]. The last author described a more inferior and anterior position of the tongue in patients with class III malocclusion and showed that the bolus transfer was actually different. However, the results may be due to the prevailing infantile and inconstant swallowing between 6 and 12 years old and could have reasonably interfered in our observations on the atypical swallowing.  
In the past, one of the major issues has been the oversimplification of the concept of myofunctional anamnesis and therapy. It is still a debated subject, and more clinical and academic research should be encouraged. Thus, many authors report the need to establish neuromuscular balance to achieve stable esthetic and functional goals [12].  
Ankyloglossia is characterized by the tethering of the tongue to the floor of the mouth resulting in a forward push of the low postured tongue. This often results in the growth of the mandible in a prognathic manner [33]. The outcomes of this study showed a significant correlation between the presence of a short fronulum and a class III malocclusion. In addition, [PERSON] et al. in 2017 affirmed that ankyloglossia could be associated with occlusal problems and craniofacial development and that early diagnosis and treatment provide a better prognosis in the treatment of class III malocclusions [12; 34].  
If the maxillary growth is restricted, it could often result in a diminished lingual volume. The inadequacy of the intraoral space of the tongue may lead to an inferior positioning of it and a prognathic force on the mandible [33].  
The growth and development of the orofacial musculature should be emphasized as its disorder constitutes an unfavorable factor in the management of malocclusion [33]. The two exercises requested during the present study were useful to introduce a more clinical myofunctional registration. The incorrect accomplishment of both the \"hold and pull\" and the \"chuck\" exercise [30; 31] was significant in Group 1. The patients who could not perform the exercises correctly presented incoordination in tongue movement and praxil lingual competence. Furthermore, the missed achievement of the first suggested a disturbed function of the sublingual glands.  
A stomatognathic system is a functional unit characterized by temporomandibular joint, dental and skeletal components, soft tissues, and masticatory muscles. The harmony between these structures enhances different functional tasks, such as speaking, chewing, and swallowing, and interferes with maxillofacial growth [34; 35; 36].  
The present study may enhance the relationship between the myofunctional disorders and class III malocclusion, characterized by maxillary hypoplasia, with a posterior crossbite. As a result of statistically significant outcomes, it is reasonable to recommend during anamnestic procedures that a correct approach should be to consider the overall myofunctional structures besides the tongue movements during the swallowing act.  
The cooperation between different healthcare professionals is the success key to growing patient therapies. The role of the orthodontists, pediatric dentists, and speech therapists is to analyze and diagnose all of the aspects of the stomatognathic system, including teeth, lips, respiration pattern, tongue, and deglutition. Therefore, after the interception of a pathologic alteration, it is suggested to send the patient to the specialist. The interconnection between dentist and speech and language therapist is mandatory in solving both initial and complex malocclusions in growing patients.