Stomatognathic system and the impact of the tongue on postural development during childhood: a systematic review

Abstract

The relationship between tongue function, dental occlusion, and posture is gaining increasing attention, particularly during the developmental years, a critical period for neuromuscular and skeletal maturation. A multidisciplinary care model integrating orthodontics, physiotherapy, and posturology may optimize therapeutic outcomes and preventive strategies during these pivotal phases of pediatric growth. Future research should prioritize longitudinal study designs and standardized outcome measures to clarify causal relationships better and guide clinical protocols.

Objective:
To examine the available scientific evidence regarding the association between tongue function, occlusion, and posture in children, identifying correlations with spinal alignment, cervical posture, and head position.

Methods:
A systematic review was conducted, encompassing observational studies, clinical trials, and systematic reviews published up to 2025. Studies evaluating the association between alterations in occlusal or tongue function and postural modifications in pediatric populations were included. The review is registered in the PROSPERO database (Registration Number: [ID 1115660]).

Results:
Thirty studies met the inclusion criteria. The findings indicate consistent associations between malocclusions (e.g., Class II, Class III, crossbite), tongue-related dysfunctions (e.g., short lingual frenulum, low resting tongue posture), and postural deviations such as spinal misalignments, forward head posture, scapular asymmetry, and pelvic tilt. Nonetheless, heterogeneity in study design, assessment methods, and sample characteristics constrains the robustness and generalizability of these correlations.

Conclusions:
Tongue function and dental occlusion may influence postural development in children, particularly in the cervical and craniofacial regions. While current evidence points to clinically relevant patterns, further high-quality research is needed to clarify causality and quantify effect sizes. A multidisciplinary approach, integrating orthodontics, physiotherapy, and posturology, is recommended not only for therapeutic management but also as a preventive strategy during critical stages of growth.