From the Guidelines
To examine for a high arched palate, ask the patient to open their mouth wide while you use a penlight to illuminate the oral cavity, and observe the shape of the hard palate, noting if it appears unusually high, narrow, or dome-shaped compared to the normal gently curved arch, as recommended in the assessment of children with 22q11.2 deletion syndrome 1. When examining for a high arched palate, it is essential to consider the patient's overall oral anatomy and any potential symptoms or conditions that may be associated with this feature.
- The examination should include a visual inspection of the hard palate, noting its shape and height in relation to the upper teeth.
- A normal palate has a gentle arch that rises about 1.5-2 cm from the level of the upper teeth, whereas a high arched palate will appear significantly more elevated and narrow.
- Palpation of the palate with a gloved finger can also help assess its height and contour. The importance of examining for a high arched palate lies in its potential association with various conditions, including Marfan syndrome, Ehlers-Danlos syndrome, and certain craniofacial abnormalities, as well as functional issues like difficulty feeding in infants, speech problems, or sleep-disordered breathing, which is also a concern in children with 22q11.2 deletion syndrome, where palatal abnormalities are seen in about two-thirds of children 1.
- A high arched palate can be a physical marker for certain developmental or genetic disorders, and its examination can provide valuable insights into the patient's overall health and potential needs for further evaluation or treatment.
- The palatal height is determined during embryonic development and is influenced by both genetic factors and proper tongue positioning during growth, highlighting the importance of early examination and intervention if necessary.
From the Research
Examination for High Arched Palate
To examine for a high arched palate, the following steps can be taken:
- Evaluate oral cavity morphology, including assessment of the oropharynx using Mallampati classification (MC) and the presence of a high-arched palate 2
- Perform a visual examination of the palate to check for a narrow, high arched palate, malocclusion, and congenitally missing teeth 3
- Use a quantitative method to define high-arched palate, such as measuring the height and angular based arch measurements of the palate 4
- Screen patients for OSA risk factors, including retrognathia, high arched palate, enlarged tonsils or tongue, and high Mallampati score 5
Key Findings
- The presence of a high-arched palate may be associated with sleep disordered breathing (SDB) and obstructive sleep apnea (OSA) 2, 5
- A high-arched palate can be a characteristic feature of certain syndromes, such as Noonan syndrome and Treacher Collins syndrome 3, 4
- The evaluation of oral morphology, including the assessment of the palate, is an important part of pediatric examination 2