A cephalometric assessment of children with fetal alcohol syndrome

Lateral cephalometric radiographs were quantitatively assessed in a series of 15 American black children with fetal alcohol syndrome (FAS). Although none was profoundly affected, FAS had been diagnosed in all the children at birth. Comparisons with age-, sex-, and race-matched controls disclosed a triad of facial profile differences: (1) frontal bossing, (2) palatal plane tipped up in the front with proclined upper incisors and a sharp nasolabial angle acquired from digit habits, and (3) above-average length of the mandibular corpus. Collectively these generate the perception of midface hypoplasia, although the midface actually is unremarkable in size and position. A high prevalence of chronic digit habits (8 of 15) is a secondary consideration in FAS, leading to localized skeletodental problems.