Early Diagnosis and Prophylaxis of Stomatognathic Dysfunction: The Interplay Between Feeding Modality, Occlusal Development, and Language Acquisition in Preterm Children—An Observational Cross-Sectional Study

Background/Objectives: Malocclusion and delayed expressive language are managed as separate clinical problems, yet both may be two faces of a single stomatognathic dysfunctional syndrome. This cross-sectional study investigated whether neonatal feeding modality — breastfeeding, enteral feeding with non-nutritive oral stimulation, or total parenteral nutrition — predicts occlusal morphology and language acquisition in preterm children.Methods: We enrolled 40 preterm children (gestational age below 37 weeks; corrected age 36–42 months) from two follow-up programmes in Iași, Romania; 7 of 47 were excluded. Children were stratified: breastfed (Group A, n = 14), tube-fed with non-nutritive oral stimulation (Group B, n = 13), or parenterally fed (Group C, n = 13). Occlusal morphology was scored blind (κ = 0.91); language was assessed with the Communicative Development Inventories and a phonological checklist. Kruskal-Wallis tests with Dunn-Bonferroni post hoc comparisons, Spearman rank correlation, and multivariable regression adjusting for sex, residence, and socioeconomic status were used.Results: All three outcomes differed significantly by feeding group. Kruskal-Wallis tests: occlusion H(2) = 33.1, p < 0.001; language H(2) = 34.7, p < 0.001; age at first words H(2) = 35.3, p < 0.001. Median occlusion scores: 4.50 (A), 4.20 (B), 2.30 (C); median language scores: 8.40, 7.20, 3.50; median age at first words: 11, 15 and 24 months — a 13-month gap. All Dunn-Bonferroni pairwise contrasts were significant (p < 0.05). Occlusion and language scores were near-perfectly correlated (Spearman ρ = 0.986, p < 0.001). Malocclusion subtype distribution also differed significantly (χ²(6) = 19.1, p = 0.004).Conclusions: Breastfeeding was associated with the most favourable outcomes; parenteral nutrition without oral stimulation with the greatest delays. The near-perfect occlusion–language correlation supports combined stomatognathic screening as an early diagnostic tool and non-nutritive oral stimulation during tube feeding as a prophylactic priority.