A dysfunction of the mouth is also known as an orofacial disorder. The orofacial disorder affects the affected person’s breathing, communication, and feeding. For these reasons, it is important to start therapy as soon as possible so that any complications and impairments can be treated.
What is Orofacial Disorder?
Doctors call orofacial disorders any disorders that occur in the context of the oral and facial muscles (oral and facial disorders). See usvsukenglish for What does the abbreviation CMS stand for.
Especially children who suffer from movement disorders are often affected by orofacial disorders.
This often involves damage or functional disorders of the child’s brain; a classic example is the occurrence of the orofacial disorder in poliomyelitis.
The causes of an orofacial disorder are multifactorial. This means that there can be not only functional, but also organic causes that trigger an orofacial disorder. The classic causes include – in addition to polio – chronic or permanent inflammation and enlargement of the tonsils or frequent infections of the respiratory tract.
Allergies, a shortened frenum of the tongue or genetic skeletal anomalies can also promote or trigger an orofacial disorder. Sometimes, however, psychological stress and stress factors of any kind are also possible causes that can cause an orofacial disorder. Prolonged thumb sucking, lip licking and prolonged use of a pacifier also promote an orofacial disorder.
Acquired misbehaviour – such as “wrong bottle teats” or postural problems and incorrect body tension – can also cause an orofacial disorder. Sometimes the orofacial disorder can also be triggered by tactical-kinaesthetic disorders; an occurrence in the context of general developmental disabilities (e.g. due to Down syndrome) is also possible.
Symptoms, Ailments & Signs
As a rule, the orofacial disorder manifests itself in the affected children not being able to breathe through their nose. This is because the mouth closure is missing. Sometimes you may also have difficulty swallowing. Other symptoms include communication impairments or problems with eating properly. The symptoms are relatively easy to spot; if an orofacial disorder is suspected, a medical professional should be contacted.
Diagnosis & course of disease
If the first symptoms appear, which sometimes indicate an orofacial disorder, a doctor should be consulted as soon as possible. This is because – the earlier the treatment begins – the course of the disorder can be positively influenced. As part of the treatment, an anamnesis interview is planned first; the treating doctor would also like to know information about the course of development.
Even possible causes play a role in the diagnosis, so the parents should not only be aware of any contributing factors (sucking the thumb), but also need to know the child’s eating habits and diet. This is followed by a routine sound check and check of the oral cavity and the status of the teeth.
The doctor then checks the perception and mobility of those muscles that are required for the swallowing process. The swallowing process is examined using the Payne technique. The doctor also classifies the use of so-called “lip retractors”.
This disease usually leads to various complications and discomfort in the mouth of the affected person. In most cases, this severely disrupts the patient’s communication, which can also lead to social problems. Children and young people in particular can suffer from bullying and teasing and can also develop psychological problems or depression as a result.
Furthermore, the intake of food and liquid is no longer easily possible for the affected person, so that underweight or various deficiency symptoms can occur. The quality of life of those affected is significantly reduced by this disease. Difficulty swallowing often occurs and makes everyday life difficult for the patient.
Furthermore, the parents and relatives of the patient are often affected by this disease and thus suffer from depression or other psychological complaints. The treatment of this disorder in most cases does not involve any complications. This is usually done with the help of various therapies. However, success cannot be guaranteed. It is possible that the person affected will be dependent on the help of other people for the rest of their life.
When should you go to the doctor?
If children suffer from a disorder of the chewing movements, they need medical help. If you refuse to eat or drink, there is a risk that your body will be undersupplied. A doctor must be consulted to prevent an acute health-threatening condition. Paralysis, swallowing problems, weight loss, or vocalization problems need to be evaluated and treated. Any withdrawal behavior, stress or stressful life situations should be discussed with a doctor. If the symptoms persist for several days or weeks, you should see a doctor. An increase in health irregularities must also be presented to a doctor.
A reduced sense of well-being, malaise or abnormal behavior are signs of a disorder. If participation in social life or family activities is rejected, this is usually a warning signal. A depressed mood, swings in mood or an aggressive appearance require a doctor’s visit. There is also a need for action if there is a feeling of illness or deficiency symptoms appear. Changes in the complexion, sleep disorders, attention deficits or a pale appearance can be consequences of an orofacial disorder. A doctor’s visit is advisable, since the quality of life is already severely impaired and the affected person needs medical help. If there is pain or discrepancies with an existing denture,
Treatment & Therapy
A holistic therapy is used in the context of the orofacial disorder. As part of the treatment, the doctor tries to create a muscular balance, which of course is predominantly present in the orofacial area. This balance is based on the so-called total body balance; this includes the grounding, symmetry, tone, breathing and also the erection and posture of the patient.
First comes the KOST – this is the “body-oriented speech therapy” according to Codoni. The physician develops a manual speech and voice therapy, tries to promote elements from the sensory integration and primarily ensures that a craniosacral therapy takes place.
After carrying out and creating the KOST, an attempt is made to wean various favorable factors. These include thumb sucking or constant use of a pacifier. Subsequently, the main focus is placed on muscle training. The affected person trains the muscles of the tongue, the lip as well as the jaw and chewing muscles.
This is the only way to achieve orofacial balance. This is followed by training in the physiological resting position of the tongue, nasal breathing and the physiological swallowing pattern. It is important that the treatment of the orofacial disorder takes place sequentially; the doctor must go through the steps – together with the patient – from the beginning so that maximum success can be achieved.
Due to the fact that each patient has individual problems or the orofacial disorder can be more or less pronounced, it is important that a face former and ballovents are also used. They can also be helpful with individual problems.
Other methods that can be included in the therapy are, for example, the holistic therapies according to S. Codoni, any myofunctional therapies according to A. Kittel as well as orofacial regulation therapy as well as PNF and manual therapy of the voice. Furthermore, elements from the so-called sensory integration therapy are also applied; Finally, neurolinguistic programming takes place.
Outlook & Forecast
An orofacial disorder is a dysfunction of the muscular functions in the facial area around the mouth. The orofacial disorder causes swallowing and speech disorders. All movements in this area are impeded, such as swallowing or speaking. The cheek, lip and tongue muscles are affected.
The prognosis has improved slightly with newer treatment approaches. The previous therapeutic approach was improved by a playful therapeutic approach. The treatment with it mainly affects sick children from the age of four. The orofacial dysfunction of those affected can now be corrected or compensated for by the treating therapists and speech therapists with whole-body coordination, stimulation and playful perception exercises.
The therapy begins with an intensive phase. It is then transitioned into a less intense interval phase. In this, what has been achieved is tested again and again – for example with fun swallowing tests. Provided that the parents work consistently to reduce the consequences of the orofacial disorder, the success of the treatment is quite good. The articulation and the remaining disturbances caused by the orofacial dysfunction can often be significantly improved.
The prognosis is good if the therapy can be adapted to the individual circumstances of the child. The prerequisite is a developmental age between four and eight years that allows the child to actively participate. The orofacial disorder cannot be eliminated, but it can be alleviated.
The orofacial disorder can only be prevented to a limited extent. In this way, parents can make sure that their children do not suck their thumbs or are busy with their pacifiers, if at all. However, if the orofacial disorder occurs due to an illness (e.g. polio), preventive measures are usually not possible.
Orofacial disorders can take different forms and require individual therapy and aftercare. Generally, as part of the follow-up care, it is checked whether the patient is symptom-free. During the anamnesis, the doctor also clarifies open questions from the patient. During the physical examination, any surgical scars and any remaining deformities are examined.
To do this, the doctor uses the necessary procedures and measuring instruments, such as imaging procedures or taking blood. If necessary, contact can be made with a therapist. This is necessary above all in the case of long-term illnesses, since mental problems often develop as a result of the speech disorders. These must be clarified and treated in discussion with the therapist.
Drug treatment of any psychological complaints requires comprehensive aftercare, often going beyond the treatment of the physical disorders. The aftercare of the orofacial disorder is usually carried out by the general practitioner or a speech therapist. Usually only a single follow-up examination is scheduled, since an orofacial disorder, once cured, usually neither increases nor worsens. If symptoms persist, therapy must be resumed. Individual symptoms and complaints such as the typical cleft lip, jaw and palate require independent aftercare.
You can do that yourself
Patients with the orofacial disorder suffer from respiratory disorders. In many cases, the impairments trigger diffuse fears. It is therefore particularly important in everyday life to remain calm if possible. Panic should be avoided under all circumstances, as it leads to an increase in symptoms and thus to further shortness of breath.
The disturbances in communication trigger desperation and helplessness in those affected and their families. The restrictions should be met with a positive basic attitude. The adversities in everyday life can be dealt with slowly and with a lot of understanding. Sign language or body language can make up for the lack of verbal communication. This enables a sufficient exchange in everyday life.
In addition, it is important to have a positive attitude. The joy of life should be promoted despite the illness, so that the handling of the illness is more successful. In the case of depressive phases, mood swings and apathy, the help and support of a therapist should be sought . In everyday life, motivating words are important for the patient. Contact with other sufferers can be helpful in order to give mutual support. In self-help groups and internet forums, open questions that affect those affected are clarified. Exercises and training units should be inserted independently between the therapy sessions. These help alleviate the symptoms.