Lingual and Maxillary Labial Frenuloplasty with Myofunctional Therapy as a Treatment for Mouth Breathing and Snoring

Chronic mouth breathing may adversely affect craniofacial development in children and may result in anatomical changes that directly impact the stability and collapsibility of the upper airway during sleep. Mouth breathing is a multifactorial problem that can be attributed to structural, functional, and neurological etiologies, which are not all mutually exclusive. While therapeutic interventions (myofunctional, speech and swallowing, occupational, and craniosacral therapy) may address the functional and behavioral factors that contribute to mouth breathing, progress may sometimes be limited by restrictive lingual and labial frenum that interfere with tongue and lip mobility. This case report explores the case of a three-year-old girl with mouth breathing, snoring, noisy breathing, and oral phase dysphagia that was successfully treated with lingual and labial frenuloplasty as an adjunct to myofunctional therapy. Within four days of the procedure, the patient had stopped snoring and demonstrated complete resolution of open mouth breathing. The patient was also observed to have increased compliance with myofunctional therapy exercises. This report highlights the effectiveness of surgical interventions to improve the efficacy of myofunctional therapy in addressing open mouth posture and low tongue resting position.

Treatment of tongue dysfunction: rehabilitation for prescribers’ practice

Immature tongue function so-called “tongue-thrust or infantile and teeth apart swallow” and its rehabilitation involves multiple specialities in dentistry (pediatric dentistry, orthodontics, management of temporomandibular disorders, periodontics,…). Fifty years ago Mrs Fournier described a tongue rehabilitation technique. Given the difficulty to find a physiotherapist able to practice such a therapeutic, the aim of this article is to describe this therapeutic so that non-physiotherapists practitioners be able to initiate it and to teach it to their patients, at least for simple cases. It includes corrections of tongue immaturity, tongue resting position, deglutition and phonation. These changes might involve adaptive cortical neuroplasticity. Indeed these last years it has been shown in humans that standardised and calibrated tongue lift or protrusion exercises induce such plasticity in the tongue motor cortex.