Palatal plate therapy indicated in severe cases of orofacial dysfunction but only as part of holistic multi-disciplinary management


We recently posted about the findings of a review of the literature relating to orofacial regulation therapy which concluded that whilst the results of published studies inferred significant positive impacts, there was a need for larger multi-centre research to produce more statistically significant and valid results.

Given these findings, this paper looked in more detail at the provision of one aspect of the orofacial regulation therapy concept –  palatal plate therapy (PPT). This is an approach which aims to improve the function of the muscles of the mouth to help with chewing and improve muscle tone.

The authors looked at 16 papers which involved PPT therapy in patients with Down syndrome and described its impact on orofacial dysfunction.

They found that the studies identified as outcomes, improved facial expression, lip hypotonicity, tongue and mouth posture and that the positive trends remained post-treatment.  In addition, the studies appeared to suggest that the worse the baseline values had been, the better the outcomes were.

However, the studies suggested that compliance with palatal plates appeared to decrease with age. This appeared to be related to tooth eruption (the process by which teeth enter the mouth and become visible). They also found there was a key role for parents and carers in the process, in particular with assisting with compliance with the wearing of the plate.

They conclude that from their review, the use of palatal plate therapy in severe cases of orofacial dysfunction is indicated, but that mild to moderate orofacial dysfunction may be better managed by using other aspects of orofacial regulation therapy, delivered by the multi-disciplinary team.

They also point out that palatal plate therapy “cannot be used alone and should be used, as required, as part of the holistic management of OD, using the OFRT concept.”

The use of orofacial regulation therapy, including Palatal Plate Therapy, in the management of orofacial dysfunction in patients with Down syndrome, Kelly G et al., in Journal of Disability and Oral Health, 14, 1, 15-24

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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