Effects of Orofacial Regulatory Therapy in children with Down syndrome

The protrusive and lower position of the tongue in subjects with Down syndrome is caused by the muscle hypotonia and not by macroglossia. This posture of the tongue could generate drooling, mouth breathing, lip incompetence, infections and alterations in chewing, swallowing and phonation. Dental decay, periodontal disease, dental malpositions, teeth retention, changes in the eruption and malocclusions could occur as well. Objective: To evaluate the changes in the tongue posture after a long-term therapy, with a repositioning plate in children with Down syndrome. Methods: A quasi experimental comparative study was performed. An informed written consent was obtained from the parents of each child and the statistical committee of the CES University approved the methods of the study. Twenty five 0 to 15 months old children with Down syndrome were included in the investigation. An extra and intraoral examination and digital photographies with a calibrated technique and taken by a standardized investigator were obtained from each child. The pictures were analyzed with Scion image®. A Castillo-Morales repositioning plate, constructed with a standardized technique was used by each of the children for one year. Each six months, examinations and photographies were taken to each subject. The data were analyzed using student t and Mann Whitney tests. Results: after one year of using the Castillo Morales oral plate, statistically significant differences were found for the position of the tongue, which was positioned in the palate and more posteriorly. Improvements were also found for the lip competence and drooling. Even though, it was not the aim of this study, it was observed that the therapy was comfortable and accepted both by parents and patients. Conclusion: The orofacial regulatory therapy at early ages in children with Down syndrome, using the Castillo Morales plate improves the position of the tongue, which promotes a better orofacial function.