ABSTRACT
Infants with Down syndrome often present with a familiar orofacial disorder which exists at birth or becomes more pronounced by the end of the first year. The primary pathology includes hypotonicity of the perioral muscles, lips, and masticatory muscles and a protruding tongue, later followed by active tongue protrusion. This results in problems with sucking, swallowing, drooling and dentition. Early intervention methods employing the combination of Castillo-Morales Manual Orofacial Therapy and his specially designed palatal plate, can improve orofacial function, facial appearance and prevent secondary conditions like pseudoprognathism, dental diseases, malocclusions, open mouth habit and pseudomacroglossia. This retrospective study examines the outcome of therapy, as prescribed by Castillo-Morales, in 39 children with Down syndrome. Normally, the average age to begin oral therapy is between six to eight months. The children were treated with the Castillo-Morales Manual Orofacial Therapy and his palatal plate for an average of 17.9 months. In this study, clinical evaluations at the beginning and the end of therapy focused only on open mouth posture and tongue protrusion. In addition, the direct stimulating effect of the palatal plate on tongue protrusion was evaluated. Significant positive results were observed in all three areas.
Subject(s)
Down Syndrome/complications , Facial Muscles/physiopathology , Physical Therapy Modalities/methods , Child, Preschool , Combined Modality Therapy , Down Syndrome/physiopathology , Female , Humans , Infant , Male , Mouth Breathing/etiology , Mouth Breathing/therapy , Orthodontic Appliances , Palate , Retrospective Studies , Tongue Habits/therapyABSTRACT
Infants with Down syndrome often present with a typical orofacial disorder, the features of which include hypotonicity of the perioral muscles, lips and chewing muscles, and a protruding tongue, later followed by active tongue protrusion, as well as problems with sucking, drooling, etc. This study presents the effects of Castillo-Morales' therapy with 67 Down syndrome children (average age at start of therapy 13.9 months), who wore the palatal plate intermittently for an average of 12.1 months. Significant positive results were obtained in spontaneous tongue position, upper and lower lip tonicity and position, mouth closure, drooling and sucking.
Subject(s)
Down Syndrome/rehabilitation , Macroglossia/rehabilitation , Masticatory Muscles/physiopathology , Muscle Hypotonia/rehabilitation , Orthodontic Appliances, Removable , Sialorrhea/rehabilitation , Tongue Habits/therapy , Child , Child, Preschool , Combined Modality Therapy , Down Syndrome/physiopathology , Down Syndrome/psychology , Female , Follow-Up Studies , Humans , Infant , Macroglossia/physiopathology , Macroglossia/psychology , Male , Muscle Hypotonia/physiopathology , Muscle Hypotonia/psychology , Physical Therapy Modalities/methods , Sialorrhea/physiopathology , Sialorrhea/psychology , Tongue Habits/psychologyABSTRACT
About 23 percent of the sixty-eight children with cerebral palsy, studied at the Werner-Otto-Institute's Pediatric Rehabilitation Center, suffered from a spastic tetraparesis. About 19 percent suffered from an athetosis; about 20 percent from a hypotonia, including three with cerebellar ataxia. The remainder of the group had minimal sequelae of cerebral palsy; mental problems were predominant. Their orofacial dysfunctions were treated according to the therapeutic concepts of Castillo-Morales.
Subject(s)
Activator Appliances , Cerebral Palsy/therapy , Dental Care for Disabled , Macroglossia/therapy , Orthodontics, Corrective , Adolescent , Athetosis/therapy , Cerebral Palsy/physiopathology , Child , Deglutition Disorders/therapy , Humans , Mastication , Muscle Hypotonia/therapy , Paraparesis, Tropical Spastic/therapy , Sialorrhea/therapyABSTRACT
Since Castillo-Morales developed the Orofacial Regulation Therapy for children with Down syndrome in the mid 1970s, close observation of orofacial symptoms in the growing child has led to new findings. Primary orofacial signs are present at birth through age one; secondary alterations develop with untreated school-age children. A synopsis of the most important disorders in children with Down syndrome is given. Findings that relate to malfunction are summed up; these findings can be influenced by Orofacial Regulation Therapy.
Subject(s)
Down Syndrome/pathology , Face/abnormalities , Jaw Abnormalities/pathology , Mouth Abnormalities/pathology , Child , Child, Preschool , Dental Care for Disabled , Down Syndrome/embryology , Humans , Infant , Infant, Newborn , Maxillofacial Development , Muscle Hypotonia , Palate/abnormalities , Tongue/abnormalitiesABSTRACT
The varying hypotonia in Down syndrome is one of its most dramatic signs. In particular, the facial expression and oral dysfunctions of these handicapped persons are uniquely characteristic. The more-or-less permanently open mouth; the prolapse of the tongue, exposed on the everted lower lip; and a lack of mastication, deglutition and speech are primarily caused by the hypotonic orofacial muscles. Breathing through the mouth leads to a dehydration of bacteria and plaque on gums and teeth, and ultimately to premature destruction of the dentition. This developmental syndrome indicates the need for early functional training of the orofacial muscles. Oral Regulation Therapy as described by Castillo-Morales was applied to seventy-four children here, with encouraging results.
