Effects of two types of appliances on orofacial dysfunctions of disabled children

Habitual mouth-breathing, feeding disorders, lack of mastication, protrusion of the tongue, lip incompetence, drooling as well as swallowing and speech disorders are the problems most often seen in disabled children with orofacial muscle dysfunction. The aim of this study was to improve these functional problems by using either the Castillo-Morales palatal plate or the Dr. Hinz oral screen and evaluate their effects on this special group. Thirty one children with cerebral palsy, 6 children with Down syndrome and 13 children with mental motor retardation, at ages between 3-7, participated to this study. The Dr.Hinz oral screen and Castillo-Morales palatal plate were used by the children for 12 months. Photographs and video images were taken at the beginning and at the end of the study. The changes in oral functions were recorded on standardized forms by the parents and the doctor. At the end of the therapy period, relapse was evaluated without the appliances for 3 months more. Statistical analysis of oral functions were calculated using the 'sign test' and 'proportion for difference'. Both of the appliances were observed to efficiently aid the development of oral functions. However patients who used the appliances 3-4 hrs/day were found to have a more favorable outcome than patients using the appliances for 1-2 hrs/day. Also the Castillo-Morales palatal plate was found to be more effective and easily accepted in this study group. Relapse results showed that in 44.6 % of the children there was stability in the acquired oral functions. 13.8 % of the children who used the appliances less than 2 hours in the study period showed a regression in their acquired oral functions. In this study, both of the appliances were found to have a positive role on the improvement of orofacial dysfunctions which affects the social acceptence of this special group negatively. Conscientiousness of the family and daily usage times were found important factors on the success.