FROGGY MOUTH: A new myofunctional approach to atypical swallowing

Atypical swallowing is a myofunctional problem, characterised by an altered lingual posture during swallowing. Primary infantile deglutition develops around the 12th week of intrauterine life and it is characterised by a forward tongue posture and contraction of the perioral muscles (orbicular and buccinator), leading to a higher negative pressure in the oral cavity.

In normal conditions, around the age of 3 and with the development of alternate unilateral mastication, the infantile deglutition pattern changes into a so-called mature deglutition pattern.

During adult or mature swallowing, dental arches are in contact and tongue is elevated, resting in the posteriorsuperior part of the palatine vault. 

During this phase the tongue pressure stimulates the anteroposterior and transversal growth of the maxilla. 

If transition from the infantile to the adult swallowing does not take place, the former triggers a pathological mechanism, defined as atypical swallowing.

The aetiology is multifactorial

► Altered lifestyle such as prolonged bottle feeding, late weaning, consistency of food (lack of solid food).

► Bad habits such as finger or dummy sucking, onycophagy, labial interposition. 

► Respiratory problems such as oral breathing, adenoid hypertrophy, tonsillar hypertrophy, rhinitis, bronchial asthma. 

► Congenital oral anomalies (short lingual frenulum or ankyloglossy). 

Atypical deglutition is frequently correlated with the following

Dental malocclusions: proclined maxillary anteriors, increased overjet, openbite, flaring and spaced dentition.

Skeletal malocclusions: sagittal and transversal discrepancies with a narrow and protruded maxillary arch, mandibular retroposition.

The high prevalence of malocclusions related to atypical swallowing makes this a subject of strong interest in scientific researches. Because of the multifactorial aetiopathogenesis, high incidence and the correlation with dento-skeletal malocclusions, this topic is not only very interesting for clinicians, but is also strongly debated among healthcare providers. 

A literature review on this subject confirms that orthodontic treatment alone is not sufficient to solve the problem in patients with atypical swallowing. This requires a multidisciplinary therapy, orthodontic and myofunctional approach, to ensure optimal and long-lasting results. 

To obtain an adequate myofunctional correction of atypical swallowing has been treated with appliances such as palatal tongue crib, fixed or removable, the Tucat pearl or speech therapy exercises, requiring a high compliance from the patient, and giving unpredictable and unstable results. 

The aim of this article is to describe the clinical protocol of Froggy Mouth, an innovative and simple myofunctional appliance used in order to solve atypical swallowing and to allow myofunctional correction of altered tongue position. 

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