Meet the Journal’s Editorial Review Board Members

I am honored to take on the role as Editor-in-Chief (EIC) of the International Journal of Orofacial Myology and Myofunctional Therapy (IJOM).To prepare for my role as EIC, I set two major goals to address today’s quickly evolving publication standards and the expansion and growth of the discipline of orofacial myofunctional disorders. The first was to establish an on-line submission and review process and an on-line archive for all past articles. The second critical goal was to recruit and enlist an international group of highly respected scientists and doctoral-level practitioners who represent diverse topics related to orofacial myofunctional disorders and therapy to serve on the journal’s Editorial Review Board (ERB). I am proud to introduce this new slate of ERB members.

Development of a concept for a mobile application to support orofacial myofunctional therapy

This study aimed to develop a concept for a mobile health application, an app-based exercise tool, to support the treatment of orofacial myofunctional disorders by speech-language therapists (SLTs). Method:A sequential mixed research design combining qualitative research and user-centered software development was applied. Qualitative interviews and focus groups were conducted with eight SLTs, one patient and three relatives to gather ideas for an app to support orofacial myofunctional therapy. On the basis of the findings, a paper-based prototype was developed, which was then evaluated by seven end users, to refine the concept of the app. Results: Qualitative data on desirable functionalities were clustered into topics and related subcategories containing general ideas for the app – a control mechanism, a reward system, the visualization of exercises, and pop-up messages for reminders and recommendations. The paper prototype was developed that addressed these functionalities. Discussion: An app-based exercise tool is considered to have added value for orofacial myofunctional therapy. A prototype for a mobile application is ready for programming and subsequent testing in the treatment of orofacial myofunctional disorders by conducting additional interviews to ascertain patients’ perceptions.

Feasibility of using a tongue-activated joystick by healthy pre-teen children

PURPOSE: To investigate the motivation and the effects of: tongue movement direction; resistance force level; repetition number; and sustained tongue contraction duration on tongue motor performance in healthy pre-teen children using computer games. METHODS: An analytical observational cross-sectional study was conducted with 15 healthy 11-13 year-old children with normal lingual strength. The participants played six computer games using a tongue-controlled joystick. The series varied the time for continuous force application on the target (3 and 5 seconds) and the target force level (0.5, 1 and 2 N). After the tests, the participants answered a questionnaire about their impressions and reactions to the game. The variables analyzed were number of attempts to score (NAS), time for which the target force was maintained (TTFM), and the time spent for scoring (TSS). RESULTS: Of 43 normally developing candidates screened for the study, 15 (35%) were included for having entirely normal tongue structure and function and for being able to complete all of the study tasks. Of the 15 participants, 11 (73.3%) said that it was easy to play, three (20.0%) found it a bit hard to play, and only one (6.6%) considered it difficult to play. The results suggest that healthy individuals with normal lingual structure and function are able to successfully perform the games, but those with longer durations of sustained contraction (5 seconds) and the most required force (2 N) are the most difficult. Leftward and upward movements were more difficult than rightward and downward movements. CONCLUSION: All of these carefully selected participants were able to perform all of the study tasks, indicating that this method is feasible for pre-teens with normal lingual structure and function. The joystick device encouraged the participants to perform tongue movements that may be part of the typical orofacial myofunctional treatment exercises for tongue function. Results indicated that this game has the potential to be highly motivating for pre-teen children who are able to perform the tasks.

Development of lip closing function during taking food into the mouth in children with Down syndrome

Children with Down Syndrome (DS) show developmental retardation of gross motor function including acquisition of oral movements related to eating and swallowing. To characterize the process of development/acquisition of eating/swallowing function of children with DS, interlabial pressure (IP) during taking food into the mouth was assessed. This study included 99 children with DS (birth to 4 year-old), and 112 age-matched control children showing typical development. IP during taking food into the mouth was measured as an objective index of lip closing function. The system for measuring IP during taking food into the mouth consisted of a strain gauge-pressure sensor connected to a strain-measuring device, which sent data to a personal computer installed with electromagnetic oscillograph software to display pressure waveforms. The DS and typically developing children were grouped into each age group and the data were compared between matched-age groups. IP during taking food into the mouth, pressure-time (PT), variation coefficient (VC) of IP during taking food into the mouth and VC of PT were analyzed using the unpaired t-test. Analyses showed a significantly higher IP during taking food into the mouth in the DS population than in the typically developing children in the 2 and 3 year old (P = .042 and .049, respectively) groups. No significant difference was observed between the DS and typically developing groups with respect to PT, VC of IP during taking food into the mouth or VC of PT for any age group. Children with DS showed a process of acquisition of lip closing function during taking food into the mouth similar to the process found in typically developing children, even though children with DS experience developmental retardation in gross motor and cognitive functions.

Enhancing the evidence base in orofacial myology

The purpose of this article is to stimulate research in orofacial myology. The research-to-practice gap may be reduced by highlighting concepts relating to evidence-based practice. Information is also presented on the International Association of Orofacial Myology Institutional Review Board process.

Investigating factors related to the acquisition of masticatory function in Down syndrome children

Down syndrome (DS) has the highest prevalence of any chromosomal abnormality identified in newborns. DS children have specific eating and swallowing difficulties such as poor tongue control, mouth opening, swallowing food without chewing, and both facial and occlusal abnormalities. DS children are also at high risk of aspiration, and swallowing food without chewing is considered to be a factor associated with increased risk of aspiration and eating problems. This study aimed to identify factors preventing the acquisition of masticatory function in DS children. The subjects were 75 outpatient DS children (44 males, age range 12 to 36 month-old, mean age 33.0 ± 7.0 month-old; 31 females, age 12 to 36 month-old, mean age 20.8 ± 8.0 month-old), who had not yet acquired masticatory function, out of 319 who visited the clinic between October 2012 and October 2017. The information necessary for assessment was retrospectively extracted from the medical records of the subjects. The items examined included age, birth weight, nutritional intake, picky eating, tactile hyperesthesia, cognitive development assessed by Ohta stage, gross motor function, occlusal condition by Hellman’s dental age, and tongue thrust/lip closure/mastication while eating. The relationships between the acquisition of masticatory function and these items were investigated after one year of rehabilitation. The revealed age, low birth weight, picky eating, and gross motor function to be relevant factors. Among these, gross motor function was found to be the factor most strongly associated with acquisition of masticatory function.

Juvenile dermatomyositis - A case report with review on oral manifestations and oral health considerations

Juvenile Dermatomyositis is the most common inflammatory myositis in children, distinguished by proximal muscle weakness, a characteristic rash and Gottron’s papules. The oral lesions most commonly manifest as diffuse stomatitis and pharyngitis with halitosis. We report a case of an 8 year old male with proximal muscle weakness of all four limbs, rash, Gottron’s papules and oral manifestations. Oral health professionals must be aware of the extraoral and intraoral findings of this rare, but potentially life threatening autoimmune disease of childhood, for early diagnosis, treatment, prevention of long-term complications and to improve the prognosis and hence, the quality of life for the patient.

Facial burn during orthognathic surgery: Case report

Despite the fact that the advances in surgical techniques have contributed to the reduction in the number of complications associated with orthognathic surgery, problems resulting from different phases of treatment, treatment planning, and postoperative period may occur. This paper presents a case of facial soft tissue lesion, burn in the lower lip region, in a patient with Class III malocclusion during orthognathic surgery. A 22-year, 3-month-old male patient with Class III malocclusion was burned in the paramedian region of the lower lip due to unnoticed overheating of the low-speed handpiece during sagittal osteotomy of the left mandibular ramus. The injury to the patient could have resulted in legal repercussions against the dental surgeon. However, that did not occur. The satisfaction with the aesthetic and functional results, from the standpoint of both dental and facial aspects, was more important for the patient than the aesthetics of the burn sequelae. Although orthognathic surgery is a safe and widely used procedure in association with orthodontic treatment, the risk of complications always exists. No matter how skilled and self-confident the surgeon is, careful attention to the variables that can be controlled should be taken into account in order to reduce the chance of complications that may result in irreversible damages.

Examining the effects of ankyloglossia on swallowing function

Oropharyngeal dysphagia (OPD) involves difficulty during one or more of the stages of swallowing, resulting in difficulty moving the bolus from the mouth to the stomach. A deficit in tongue mobility, such as that found with ankyloglossia, may affect the oropharyngeal transit time of the bolus and predispose a person to OPD. This study was conducted to examine the possible relationship between tongue tie and oropharyngeal dysphagia. Data were gathered on 8 participants (5 females, 3 males) between the ages of 12-43 years. The Lingual Frenulum Protocol (Marchesan, 2012) was used to determine tongue tie. An Iowa Oral Pressure Instrument (IOPI) measured tongue tip, tongue dorsum, and lip strength, and a combination of electromyography, and the five- finger palpation method measured laryngeal timing. Measurements were compared with normative data from Holzer (2011). Results revealed that participants with ankyloglossia had signs of oral stage dysphagia, including reduced articulator strength (tongue tip and dorsum, and lips) and reduced masseter activity. Oropharyngeal transit times were not significantly different from the norms.