Orofacial myofunctional reeducation: how to handle simple in office cases?

The prevalence of lingual dyspraxia is high but not all patients require management by a physical therapist. The aim of this article is to propose a decisional flow chart separating, via diagnostic criteria, patients who can be managed in office from patients requiring oromyofunctional rehabilitation by an oro-myo-functional rehabilitation (OMR) professional and to provide, if necessary, simple exercise sheets.

An expert, a maxillofacial physiotherapist from the Fournier school, has proposed, based on the literature, her experience as a clinician and in consultation with orthodontists, different criteria for the severity of dyspraxia as well as exercises to be implemented for cases that are manageable in the office.

The decision tree, diagnostic criteria and exercises are provided.

The flowchart is based on the literature, mainly on expert opinion given the low level of evidence of published studies. The exercise sheet was created by a physiotherapist from the Fournier school and necessarily reflects this influence.

Further studies such as a clinical trial could compare the validity of the WBR indication obtained by an orthodontist using the decision tree with the blinded indication given by a physical therapist. In addition, the effectiveness of in-office rehabilitation could be evaluated using a control group.