The orofacial function in 20 children with Down syndrome was evaluated after 4 years of palatal plate therapy in 9 of the children (PPG); the remaining 11 were untreated age-matched controls (CG). All 20 children had received continuous orofacial physical therapy from their speech therapist during the treatment period. A clinical extra- and intraoral examination was performed, including oral motor function, facial expression, the occurrence of malocclusions, and hypertrophic tonsils. A questionnaire requesting data on breathing patterns, drooling, eating problems, and communicative preferences was answered by the parents. An articulation assessment was performed by two speech and language pathologists blinded to the treatment status of the children in order to find out whether the palatal plate had stimulated to improved oral speech behavior. The results for oral motor function showed significant differences between the groups in favor of the PPG for the summary variables for: visible tongue (P < 0.01), visible tongue during non-speech periods (P < 0.05), and lip-rounding during spontaneous speech (P < 0.01). During non-speech time, the PPG had their mouths open significantly less than the CG (P < 0.05). Expressivity of facial expression on a visual analog scale in the PPG scored 75.6 +/- 13.3 compared to 51.8 +/- 25.7 in the CG (P < 0.05). The intraoral examination showed that 6/9 children in the PPG and 7/11 in the CG had enlarged tonsils, resulting in more than 50% inter-tonsillary space reduction. Despite these findings, and no significant differences between the groups with respect to mouth/ nose breathing, nocturnal snoring was significantly less in the PPG than in the CG (P < 0.05), according to the parental questionnaire. After 4 years of palatal plate therapy, orofacial function had improved significantly in the 9 PPG children and specifically in terms of tongue position and lip activity.

The effect of palatal plate therapy on oral dysfunction in children with Down syndrome was studied during a 1-year period. Twenty-nine subjects with a mean age of 24 months were randomized to a test group or to a control group. The variables concerning orofacial muscle function--that is, "closed mouth', "tip of the tongue visible', "open mouth', "inactive protrusion of the tongue', and "active protrusion of the tongue'--were monitored by video recordings. After 12 months of therapy the mean duration of the factor "closed mouth' was significantly longer (p < 0.001) and "inactive protrusion of the tongue' significantly shorter (p < 0.001) in the test group than in the control group. The results indicate that in children with Down syndrome, palatal plate therapy may be a valuable complement to a training program for improving orofacial muscle function.

Oral motor function was evaluated after 4 years of palatal plate therapy in nine children with Down syndrome (DS); 11 children with DS constituted the control group. During the treatment period all children had orofacial physiotherapy with their speech pathologist. An extraoral examination was performed, as was a video registration of the face. Nine different variables showing positions of the lips, tongue, and facial expression were examined. Children in the palatal plate group (n = 9) had significantly more rounding lips during speech (P< 0.05) than children in the control group (n = 11). The active variables describing normal muscle tension were diagnosed to constitute 81.0% +/- 11.0% of the registered video time in the palatal plate group, compared with 68.2% +/- 22.5% in the control group. Statistically significant differences were found between the groups in the summary variables describing an inactive open mouth and inactive tongue protrusion (P< 0.01). The results indicate that palatal plate therapy has a long-term effect on oral motor function.

AimsTo investigate the prevalence and risk factors of dental erosion (DE) among a group of adolescents in Stockholm County.Materials and methodsThis cross sectional cohort study was conducted at three clinics of the Public Dental Service in Stockholm County. Fifteen and 17 year old adolescents (1335) who scheduled their regular dental health examination were asked to participate. After drop-outs a sample of 1071 individuals, 547 males and 524 females were enrolled in the study. Presence of erosive wear was diagnosed (yes/no) on marker teeth by trained dentists/dental hygienists and photographs were taken. The adolescents answered a questionnaire regarding oral symptoms, dietary and behavioural factors. Two calibrated specialist dentists performed evaluation of the photographs for severity of DE using a modified version of the Simplified Erosion Partial Recording System (SEPRS).ResultsDE was clinically diagnosed in 28.3% of 15 years old and 34.3% of 17 years old. Severe erosive wear (grade 3 and 4 according to SEPRS) was found in 18.3% of the adolescents based upon the intra-oral photographs. DE was more prevalent and severe among males than females. Clinically diagnosed erosive lesions correlated significantly with soft drink consumption (p < 0.001), the use of juice or sport drinks as a thirst quencher after exercise (p = 0.006) and tooth hypersensitivity when eating and drinking (p = 0.012). Furthermore, self-assessed gastric reflux was a factor strongly associated with DE (p < 0.001).ConclusionThe study indicated that DE was common among adolescents in Stockholm County and associated with both internal and external risk factors.