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

Introduction: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. Material and Method: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. Results:The decision tree, diagnostic criteria and exercises are provided. Discussion: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. Conclusion: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.