Abstract

The aim of this study was to investigate whether training with an oral screen can improve oral motor function in patients with stroke and peripheral palsy. The participants in the study were eight patients with orofacial dysfunction after stroke, included 7–14 months after onset, and seven patients with peripheral palsy, included 14–28 months after onset. A customized oral screen in acrylic was made for each participant. The screen had a tube around the handle to allow air to pass when measurements were made of the perioral muscle force. When measuring the ability to suck, the hole was sealed with wax. The participants trained with the oral screen two times daily for 5 min. Measurements were made at baseline, after 1 month and thereafter every third month until no further improvement was achieved. Measurements were made with two different instructions, to squeeze and to suck. In the stroke group, muscles around the mouth improved when pouting and smiling; these participants also achieved statistically significant changes when sucking. For the peripheral palsy group, little improvement could be seen when pouting and smiling. However, these patients reported less or no drooling, and the measurements for sucking increased significantly for six of the seven patients. The first recorded significant change was seen in the stroke group after 4 weeks training and in the group with peripheral palsy after 6 weeks. Training with a custom‐made oral screen can significantly improve perioral muscle force and the ability to create negative intraoral pressure. The patients reported less leakage in saliva, drink, and food as well as fewer bite injuries and less food accumulation.

Highlights

  • Orofacial dysfunction can be defined as affected facial expression, impaired intelligibility, eating and drinking problems, and drooling (Bakke, Bergendal, McAlister, Sjögreen, & Åsten, 2007)

  • Patients who have impaired orofacial functions due to stroke, tumor surgery, Bell's palsy, or infections often suffer from problems such as leakage of saliva, beverage, and food due to reduced lip force (LF) (Hägg, Olgarsson, & Anniko, 2008)

  • The aim of this study was to investigate whether training with an oral screen can improve oral motor functions in patients with stroke and peripheral palsy

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Summary

Introduction

Orofacial dysfunction can be defined as affected facial expression, impaired intelligibility, eating and drinking problems, and drooling (Bakke, Bergendal, McAlister, Sjögreen, & Åsten, 2007). Patients who have impaired orofacial functions due to stroke, tumor surgery, Bell's palsy, or infections often suffer from problems such as leakage of saliva, beverage, and food due to reduced lip force (LF) (Hägg, Olgarsson, & Anniko, 2008). It has long been known that longstanding orofacial dysfunction can result in teeth moving out of their position and malocclusion due to lack in equilibrium between muscular activity in the lips and cheeks on the outside of the dental arch and the tongue on the inside (Tomes, 1873). It has been shown that malocclusion is more frequent among children swallowing without tooth contact especially in combination with tongue thrust (Melsen, Attina, Santuari, & Attina, 1987). Reduced tongue control is common and leads to several difficulties such as poor oral clearance and bite wounds (Gabre, Norrman, & Birkhed, 2005; Veis & Logemann, 1985).

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