Incompetent lip seal affects the form of facial soft tissue in preschool children

Environ Health Prev Med

et al. 2021

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Background Systemic and local factors may lead to disruption of craniofacial growth and development, causing an imbalance between the orofacial skeleton, muscle and soft tissue, dental occlusion, and the dental arch during growth periods. We aimed to reveal whether the prevalence of incompetent lip seal (ILS) varies with age and region, as well as to clarify the factors related to an ILS, in a national, large-scale epidemiological study. Methods We surveyed 3399 children, from 3 to 12 years of age, visiting 66 pediatric dental clinics throughout Japan. For this survey, we employed a questionnaire consisting of 44 questions regarding daily health conditions and lifestyle habits. We evaluated the differences in ILS prevalence by age and region (using a Cochran-Armitage test for trend and a Kruskal-Wallis test), and the relationship between ILS and factors investigated in the questionnaire (using Spearman’s rank correlation coefficient). Results We observed that 30.7% of Japanese children exhibited an ILS and that the ILS rate increased with age (p < 0.001). There were no regional differences in the rate of ILS in Japanese children (p = 0.506). We revealed that 12 of 44 survey items exhibited a statistically significant correlation with ILS (p < 0.001), using Spearman’s rank correlation coefficient. These items involved orofacial morphology, mouth breathing, and possibly, allergic rhinitis. Conclusion The rate of ILS seems to increase with age in children, throughout Japan. Therefore, this disorder may not self-correct during the growth periods in these children. Guidelines are required for pediatric dentists to recognize ILS among children aged 3–12 years.

Section: Discussionmentioning

confidence: 99%

Prevalence of an incompetent lip seal during growth periods throughout Japan: a large-scale, survey-based, cross-sectional study

Nogami

Environ Health Prev Med

et al. 2021

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“…If this balance is lost, the dental arch form would collapse due to the constant separation of the upper and lower lips (Harari et al, 2010 ; Lofstrand‐Tidestrom et al, 1999 ). To examine the influence of an ILS on the form of facial soft tissues in preschool children 3–5 years of age, we had previously measured the differences in the three‐dimensional facial images between children with and without ILS (Inada et al, 2021 ). We observed that the influence of an ILS on the facial form begins to appear even before 3 years of age, and children with ILS have anteriorly prominent subnasales and lips and a flatter nose.…”

Section: Introductionmentioning

confidence: 99%

Factors related to mouth breathing syndrome in preschool children and the effects of incompetent lip seal: An exploratory study

Clinical & Exp Dental Res

Kaihara

et al. 2022

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Objectives: A set of orofacial signs and symptoms completely or partially present in individuals who replace the correct pattern of nasal breathing with an oral or mixed pattern is defined as mouth breathing syndrome (MBS). In a previous report, it was clarified that an incompetent lip seal (ILS) affected the occurrence of MBS among primary school children. However, the factors related to MBS and the effect of ILS in preschool children remain unclear. The purpose of this study was to clarify the factors relevant to MBS in preschool children and investigate the relationship of ILS to MBS. Material and Methods:We surveyed 285 preschool children between 3 and 5 years of age. Their guardians completed the questionnaire, which consisted of 44 questions regarding the children's daily health conditions and lifestyle habits. To classify the closely related questions into their respective factors and to examine the strength of the correlation between the newly revealed factors, an exploratory factor analysis with promax rotation was performed. Results:The factor analysis identified nine items representing four factors. Factors 1-4 were defined as "diseases of the nose," "ILS," "problem with swallowing and chewing," and "eating and drinking habits," respectively. Factor 2 most strongly correlated with Factor 1, and both Factors showed a relatively strong correlation with Factor 3. Conclusions:The initial stage of MBS may be present in preschool children. ILS and diseases of the nose can cause poor development of oral functions, such as breathing and eating.

“…Several reports indicate that children with ILS have lower lipclosing strength (LCS) (Inada et al, 2019;Lambrechts et al, 2010;Saitoh et al, 2017;Saitoh et al, 2018)…”

Section: Introductionmentioning

confidence: 99%

“…Gross et al also reported that a prolonged open mouth posture during childhood results in a narrow maxillary arch and longer facial height (Gross et al, 1990). Moreover, Inada et al reported that ILS affects facial soft tissue form, exemplified by nasal prominence, sagittal facial convexity, and acicular lips in early childhood (Inada et al, 2019). ILS can also cause common clinical manifestations and symptoms of airway obstruction, such as mouth breathing, allergic disorders, asthma, sore throat, and rhinitis; in addition, these clinical manifestations can induce ILS (Diouf et al, 2018; Galvez & Methenitou, 1989; Hu et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Lip‐closing strength in children is enhanced by lip and facial muscle training

Nogami

Clinical & Exp Dental Res

et al. 2021

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Objectives Weakening of lip‐closing strength (LCS) associated with an incompetent lip seal (ILS) may affect the oral balance between the lip and tongue pressures. The purpose of this study was to evaluate the effects of lip‐closing training in children with lower LCS and/or abnormal habits across different age groups and to compare its effects on increasing LCS in children with malocclusion and/or oral habits. Material and Methods Lip‐closing training was performed by 154 Japanese children aged 3–12 years using a specialized training device at home for 3 months. Children with oral habits and/or exhibiting less than standard LCS were included. LCS was measured using a digital strain force gauge at a dental clinic at the beginning (T0) and after each month (after 3 months: T3). Results Children had higher LCS responses after lip‐closing training. The first month of lip‐closing training was more effective than the subsequent months. With lip‐closing training, the LCS increased from an average of 6.2 N (T0) to 11.4 N (T3) in Group I, 7.9 N (T0) to 12.8 N (T3) in Group II, and 6.8 N to 11.4 N in Group III. Anterior cross bite, including reverse bite, open bite, and tongue thrusting, significantly reduced training effects. Conclusion Our findings showed that lower LCS in children with ILS resulted in greater responses to lip‐closing training in a short period, but oral dysfunction, such as abnormal habits, inhibited the positive effects of training. Our results suggest that less detrimental effects of malocclusion and abnormal oral habits lip‐closing training enhances LCS in younger children.