For a Better Lip Seal

by Dr. Michel Champagne dmd, magd, ibo, cde

Many patients, starting with younger patients, present a weak or no lip seal at all with or without an anterior open bite. Such a functional anomaly should be corrected but to have success with this correction any airway problem should be corrected first. An ENT consult is necessary in most of the cases. Once the airway problem has been cleared, the clinician should look for a simple and practical approach (for both the office and the patient) to solve the problem. Any protocol that is too demanding will probably fail. Dr. Kondo, a Japanese orthodontist, author of the book’’ Muscles Win’’, recommends simple exercises. She believes in simplicity to maximize efficacy. For this simplicity, we have to use a protocol that is neither excessive in time (daily schedule) nor in costs.

 

The approach I recommend follows the principles of Drs. Kondo and Menzel (orthodontist from Germany):

1. Treat all airway problem first, an ENT consult and treatment may be needed.
2. Treat all maxillary transverse problem by palatal expansion or arch development.
3. Correct all large overjet.
4. Introduce lip strengthening exercises with the use of the Face Former, compression and traction exercises (Figures 1 to 4).
5. Introduce swallowing exercises that we will call ‘’tongue crepes’’ (Figure 5).
6. The exercises are done morning and evening, minimum of 2 times a day.

   

Figure 1.      Traction exercise                           Figure 2.   Lip compression                                            Figure 3. Face Former

 

 

Figure 4. Exercises

The swallowing and lip exercises can be started early if transverse and antero-posterior corrections are treated with removable appliances. The patient can remove the appliance a few minutes each day for the training program. Let me describe the exercises suggested by Dr. Kondo to guide you incorporate them into your treatment routine.

 

     

Images from the book ‘’Muscles Win’’ by Dr. Kondo. We have called it the ‘’Tongue Crepe’’.

Some of you might say that few orthodontists use such an approach. And my answer will be that it may depend of the area, country or even the continent you work in. I can add that in your practice you have to make a choice i.e. do you choose to treat only the dentition or you want to take a broader approach and also take care of the function. You have to choose if you want to practice as a technician or as a doctor in dental medicine. I do not care if you are a specialist or a general dentist but I do care of the choice you make. Just be happy with your choice.