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Original Research

Open Access

Orofacial dysfunction screening examinations in children with sleep-disordered breathing symptoms

  • Dao Anh Hoang1,3
  • Van Nhat Thang Le1
  • Tam Minh Nguyen2
  • Triin Jagomägi3,*,

1Faculty of Odonto-Stomatology, Hue University of Medicine and Pharmacy, Hue University, 49120 Hue, Vietnam

2Department of Family Medicine, Hue University of Medicine and Pharmacy, Hue University, 49120 Hue, Vietnam

3Institute of Dentistry, Faculty of Medicine, University of Tartu, 50090 Tartu, Estonia

DOI: 10.22514/jocpd.2023.032 Vol.47,Issue 4,July 2023 pp.25-34

Submitted: 22 November 2022 Accepted: 23 February 2023

Published: 03 July 2023

*Corresponding Author(s): Triin Jagomägi E-mail:


Orofacial myofunctional disorders (OMD) and sleep-disordered breathing (SDB) may present as comorbidities. Orofacial characteristics might serve as a clinical marker of SDB, allowing early identification and management of OMD and improving treatment outcomes for sleep disorders. The study aims to characterize OMD in children with SDB symptoms and to investigate possible relationships between the presence of various components of OMD and symptoms of SDB. A cross-sectional study of healthy children aged 6–8 from primary schools was conducted in central Vietnam in 2019. SDB symptoms were collected using the parental Pediatric Sleep Questionnaire, Snoring Severity Scale, Epworth Daytime Sleepiness Scale, and lip-taping nasal breathing assessment. Orofacial myofunctional evaluation included assessment of tongue mobility, as well as of lip and tongue strength using the Iowa Oral Performance Instrument, and of orofacial characteristics by the protocol of Orofacial Myofunctional Evaluation with Scores. Statistical analysis was used to investigate the relationship between OMD components and SDB symptoms. 487 healthy children were evaluated, of whom 46.2% were female. There were 7.6% of children at high risk of SDB. Children with habitual snoring (10.3%) had an increased incidence of restricted tongue mobility and decreased lip and tongue strength. Abnormal breathing patterns (22.4%) demonstrated lower posterior tongue mobility and lower muscle strength. Daytime sleepiness symptoms were associated with changes in muscle strength, facial appearance, and impaired orofacial function. Lower strengths of lip and tongue or improper nasal breathing were more likely to be present in children with reported sleep apnea (6.6%). Neurobehavioral symptoms of inattention and hyperactivity were linked to anomalous appearance/posture, increases in tongue mobility and oral strength. This study demonstrates a prevalence of orofacial myofunctional anomalies in children exhibiting SDB symptoms. Children with prominent SDB symptoms should be considered as candidates for further orofacial myofunctional assessment.


Orofacial dysfunction; Sleep-disordered breathing; Screening examination

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Dao Anh Hoang,Van Nhat Thang Le,Tam Minh Nguyen,Triin Jagomägi. Orofacial dysfunction screening examinations in children with sleep-disordered breathing symptoms. Journal of Clinical Pediatric Dentistry. 2023. 47(4);25-34.


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