Screening for undiagnosed tongue dysfunction and its related issues in the healthy population

Abstract

The tongue has a functional role in regulating and ensuring proper development of the orofacial structures and musculature with regard to form and function. Undiagnosed tongue dysfunction contributes to orofacial myofunctional disorders, which yield significant health morbidities that include craniofacial maldevelopment and dysfunctional breathing. To date, the routine dental clinical examination does not include a functional tongue assessment, which highlights the lack of research on the screening potential that dentists can offer. A total of 322 healthy subjects were randomly recruited from the dental outpatient clinic of the National University of Malaysia based on the inclusion and exclusion criteria. The clinical screening included a functional tongue assessment using the newly developed tongue range of motion ratio (TRMR) and identifying the signs and symptoms of orofacial myofunctional disorders. The prevalence of tongue dysfunction was found to be 62.1%. The sensitivity and specificity of using TRMR to assess tongue dysfunction were 80.7% and 67.5%, respectively. Tongue scalloping (89.2%) and maxillary transverse growth abnormalities (55.6%) were the common signs of orofacial myofunctional disorder in patients with functional tongue limitation. The inter-rater reliability ranged from 0.75 to 1.00. Dentists have a pivotal role in screening for functional tongue issues, and improved screening strategies can lead to early referrals for therapeutic interventions such as myofunctional therapy (MFT) or frenectomy, especially in the young population to avoid further systemic complications related to the consequences of mouth breathing