An oral vestibular plate (MVP) is an orthodontic appliance used in early treatment starting at age 4, particularly to stop so-called habits (habits that damage the dentition; orofacial dyskinesias). The changeover from mouth breathing to nose breathing can also be supported by MVP. If habits are stopped early, this may eliminate the need for orthodontic measures later. To achieve this goal with an MVP, the 4th and 5th years of life are considered the most favorable time period. All habits have in common that they can have a damaging effect on tooth position as well as on the development of the upper and lower jaws and their positional relationship to each other.
Indications (areas of application)
Harmful habits that can be stopped by wearing an MVP include:
- Sucking the thumb or other fingers: this can lead to the so-called open-sucking bite, in which the anterior teeth no longer make contact when they bite together. Sucking causes the upper incisors in particular to move forward and with them the upper jaw segment in which they are located. As a result, the upper jaw may be transversely (width-wise) inhibited in growth and the tongue may habitually position itself between the incisors. Depending on the duration of the habit, both the first and second dentition (both deciduous and permanent teeth) may be affected
- The pacifier or soother: although the soother can help to wean off thumb sucking, it too, even if anatomically shaped, has consequences for the development of the dentition and must therefore be weaned off in a second phase itself.
- An incorrect swallowing pattern: in so-called visceral swallowing, the tongue is pressed against the incisors during each swallowing process, instead of attaching to the roof of the mouth, as in so-called somatic swallowing. As a result, the upper and lower incisors move out labially (forward).
- Cheek biting and sucking: the teeth are inhibited in their longitudinal growth on the corresponding side, the jaws can develop laterally unequal due to the muscle movement directed to one side.
- Lip biting, sucking and pressing: the upper incisors get pressure from labial (from the lip) when pressing, biting or sucking on the upper lip and react with tilting orally (towards the oral cavity) if not all incisors have erupted yet, which in turn can mean an obstacle to eruption for the still following incisors. When sucking on the lower lip, the upper incisors tend to tilt labially (forward), in addition, the lower jaw gets into a forced recession.
- Embedding of the lower lip: backward displacement of the lower jaw and tilting of the upper incisors forward can be the result.
- Tongue depressions: strong tongue pressure can cause a gap tooth position and be associated with speech disorders.
- Speech disorders such as lingual sigmatisms (tongue-related s sound malformations).
- Habitual (habitual) mouth breathing.
- Chewing on fingernails, pencils and the like can have a similar effect to sucking.
An MVP can help both to stop Habits in a developmental phase, in which it has not yet come to a maldevelopment of tooth position and jaws, and to reverse maldevelopments that have already occurred in moderation.
The procedure
Prefabricated oral vestibular plates are available in different sizes, which are adapted to the primary or mixed dentition. In the simplest case, an MVP consists of a rigid or elastic plastic shield worn in the oral vestibule (space between the lips or cheeks and teeth). Depending on the indication, the MVP can also be supplemented by a cap in the tongue cavity, a tongue guard or a bead suspended movably on a wire hanger in the tongue cavity. These different types are used in accordance with the indication:
- Sucking: the simple MVP keeps the thumb away from the teeth and jaws as a deforming element. In the case of sucking open bite with tongue insertion, an MVP with tongue guard can also be used.
- Soother: a simple elastic MVP is offered as a teat replacement.
- False swallow pattern: the tongue is guided to the roof of the mouth with an MVP bead during the swallowing process. Through the movable suspended bead, the tongue is playfully accustomed to a position further dorsal (back).Similarly, but without the active training effect works MVP with tongue grille, which passively keeps the tongue away from the incisors.
- Cheek biting and sucking: a simple MVP prevents sucking between the teeth.
- Lip biting and sucking: is also prevented by a simple MVP. Not so effective can be addressed against lip pressing, because even with MVP is possible to build up the pressure of pressing, albeit more uncomfortable.
- Embedding of the lower lip: is prevented by a simple MVP. If the lower jaw is already displaced back by the habit, a MVP with coping is more useful; the lower incisors bite on the coping, which affects the position of the lower jaw ventral (forward).
- Tongue press: MVP with tongue guard
- Speech disorders: can be accompanied by logopedic measures with an MVP bead therapy. Also for a muscle-weak tongue, the bead is an ideal training tool.
- Habitual (habitual) mouth breathing: often the habitually open mouth is accompanied by weak lip tone. This can be strengthened by a simple MVP and exercises to hold it through the lips. In case of obstructed nasal breathing (ear, nose and throat doctor!) The MVP must be provided with air holes, which are successively closed in the course of the conversion to nasal breathing.
- Chewing fingernails, etc.: a simple MVP is offered as a substitute.
