Effect of orofacial exercises on oral aperture in adults with systemic sclerosis

Abstract

Purpose: To examine the effect of a home orofacial exercise program on increasing oral aperture among adults with systemic sclerosis (SSc). Method: Forty-eight adults with SSc were assigned randomly to the multifaceted oral-health intervention or usual dental care control group. Participants with an oral aperture of <40 mm in the intervention group received an orofacial exercise program, which included daily manual mouth-stretching and oral-augmentation exercises twice a day with a total of 6 minutes for 6 months. The outcome measure was oral aperture which was measured at baseline, 3-months, and 6-months intervals. Results: A significantly larger increase in oral aperture for participants received the orofacial exercise program was found when compared to those in the usual care at 3 months (P = 0.01), but not at 6-months evaluation. Participants’ adherence rate to the exercise program was low (48.9%). Conclusions: The orofacial exercise program intervention for adults with SSc and microstomia did not show significant improvement at 6 months. In addition to the low exercise adherence rate, insufficient frequencies, repetitions, and durations of the orofacial exercises may contribute to these results.

Implications for Rehabilitation

• Microstomia in adults with systemic sclerosis (SSc) has profound impacts on their quality of life.

• Orofacial exercise programs have the potential to improve the size of oral aperture.

• Brief daily orofacial home exercises for 6 months did not result in a significant increase in the size of oral aperture.

Keywords::

• scleroderma
• microstomia
• interincisal distance

Acknowledgments

The authors wish to thank the dental hygienist, Pemra L. Hudson, RDH; for conducting the oral examination.

Declaration of interest: This study was supported by a grant awarded to the first author from the Scleroderma Foundation. Additional support was provided by the National Institute of Dental and Craniofacial Research (Grant # 1R21DE017360-01A2); the Multidisciplinary Clinical Research Center grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health (Grant # P60 AR049459), the South Carolina Centers of Biomedical Research Excellence (COBRE) for Oral Health with funding provided by the National Institutes of Health (NIH) and the National Center for Research Resources (NCRR) with a P20 RR-017696, and the South Carolina Clinical & Translational Research Institute, Medical University of South Carolina’s CTSA, NIH/NCRR Grant Number UL1RR029882. The authors report no conflicts of interest.