Appliance for chronic drooling in cerebral palsy patients

Resident: Roberts
Date: 5/7/10
Article title: Appliance for chronic drooling in cerebral palsy patients
Author: Inga, Charlie et al.
Journal: Pediatric Dentistry
Volume 23:3
Year: 2001
Discussion
The drooling appliance is very similar to an orthodontic retainer in its design and fabrication. It is an intraoral appliance with full palatal coverage that is constructed of dental acrylic with wire clasp arms and a labial bow. A movable rolling bead is placed in the posterior aspect of the appliance. The location of the place of the bead is dependent on the swallowing pattern of the child Normal tongue position during swallowing is in the midline; however patients with CP may have a deviation to one side or the other. It is critically important to place the bead so that the tongue will be able to come in contact with it and yet be positioned far back in the throat. Instructions on how to use the appliance are controversial. Some clinicians believe that the appliance should only be used when in public places where drooling is a social stigma. They believe that the patient will become resistant to the effect of the appliance. Others believe that it should be used all the time and that the bead should be manipulated as the tongue position changes. Both have been proven to be effective. One recommendation in the article was that the patient be of age and have the cognitive ability to understand the appliance and be involved with the fabrication of it by responding to verbal commands to swallow and helping to determine proper bead placement.
Assessment: Short article and did not get much into explaining why this physiologically worked.