Role of physiotherapy in management of orofacial diseases

Priyanka P Ostwal; Anisha Kaur Johar; Shubham Gupta; Swagata A Patangankar; Pratik Surana; Ruchi Gopal

doi:10.4103/ijmo.ijmo_10_20

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Year : 2021 | Volume : 6 | Issue : 1 | Page : 11-13

Role of physiotherapy in management of orofacial diseases

Priyanka P Ostwal¹, Anisha Kaur Johar², Shubham Gupta³, Swagata A Patangankar¹, Pratik Surana⁴, Ruchi Gopal⁵
¹ Assistant Professor, Department of Kinseotherapy and Physical Diagnosis, Oyster College of Physiotherapy, Aurangabad, Maharashtra, India
² Department of Electrotherapy and Electrodiagnosis, Oyster College of Physiotherapy, Aurangabad, Maharashtra, India
³ RK Dental Clinic, Raniganj, West Bengal, India
⁴ Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Maitri College of Dentistry and Research Center, Durg, Chhattisgarh, India
⁵ Senior Lecturer, Department of Pedodontics and Preventive Dentistry, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India

Date of Submission	09-Nov-2020
Date of Acceptance	11-Dec-2020
Date of Web Publication	17-Feb-2021

Correspondence Address:
Dr. Pratik Surana
Department of Pedodontics and Preventive Dentistry, Maitri College of Dentistry and Research Center, GE Road, Anjora, Durg - 491 001, Chhattisgarh
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijmo.ijmo_10_20

Abstract

Physical therapy (PT) also known as physiotherapy is concerned with the evaluation, diagnosis, management of disease, and disability through physical means. Physiotherapy can be used for management of various orofacial diseases such as temporomandibular joint disorder, facial paralysis, myofacial pain dysfunction, oral submucous fibrosis, and trismus. It is a noninvasive, safe, convenient, and cost-effective treatment option that can be used as simultaneously with other treatment procedures. The present article provides insight of physiotherapy as an adjunct therapy in the treatment of oral-facial diseases.

Keywords: Orofacial diseases, physiotherapy, thermal therapy, transcutaneous electric nerve stimulation

How to cite this article:
Ostwal PP, Johar AK, Gupta S, Patangankar SA, Surana P, Gopal R. Role of physiotherapy in management of orofacial diseases. Int J Med Oral Res 2021;6:11-3

How to cite this URL:
Ostwal PP, Johar AK, Gupta S, Patangankar SA, Surana P, Gopal R. Role of physiotherapy in management of orofacial diseases. Int J Med Oral Res [serial online] 2021 [cited 2022 May 26];6:11-3. Available from: http://www.ijmorweb.com/text.asp?2021/6/1/11/309659

Introduction

Physical therapy (PT) also known as physiotherapy is one of the branches of health profession which is concerned with the evaluation, diagnosis, management of disease, and disability through physical means.^[1] Physiotherapy is an old age remedy, physicians such as Hippocrates and later Galen are believed to have been the first practitioners of PT, advocating massage, manual therapy techniques, and hydrotherapy to treat people in 460 BC. After the development of orthopedics in the 18^th century, machines such as the Gymnasticon were developed to treat gout and similar diseases by systematic exercise of the joints, similar to later developments in PT.^[2]

The use of PT is not limited to only the medical field it is often used in dental or orofacial disease as an adjuvant therapy. It can be used for management various orofacial disorders such as temporomandibular joint (TMJ) disorder, facial paralysis, myofascial pain dysfunction, oral submucous fibrosis, and trismus.^[2],[3] The present article provides insight of physiotherapy as an adjunct therapy in the treatment of oral-facial diseases [Table 1].

Table 1: Scope of physiotherapy

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Type Physiotherapy Exercises and Its Application in Dentistry

^[1],[4]

Physical therapy

It includes the application of specific exercises, manual therapy, and manipulation and aims to relieve pain and improve function. It uses facial strengthening exercise, massage therapy, mouth opening exercise for trismus, tongue exercise, and yoga.

Tongue exercise

Many malocclusions such as tongue thrusting, mouth breathing develop as a result of abnormal tongue position. Early correction or interception of these habits by tongue exercises is one of the easiest ways of managing the habit in most of the pediatric patients. One of the most effective and commonly used exercises is the 4S exercise. This includes identifying the spot by the tongue, salivating, squeezing the spot, and swallowing. The four steps are as follows:^[5]

Spotting exercise (1S) - Spot should be the rest position of the tongue
Salivation exercise (2S) - The tongue is placed on the spot, which results in salivation
Squeezing exercise (3S) - The tongue is squeezed vigorously with the teeth closed against the spot followed by relaxing
Swallowing exercise (4S) – After squeezing, the next step is to swallow the spot. This new swallowing pattern should be practiced at least 40 times a day.

Lip exercises

Incompetent lip seal is one of the features of mouth breathing. If there is a patient with hypotonic short upper lip, the patient is asked to stretch the upper lip over the lower lip without opening the mouth. The holding time is 30 s with a frequency of 15–20 times a day. This will improve the tonicity of the upper lip. Another exercise is asking the patient to stretch the upper lip in a posterior inferior direction toward the chin by overlapping the lower lip, which additionally helps in maintaining the oral seal during swallowing.^[6]

Electro therapy

It involves the application of electric current and used for the treatment of acute or chronic orofacial pain. It uses transcutaneous electric nerve stimulation (TENS), therapeutic ultrasound, diathermy, acupuncture, laser therapy, ultraviolet radiation, and infra radiation.

Transcutaneous electric nerve stimulation

TENS utilizes low-frequency current and it is widely used for acute and chronic pain in various conditions.^[7]

Indications of TENS in dentistry: Traumatic injury, myofascial pain dysfunction, TMJ pain, trigeminal neuralgia, peripheral nerve injury, and facial pain
Contraindications: Patients with pacemakers, pregnancy, apprehensive patients, and epileptic patients.

Laser therapy

The term LASER is an acronym for “Light Amplification by the Stimulated Emission of Radiation.” Low-level laser therapy (LLLT) is used by some physiotherapists to treat various musculoskeletal conditions. LLLT is believed to affect the function of connective tissue cells (fibroblasts), accelerate connective tissue repair, and act as an anti-inflammatory agent.^[8]

Indications: TMJ disorder, myofascial pain dysfunction, neuralgic pain, herpetic ulcer, and accelerating healing of wound
Contraindications: Photosensitive areas of skin, neoplastic area.

Thermal therapy

It involves the application of external heat or cold over the tissue. It uses hot packs, paraffin wax, ice packs, ice massage, cryotherapy, and cold spray.

Heat application

Heat is applied in though hot packs, paraffin, or hydrotherapy. The application of heat causes increase in the blood flow through vasodilatation. The metabolic rate and the tissue extensibility will also increase. Heat increases oxygen uptake which accelerates tissue healing.^[1],[9]

Indications: Myofascial pain dysfunction, TMJ disorder, traumatic injury, muscle spasm, and trismus
Contraindications: In patients with recent hemorrhage, bleeding, localized infection and over areas of metal implants.

Cold application

Cold is applied through ice packs, cooling gel packs, or cold spray. The application of cold decreases the temperature of the skin/soft tissue that leads reduction in blood flow by vasoconstriction and reduces the tissue metabolism neuronal excitability, inflammation, and conduction rate, and tissue extensibility.^[1],[9]

Indications: Postoperative pain, post tooth extraction, postoral surgical procedures, and swelling in injured tissues
Contraindication: Peripheral vascular disease, rheumatoid arthritis, and sickle cell anemia.

Conclusion

Physiotherapy is an evidence-based treatment option widely used by medical as well as paramedical professionals. Variety of physiotherapy modalities can be used for the treatment of orofacial diseases with or without other treatment procedures. It is a noninvasive, safe, convenient, and cost-effective treatment option that can be used as simultaneously with other treatment procedures.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1.	Shah J, Chaudhari N, Kharodia N. Scope of physiotherapy in oral medicine. J Gov Dent Coll Hosp 2014;1:16-22.
2.	Available from: https://en.wikipedia.org/wiki/Physical_therapy#:~:text= Physical%20^therapy%20(PT)%2C%20also,resulting%20from%20injury%2C%20trauma%20or. [Last accessed on 2020 Nov 07].
3.	Aggarwal A, Keluskar V. Role of Physiotherapy in treatment of certain Oro facial disorders. Biosci Biotechnol Res Commun 2010;3:7-13.
4.	Allen RJ. Physical agents used in the management of chronic pain by physical therapists. Phys Med Rehabil Clin N Am 2006;17:315-45.
5.	Chawla HS, Suri S, Utreja A. Is tongue thrust that develops during orthodontic treatment an unrecognized potential road block? J Indian Soc Pedod Prev Dent 2006;24:80-3. [PUBMED] [Full text]
6.	Frankel R. Lip seal training in the treatment of skeletal open bite. Eur J Orthod 1980;2:219-28.
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8.	Available from: https://www.physio-pedia.com/Low_Level_Laser_Therapy. [Last accessed on 2020 Nov 07].
9.	Available from: https://www.physiopedia.com/Thermotherapy#:~:text= Heat%20increases%20oxygen%20uptake%20and, and%20increases%20^the%20catabolic%20rate. [Last accessed on 2020 Nov 07].