A Customized Mouthguard Design for a Child with Orofacial Myofunctional Disorder: A Case Report

When fabricating custom-made mouthguards for children, tooth replacement is an important factor for dentists to consider. In addition, orofacial myofunctional disorders and deleterious oral habits-such as incompetent lip seal and tongue thrusting-are relatively common among children and are associated with an increased risk of oral and dental trauma. Therefore, individual oral functional characteristics should be taken into account when designing custom-made mouthguards for pediatric patients. This report presents a case involving the design, fabrication, and appliance management of a custom-made mouthguard for a Japanese boy exhibiting incompetent lip seal and tongue thrusting. In this case, the anterior palate region of the mouthguard was left uncut, and multiple holes were created using a carbide bur to permit tongue-palate contact and provide sensory feedback related to tongue elevation. Over a 20-month follow-up period, no oral or dental trauma was observed. During appliance use, the patient demonstrated improved tongue elevation and an increased frequency of lip seal at rest. This case illustrates a custom mouthguard design that incorporates individual oral functional characteristics in a pediatric patient.