The activating palatal plate, which was first reported by Castillo-Morales et al. in 1982, was used for treatment of oral dysfunctions in a patient with Down syndrome. The Castillo-Morales palatal plate has acrylic protuberant bodies which give tactile stimuli to mucosa of the hypotonic tongue and lip. The tongue stimulator whose shape is like a button with a deep central hole is placed at the posterior edge of the palatal plate. The lip stimulator which takes corrugated form is located in the vestibular front part of the plate. Mechanical stimulation of the tongue and upper lip makes the tongue withdraw and mouth close reflexively, resulting in improvement of oral dysfunctions in Down's syndrome.
We treated 6 cases of Down's syndrome, complicated with cleft lip and palate in 2 and congenital heart disease in 3. They had some oral dysfunctions, as a lack of sucking, deglutition and mastication, caused by hypotonia of the tongue and orofacial muscles. Moreover, most cases breathed through the mouth and often suffered from respiratory infections.
Five of 6 cases who wore the Castillo-Morales palatal plate at the age of between 4 months and 1 year 9 months were successfully treated. The orofacial hypotonic symptoms were significantly reduced to allow improvement in sucking, deglutition, mastication, and facial expression. Improvement of oral dysfunctions prevented maxillary hypoplasia and encouraged regular development of the mid-face region. But one case who started the treatment at the age of 4 years 5 months refused the palatal plate.
The Castillo-Morales palatal plate is possible of improvement of oral dysfunctions in Down's syndome, leading to long-term consequence of regular orofacial growth.