Specialist article: nose and breathing
“Polyps” in your child?Why a clear nose is only the beginning
Your child breathes through the mouth, snores at night, and the word “polyps” comes up at the doctor’s? Here you can find out what distinguishes “polyps”, adenoids and nasal polyps, what studies show about adenoid surgery, and why nasal breathing is a pattern of breathing, swallowing and head balance that a child can learn.
Does this sound familiar?
The mouth is open, and everyone is talking about polyps?
What applies to your child?
Tap whatever applies to you.
If several points apply, it is worth taking a closer look at how your child breathes. An enlarged adenoid can block the nose. But whether a child breathes through the nose also depends on the pattern with which they hold their lips, tongue and head. This pattern can be trained.
“Polyps” or nasal polyps?Still mouth breathing after surgeryRecurrent tonsillitisThe key points at a glance
- In children, “polyps” usually refers to the enlarged pharyngeal tonsil, known in medical terms as adenoids. True nasal polyps are a condition of the nasal mucosa, mainly in adults.
- Large adenoids can block the nose, and the child switches to the mouth. As an emergency solution, this makes sense. If it remains as a pattern, it comes at a price for sleep, the middle ear and the development of the jaw and face.
- Adenoid surgery can open the airway. It does not change the breathing pattern by itself. For this, we rely on training the basic functions of breathing, swallowing and head balance.
Video
Nasal polyps and adenoid growths: nasal breathing in children
Das Video lädt erst nach dem Klick. Dann werden Daten an YouTube (Google) übertragen.
Terms
Polyps, adenoids, nasal polyps: three words, two things
When a paediatrician talks about polyps, this means something different from a finding of nasal polyps in an adult.
In everyday language, enlarged pharyngeal tonsils in children are called polyps. The technical term is adenoids or adenoid vegetations. The pharyngeal tonsil sits high up in the nasopharynx, where the back of the nose meets the throat. It is part of the immune tissue and is present in every child. It only becomes an issue when it is so large that it narrows the airway behind the nose.
Polyps in children (adenoids)
- Enlarged pharyngeal tonsil in the nasopharynx
- Common in toddlers and pre-school children
- As a rule, shrinks as the child grows
- Narrows the airway behind the nose
Nasal polyps (mainly adults)
- Outgrowths of the mucous membrane of the nose and sinuses
- Result of chronic inflammation
- More common with asthma and in older age
- Block the nose from the inside, often with a reduced sense of smell
True nasal polyps are rare in children. In cystic fibrosis, however, they are common1. If a nasal polyp is found in a child, the cause should therefore be clarified by a doctor.
Both can obstruct nasal breathing, and both are often mentioned in the same breath. This article is mainly about the adenoids in children and the mouth breathing they can trigger. Nasal polyps in adults have a section of their own.
Anatomy
The pharyngeal tonsil: large in the first years of life
In early childhood, the pharyngeal tonsil grows faster than the space it sits in. This explains why so many children of this age breathe through their mouths.
The pharyngeal tonsil lies on the roof of the nasopharynx, directly behind the nasal cavity. To the side of it, the Eustachian tube opens: the channel that ventilates the middle ear. If the tonsil is large, it narrows the path the air takes from the nose into the throat.
The air then takes the easier route through the mouth. In the model, the pharyngeal tonsil is circled in red, and the arrows show the airflow through the open mouth.
of children and adolescents in randomly selected samples had an enlarged pharyngeal tonsil, determined by nasal endoscopy. The individual studies varied widely2
was the figure in samples from clinics and practices, analysed in the same review covering a total of 5,248 children and adolescents2
As the child grows, the proportions change. In a long-term observational study from Denver, twelve children were X-rayed repeatedly from their first year of life to their eighteenth. The airway in the nasopharynx was narrow mainly in the pre-school and early school years. After that it widened, because the space grew along with the child and the pharyngeal tonsil shrank3.
When the nasopharynx is clear, air flows through the nose over the nasal turbinates into the throat and is warmed, humidified and cleaned along the way.
The width of the nasopharynx is only one half of the picture. In our view, whether a child actually uses this route depends on whether the lips, tongue and head balance close off the oral cavity.
Mouth breathing
Child breathes through the mouth: how to recognise it
Mouth breathing is often noticed first at night. During the day it shows up in small signs that are easily taken for quirks.
Typical signs are an open mouth while playing or watching TV, dry lips, snoring and restless sleep. Some children sound congested even though they don’t have a cold, and seem tired during the day.
An enlarged pharyngeal tonsil is a common cause, but not the only one. Often several things come together, such as an allergic swelling of the nasal mucosa and a habit that became established while the nose was blocked.
of mouth-breathing children aged 3 to 9 slept with their mouths open in a study from Brazil; 79% snored4
of these children had allergic rhinitis, i.e. allergic inflammation of the nasal mucosa4
had an enlarged pharyngeal tonsil. Many children had both, so the percentages overlap4
Watch your child while they play or watch TV. How are their lips?
Chain of cause and effect
From obstacle to pattern
A large pharyngeal tonsil is an obstacle. What becomes of it is decided in the nervous system.
If a child breathes through the mouth for weeks and months, more than just the airway adapts. The lips stay open, the tongue drops down from the palate so that air can flow through the mouth, and, in our view, the head shifts slightly forward because this widens the space in the throat.
The nervous system stores this compensation as a preferred pattern. Early habits such as dummies, bottles or thumb-sucking have a similar effect, keeping the tongue away from its tongue reference position on the palate.
The nose is blocked
A large pharyngeal tonsil, an infection or an allergy narrows the airway. The mouth steps in.
The body compensates
Lips open, tongue low, head slightly forward. The nervous system stores the compensation as a preferred pattern.
Form follows
During growth, the palate, jaws and tooth position adapt to the forces acting on them day after day.
Complaints arise
Snoring, restless sleep, frequent infections, a poorly ventilated middle ear. When and how severely depends on the extent, the duration and the child’s age.
If a child sleeps restlessly with an open mouth, they lack restful sleep, and during the day this can show up as tiredness, restlessness or concentration problems. If the enlarged adenoids also block the Eustachian tube, fluid can collect in the middle ear. The child hears less well, and this also makes learning to speak more difficult. These consequences are often looked at individually and rarely connected with breathing.
In our view, a disturbed basic function usually stands at the start of many such chains. Muscles that are not integrated into their function are not used and lose tension. If hardly any air flows through the nasopharynx any more, the immune tissue there lacks airflow, humidification and cleansing. The conclusion suggests itself that enlarged adenoids and mouth breathing sustain each other. The adenoids block the nose, and the lack of airflow favours their staying large. This has not been studied in this form; it is our view.
The nose is clear. The pattern remains.Once the open mouth has become a habit, a child often keeps breathing through it, even when the nose has long been clear. The basic programme of nasal breathing has not been erased but overlaid, and it can be learned again.
When the nose is blocked, mouth breathing is initially a sensible emergency solution. If it persists as a pattern, it comes at a price: the tongue and lower jaw drop, hardly any air flows through the nasopharynx any more, sleep becomes shallower, and during growth the jaws and palate adapt to these forces6. In our view, this is usually the reason why a child continues to breathe through the mouth once the nose is clear.
Growth
Mouth breathing, jaws and face: what studies show
Whether mouth breathing plays a part in shaping the development of the face has been studied for decades. The findings fit together, but they do not prove everything.
A review from Chongqing summarised ten studies comparing mouth-breathing children with nasal-breathing children. In the mouth breathers, the upper and lower jaws were on average rotated backwards and downwards, the occlusal plane was steeper, the upper incisors tilted forwards, and the airways in the throat were narrower5.
Animal experiments from San Francisco show a causal link. Young rhesus monkeys had their noses closed with silicone plugs. The animals kept their mouths open, adapted their lower jaw and tongue and, over time, developed a different face and a different bite from the control animals6. Something like this cannot be tested in humans. Observations after adenoid surgery are revealing here.
aged between 7 and 12 were observed in Sweden after removal of greatly enlarged adenoids and compared with 37 children with unobstructed airways7
of follow-up, during which the lower jaw grew more horizontally in the girls than in the comparison group. The boys showed the same tendency, but it was statistically uncertain7
The Swedish study was not randomised, and narrow anatomy can in turn make breathing more difficult. In our view, the common denominator is function. The tongue, lying flat against the palate, gives the upper jaw support and direction from within. If it is missing there for many hours a day, this stimulus is missing.
Studies describe associations, not inevitability. Not every child who breathes through the mouth for a while develops a malposition, and in an individual child the direction of the effect cannot be read from their appearance.
Research
Adenoid surgery in children: what studies show
Removal of the adenoid is called adenoidectomy; if the palatine tonsils are removed as well, it is called adenotonsillectomy. For some questions, there are randomised studies on this.
The American CHAT study randomly assigned 464 children aged five to nine with obstructive sleep apnoea. Some had early surgery on the adenoids and palatine tonsils, while the others were initially monitored. After seven months, the operated group did better in terms of symptoms, behaviour, quality of life and sleep study results. Attention and executive functions, the actual primary outcome, did not differ8.
of the children operated on early had a normal sleep study after seven months8
in the group that was initially only monitored8
The picture is different for frequent infections. In the Netherlands, 111 children aged between one and six, for whom adenoid surgery had been planned because of recurrent upper respiratory tract infections, were randomly assigned to early surgery or initial monitoring. Over two years, both groups had the same number of infections, just under eight per year. Early surgery brought no advantage here9.
Whether a procedure makes sense for your child is something to discuss with your ENT practice. Training the basic functions can be combined with it, before and after surgery. How we view other treatments is explained under FaceFormer and other treatments.
Context
Nose clear, mouth open?
Many parents experience the same thing after adenoid surgery. The nose is clear, and yet the child keeps breathing through the mouth.
An operation changes the space in the nasopharynx, but the breathing pattern initially stays as it is. A child who has breathed through the mouth for years does not automatically switch after the operation, especially not at night. We see the same in adults after an operation on the nasal septum.
After the operation, adenoid tissue can grow back. An analysis of studies found this in about 8 % of children, and a repeat operation was needed in about 2 %17. In our view, it is more common than regrowth for mouth breathing to remain, even though the nose is clear. A research group from Stanford has studied this in children.
children continued to breathe through the mouth for a large part of the night during sleep after surgery on the adenoids and palatine tonsils10
still had night-time breathing disorders after surgery. All 26 were among the children who breathed through the mouth during sleep10
The authors recommend paying specific attention to mouth breathing during sleep after surgery. Children who subsequently had myofunctional therapy did better after one year than children without it. However, this was a small, retrospective analysis with nine treated children, and it was not the FaceFormer that was studied10.
Like a diversion after roadworks
When a road is closed for a long time, everyone gets used to the diversion. Once the roadworks are cleared, many still keep taking the familiar detour. This is how we see nasal breathing after adenoid surgery. The way is clear, but it is only used once the pattern has been learned anew.
Palatine tonsils
Recurrent tonsillitis: what role does breathing play?
Besides the adenoid, the throat also contains the palatine tonsils. If they become inflamed frequently, it is worth looking at how your child breathes here too.
The adenoid is not the only tonsil in the throat. The palatine tonsils, technically called tonsils, sit at the sides of the transition from the oral cavity to the throat, where a doctor looks when examining the open mouth. They are what people mean in everyday language when they talk about tonsillitis.
Tonsils are part of the immune tissue of the mucous membranes and sit where inhaled air and food first meet larger amounts of foreign substances. They are particularly active in the first years of life. Reacting and occasionally swelling up is, at first, simply part of their job. They become a matter for the ENT practice when inflammations become frequent or a tonsil stays enlarged over time.
In our view, recurrent tonsillitis usually has several causes at once, such as the many infections of nursery age or a family tendency. Mouth breathing can be one of these factors. The nose warms, humidifies and cleans the air we breathe. If your child breathes through the mouth, this filter is lost, and the air reaches the palatine tonsils cooler, drier and less clean. A small study from India examined this in children with mouth breathing.
aged between 5 and 12 who breathed through the mouth wore an oral vestibule plate (oral screen) for six months15
later, fewer group A streptococci (Streptococcus pyogenes) were detectable, the palatine tonsils were smaller and the pharyngeal space wider than at the start15
The evidential value is limited. There were 24 children, there was no comparison group, and what was studied was an oral vestibule plate, not the FaceFormer. Whether tonsillitis becomes less frequent through training nasal breathing cannot be inferred from this.
Whether tonsil surgery makes sense depends mainly on how often and how severe the inflammations are and whether they have been medically documented. A frequently cited study from the USA examined children who were affected particularly often: at least seven episodes in the year before the start of the study, five in each of the two years before, or three in each of the three years before.
aged between 3 and 15 with particularly frequent throat infections took part, 91 of whom were assigned by lot to surgery or watchful waiting, the rest according to their parents’ wishes16
of the children who had surgery had a complication from the procedure. All were readily manageable or resolved on their own16
In the first two years after the operation, the children who had surgery had throat infections less often than those who did not. At the same time, many of the children who did not have surgery had fewer than three episodes a year, and their episodes were mostly mild. The authors consider the operation justified in children who meet their strict criteria, but also see watchful waiting as supported and recommend deciding on a case-by-case basis16.
If tonsil surgery is medically indicated for your child, we do not question that. The decision lies with the ENT practice. Training the basic functions does not replace a necessary operation. It focuses on breathing, can be used as a complement before and after a procedure, and is paused during acute inflammation in the mouth, throat or airways.
Adults
Nasal polyps: a disease of the mucous membrane
True nasal polyps have nothing to do with the adenoids. They grow from the mucous membrane of the nose and sinuses.
Nasal polyps are soft, benign outgrowths of the mucous membrane. They develop as part of a chronic inflammation of the sinuses, technically chronic rhinosinusitis with nasal polyps, grow into the nose and can block it and impair the sense of smell.
How the sinuses are ventilated and why they become inflamed is explained in the article on sinusitis.
of adults had nasal polyps in a Swedish population study of 1,387 people examined, detected by nasal endoscopy11
in those over 60. Men and people with asthma were affected more often11
The European guideline EPOS 2020 describes treatment in stages. It starts with nasal rinses and a cortisone nasal spray, for more severe symptoms short courses of cortisone tablets, followed by sinus surgery and, in severe cases, antibody therapies12. How often polyps come back after surgery was tracked by an American study of 363 patients who had undergone surgery.
of those who had surgery had polyps again six months after sinus surgery, despite continued treatment with medication13
after 18 months. One risk factor was previous surgery13
Whether nasal breathing prevents nasal polyps has not been studied. Do not stop a prescribed cortisone spray on your own; the training can be combined with medical treatment.
Evidence on training
What about the training has been studied
We disclose what is available and what is not.
The only randomised study on FaceFormer therapy is the Hamburg study by the Department of Orthodontics at the University Medical Center Hamburg-Eppendorf. 45 children and adolescents with functional disorders in the oral area were assigned by lot to treatment either with the FaceFormer or with myofunctional therapy without a device. The basic functions themselves were measured, including lip closure, lip strength and swallowing pattern14.
Both groups improved. In the FaceFormer group, habitual lip closure was established more quickly, and the tongue rested against the palate more often during swallowing14. The limitations are part of the picture. After six months, only 30 of the 45 children were re-examined, a co-developer of the method was a co-author, and polyps or adenoids were not a subject of the study.
The absence of a study does not mean that the connection does not exist. It means that it has not been tested.To our knowledge, whether training changes the adenoids or nasal polyps has not been studied. What has been studied is that the basic functions can be trained. You can find all studies with their limitations under Studies and science.
Training
Training nasal breathing in children: relearning the pattern
Reminders such as “Close your mouth” rarely help for long. A breathing pattern is not a resolution but a stored sequence, and it changes through many identical repetitions. Our approach is training the basic functions of breathing, swallowing and head balance. It aims to anchor nasal breathing anew as a pattern and creates the conditions for it to become the normal case again.
If you follow this logic, this can also create the conditions for the nose’s defences to work again: filtering, humidification and the nitric oxide from the sinuses, which only reaches the lungs with the inhaled air during nasal breathing.
Breathing
The lips rest lightly together, and the air flows through the nose, where it is warmed, humidified and cleaned.
Swallowing
A person swallows many hundreds to thousands of times a day. Afterwards, the tongue settles into the tongue reference position on the palate, and the oral cavity is sealed.
Head balance
When the head is balanced over the body, the throat stays open without the head having to shift forward.
Children train with the FaceFormer ZERO. The ZERO is made of softer material; its shape and size match the ONE. It is recommended for children aged 2 to 10. From the start, children practise the basic exercise and the pull exercise.
In the pull exercise, the lips hold the FaceFormer while it is gently pulled forwards. The tongue rests against the palate and the air flows through the nose. This way, children practise nasal breathing and lip closure without having to think about their breathing.
- Day 1 to 14
Getting started
Three times a day, 5 basic exercises and 5 pull exercises each time with the ZERO. The youngest children practise through play rather than by numbers.
- Day 15 to 28
Building up
Three times a day, 10 basic and pull exercises each time.
- From week 5
Full programme
Three times a day, 20 basic and pull exercises each time, once your child is coping well. Do not practise more than three times a day.
- After a few weeks
At night too
The ZERO is added at night. If it falls out at first, that is normal.
- Over months
The pattern runs by itself
The training allows six to twelve months until the new patterns run without thinking. This is followed by maintenance training.
Children learn through play and imitation. In the free FaceFormer app, the character Facy accompanies the training; the app guides the basic exercises and keeps count.
If the family practises along, the training becomes a routine. Strength is not important. What counts is that each repetition is done cleanly.
You can find more on training with children, dummies, thumb-sucking and early signs under FaceFormer for children. You can train on your own with the app and the exercise pages. If you train with a practice, it will tailor the plan to your child. Children under 4 train with expert guidance. If the nose is completely blocked or acutely inflamed, have this checked before starting the training.
Everyday life
Nasal breathing in everyday family life
Lips closed, nose open
Show your child how the lips rest lightly together and the tip of the tongue has its place behind the upper front teeth. If you do it together, it turns into a game.
Check at night
Check now and then whether your child sleeps with their mouth closed. Especially after an adenoid operation, this is where you can see whether the pattern has already changed.
Keep an eye on dummies and thumbs
Both keep the tongue away from the palate. Support weaning playfully instead of relying on bans.
Keeping the nose clear
When your child has a cold, keep the nose clear, for example with saline solution, so that the mouth does not take over for weeks.
Don’t tape the mouth shut
A strip of tape over the mouth closes the lips from the outside but does not change the pattern. We expressly advise against it for children; more on this in the article Mouth Taping.
Do not stop prescribed treatment on your own
If your child uses nasal spray or other remedies on medical advice, discuss any changes with the practice. The training can be combined with them.
Questions
Frequently asked
What are “polyps” in children?
In children, “polyps” usually refers to the enlarged pharyngeal tonsil, known in medical terms as adenoids. It sits at the roof of the nasopharynx and is part of the immune tissue. If it is large, it narrows the airway behind the nose, and the child breathes through the mouth. It has nothing to do with the nasal polyps found in adults.
What is the difference between “polyps” and nasal polyps?
“Polyps” in children are enlarged immune tissue in the nasopharynx. Nasal polyps are outgrowths of inflamed mucous membrane in the nose and sinuses. They occur mainly in adults, more often together with asthma. In children, true nasal polyps are rare and should be checked by a doctor.
How can I tell whether my child breathes through the mouth?
By an open mouth while playing or watching TV, dry lips, snoring and restless sleep. A simple test: ask your child to close their lips and breathe calmly through the nose for one minute.
Do adenoids shrink on their own?
The adenoid is at its largest in toddlerhood and preschool age and usually shrinks as the child grows, while the nasopharynx grows with it. In our view, the pattern that became established during the period of the blocked nose often persists without targeted training.
Is adenoid surgery necessary?
You decide this together with the ENT practice. In children with obstructive sleep apnoea, a large randomised study showed a clear benefit of surgery. For recurrent infections alone, early surgery brought no advantage over watchful waiting in a Dutch study.
Why does my child keep breathing through the mouth after adenoid surgery?
Because the operation changes the space, not the pattern. In a study from Stanford, 35 of 64 children continued to breathe through the mouth for a large part of the night after surgery. A breathing pattern can be relearned through training the basic functions of breathing, swallowing and head balance.
Can adenoids come back after surgery?
Adenoid tissue can grow back. An analysis of studies found this in about 8 % of the children operated on, and a repeat operation was needed in about 2 %. In our view, it is more common for mouth breathing to remain, because the operation removes tissue, not the pattern.
Can mouth breathing influence jaw and facial development?
Studies describe, on average, jaws rotated backwards and downwards, a steeper occlusal plane and narrower pharyngeal airways in mouth-breathing children. These are associations, not inevitabilities, and in an individual child the direction cannot be read from their appearance.
Which FaceFormer is suitable for children?
Children train with the FaceFormer ZERO, made of softer material, which is recommended for children aged 2 to 10. Its shape and size correspond to the ONE. Children under 4 train with expert supervision.
Does nasal breathing prevent nasal polyps?
This has not been studied. Nasal polyps develop from chronic inflammation of the mucous membrane, and their treatment belongs in the hands of a doctor. The training can be combined with it.
What is the difference between the palatine tonsils and the adenoid?
The adenoid (pharyngeal tonsil) sits at the roof of the nasopharynx and, when enlarged in children, is colloquially called “polyps” in German. The palatine tonsils, known medically as tonsils, lie at the sides of the throat and are visible when you look into the open mouth. Both belong to Waldeyer’s ring, the immune tissue surrounding the nasopharynx and oropharynx.
Can mouth breathing promote tonsillitis?
In our view, recurrent tonsillitis usually has several causes at the same time. Mouth breathing is one possible factor among several, because the air then reaches the palatine tonsils cooler and drier, without the filter of the nose. To our knowledge, whether mouth breathing makes tonsillitis more frequent has not been examined in meaningful studies.
Is tonsil surgery advisable for recurrent tonsillitis?
You decide this with the ENT practice based on the documented episodes. A randomised study of particularly frequently affected children showed fewer throat infections in the first two years after surgery than without surgery. Nevertheless, the authors advised deciding case by case rather than following a blanket rule.
More articles from the knowledge section
Where to go next
Sources
- Beer H, Southern KW, Swift AC (2015). Topical nasal steroids for treating nasal polyposis in people with cystic fibrosis. Cochrane Database of Systematic Reviews 2015(6):CD008253. PMID 26098667. Source
- Pereira L, Monyror J, Almeida FT, Almeida FR, Guerra E, Flores-Mir C, Pachêco-Pereira C (2018). Prevalence of adenoid hypertrophy: A systematic review and meta-analysis. Sleep Medicine Reviews 38:101-112. PMID 29153763. Source
- Handelman CS, Osborne G (1976). Growth of the nasopharynx and adenoid development from one to eighteen years. The Angle Orthodontist 46(3):243-259. PMID 1066976. Source
- Abreu RR, Rocha RL, Lamounier JA, Guerra AF (2008). Etiology, clinical manifestations and concurrent findings in mouth-breathing children. Jornal de Pediatria (Rio de Janeiro) 84(6):529-535. PMID 19060979. Source
- Zhao Z, Zheng L, Huang X, Li C, Liu J, Hu Y (2021). Effects of mouth breathing on facial skeletal development in children: a systematic review and meta-analysis. BMC Oral Health 21(1):108. PMID 33691678. Source
- Harvold EP, Tomer BS, Vargervik K, Chierici G (1981). Primate experiments on oral respiration. American Journal of Orthodontics 79(4):359-372. PMID 6939331. Source
- Linder-Aronson S, Woodside DG, Lundström A (1986). Mandibular growth direction following adenoidectomy. American Journal of Orthodontics 89(4):273-284. PMID 3515955. Source
- Marcus CL, Moore RH, Rosen CL et al. (2013). A randomized trial of adenotonsillectomy for childhood sleep apnea (CHAT). New England Journal of Medicine 368(25):2366-2376. PMID 23692173. Source
- van den Aardweg MT, Boonacker CW, Rovers MM, Hoes AW, Schilder AG (2011). Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial. BMJ 343:d5154. PMID 21896611. Source
- Lee SY, Guilleminault C, Chiu HY, Sullivan SS (2015). Mouth breathing, “nasal disuse,” and pediatric sleep-disordered breathing. Sleep and Breathing 19(4):1257-1264. PMID 25877805. Source
- Johansson L, Akerlund A, Holmberg K, Melén I, Bende M (2003). Prevalence of nasal polyps in adults: the Skövde population-based study. Annals of Otology, Rhinology and Laryngology 112(7):625-629. PMID 12903683. Source
- Fokkens WJ, Lund VJ, Hopkins C et al. (2020). European Position Paper on Rhinosinusitis and Nasal Polyps 2020 (EPOS 2020). Rhinology 58(Suppl S29):1-464. PMID 32077450. Source
- DeConde AS, Mace JC, Levy JM, Rudmik L, Alt JA, Smith TL (2017). Prevalence of polyp recurrence after endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis. Laryngoscope 127(3):550-555. PMID 27859303. Source
- Korbmacher HM, Schwan M, Berndsen S, Bull J, Kahl-Nieke B (2004). Evaluation of a new concept of myofunctional therapy in children (Hamburg study). International Journal of Orofacial Myology 30:39-52. PMID 15832861. Source
- Singh M, Mathur S, Jhingan P, Jain A (2023). Assessment of changes in Streptococcus pyogenes levels using N-acetylgalactosamine-6-sulfatase marker and pharyngeal airway space with appliance therapy in mouth breathers, an ELISA-based study. Journal of the Indian Society of Pedodontics and Preventive Dentistry 41(2):111-117. PMID 37635469. Source
- Paradise JL, Bluestone CD, Bachman RZ, Colborn DK, Bernard BS, Taylor FH, Rogers KD, Schwarzbach RH, Stool SE, Friday GA, et al. (1984). Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials. New England Journal of Medicine 310(11):674-683. PMID 6700642. Source
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Get started
Ready for the training?
The free FaceFormer app guides you through the basic exercises, counts along and reminds you of your sessions. If you wish, a practice from the practitioner directory can support you.
FaceFormer ZERO + ONE
Both material hardnesses for getting started, day and night. The set for adults.
FaceFormer ZERO
The softer FaceFormer for getting started, for children and for the night.
FaceFormer ZERO Children’s Set
ZERO with hygiene box, plush bag and success book with stamp.
FaceFormer training aims to restore the physiological setting of the basic functions of breathing, swallowing and head balance, with lip closure and the tongue reference position, thereby creating the conditions under which symptoms can improve. It does not replace a medical assessment. You can find practitioners near you in the practitioner directory.
