Therapy · Working together
Complement.Don’t replace.
Braces, splint, breathing therapy device, speech therapy or surgery: each of these treatments has its own field and its own rationale. FaceFormer therapy starts at a different point, with the shared control pattern of breathing, swallowing and head balance. Here you can read how the two fit together and what to look out for when combining them.
Do not stop medically prescribed treatments on your own.
FaceFormer training is added on; it takes nothing away. Whether anything about an existing treatment changes later is something you decide together with the practice that prescribed it.
The approach
Every field in its place, the training at the start of the chain
Breathing, swallowing and head balance run continuously. If their pattern deviates, the body compensates, often for years. The consequences show up in very different places, and that is where the specialist treatments come in.
The control pattern
Breathing, swallowing and head balance are controlled together in the brainstem. This is where many causal chains begin.
The adaptation
Tongue, lips, jaw and head shift position so that breathing and swallowing can still work.
The consequences
Teeth, jaw joint, sleep, neck or speech. Many complaints can be connected with the pattern.
The specialist treatment
Orthodontics, dentistry, sleep medicine, speech therapy, physiotherapy or surgery treat what becomes visible.
Dr. Klaus-Jürgen Berndsen calls the coexistence of many specialist treatments in the same area of complaints symptom therapy in variation. This is not meant as a criticism. Each specialty is competent within its own section; what is often missing is simply a shared view of the start of the chain. FaceFormer therapy adds this view. It trains natural functions back into their pattern, and in doing so you are not doing anything wrong.
Both have their place
Braces align the teeth, a splint protects them, a breathing therapy device keeps the airways open at night. The training works on the pattern that acts on all of this every day.
Pattern, not strength
What is trained is the sequence, not muscle strength. Through many identical, clean repetitions, the nervous system learns until the pattern runs without conscious attention.
What comes of it depends on many things
That depends on how long a pattern has existed, whether structures have changed and how regularly you train. The training creates the conditions under which complaints can improve.
Teeth and jaw
Braces, retainers and splints
Orthodontics and dentistry work on the teeth, bite and jaw joint. The training works on the forces that the tongue, lips and cheeks exert on the teeth and jaws every day.
Orthodontics
Braces and aligners
- What they do. They move the teeth and jaws into a new position, either fixed with brackets, removable, or with clear aligners.
- How the FaceFormer fits in. The braces shape the form; the training shapes the pattern of tongue position, lip closure, swallowing and nasal breathing that accompanies this form in everyday life.
- When combining. You can train in parallel, during the day and at night, even with removable braces. With brackets, a strip of dental wax protects the mucous membrane and the FaceFormer.
Coordinate the process with your orthodontic practice.
Orthodontics
Retainers
- What it does. It holds the teeth in their new position after treatment, either as a wire behind the front teeth or as a removable splint.
- How the FaceFormer fits in. The retainer holds the form. The training addresses what the tongue and lips exert on the teeth every day.
- When combining. A fixed retainer stays in your mouth during training. Wear a removable one as your practice instructs.
Whether and when a retainer is no longer needed is decided solely by the orthodontic practice.
Dentistry
Occlusal splint and anti-snoring splint
- What it does. The occlusal splint is intended to protect the teeth during grinding and clenching and to relieve the jaw joint. A mandibular advancement splint holds the lower jaw forward at night.
- Our view. We take a critical view of splints. The lower jaw is guided by muscles: by the tongue, lips, chewing muscles and neck. A splint imposes a position on it from the outside; it does not change this guidance. This guidance is exactly what we adjust with the training. Mouth closure, tongue reference position, nasal breathing and head balance determine how the jaw rests and how it is guided during swallowing.
- The biomechanics behind it. As a rule, the rows of teeth touch only briefly, during swallowing. Otherwise the lower jaw rests in a floating position, without tooth contact, and the chewing muscles can rest. An occlusal splint, by contrast, places a surface between the teeth that the jaw can bite on at any time. In our view, it therefore tends, as a rule, to invite biting rather than bringing the muscles to rest.
- When combining. During the day you train as usual. Do not stop a prescribed splint on your own.
Clarify what your nights should look like with your dental practice.
The night
What belongs in your mouth at night
After a few weeks of training, you wear the softer FaceFormer ZERO at night, without exercising. It sits in the oral vestibule between the lips and teeth and supports mouth closure and nasal breathing.
If you already wear an occlusal splint, an anti-snoring splint or a breathing mask at night, you don’t simply add another device. Start with training during the day. Whether the FaceFormer is added at night, alternating with the splint or only later, is something you decide with the practice that prescribed your night-time device.
If your nose is ever blocked, for example with a cold, the FaceFormer can be removed at any time with your fingers or tongue.
Breathing and sleep
Breathing therapy device and surgery
With sleep apnoea, enlarged adenoids or a narrowed nose, medical treatment comes first. The training can accompany it.
Sleep medicine
CPAP and other breathing therapy devices
- What it does. The device keeps the airways open during sleep with slight positive pressure. With diagnosed sleep apnoea, it is a medically prescribed treatment.
- What it doesn’t do. The device does not change the control pattern of breathing, swallowing and head balance. It works as long as it is worn, which is why it is usually needed long-term.
- How the FaceFormer fits in. The training works on this pattern: lip closure, tongue position and nasal breathing, which also play a role during sleep. A long-term goal can be to review together with your sleep medicine doctor whether the device can be reduced or at some point no longer be needed.
- When combining. Never stop using the device on your own initiative. Discuss every change with your sleep medicine practice, ideally on the basis of a follow-up measurement.
The training does not replace a prescribed breathing therapy device.
ENT and maxillofacial surgery
Operations
- What it does. An operation creates space where an obstruction is in the way, for example with enlarged adenoids, a deviated nasal septum or a pronounced jaw misalignment.
- How the FaceFormer fits in. The breathing and swallowing pattern that has developed around an obstruction does not change by itself. This is where the training can follow on. It is used before and after operations on the face, jaw or tongue.
- When combining. After a procedure in the mouth, nose or throat, you only start once the wound has healed and the practice that performed the operation agrees.
Whether an operation is necessary is decided by your doctor.
Lip closure
Tape or training
Mouth tape is not a medical treatment, but the question comes up often. Both aim to keep the mouth closed at night. The way there is different.
Mouth tape
A strip of tape holds the lips together from the outside. This is passive lip closure. The lips are closed, but their muscles hardly work, and the tape itself does not change the pattern by which the tongue, lips and breathing work together.
FaceFormer training
The training practises active lip closure, together with the tongue reference position, swallowing and nasal breathing, until it runs without conscious attention. At night, the lips hold the FaceFormer ZERO themselves; the mouth is not taped shut.
Tape holds a door shut from the outside. The training adjusts the hinge, lock and frame so that it closes by itself. We do not recommend taping the mouth shut at night, especially not if the nose is not clear, for example with a cold or allergy. If you snore with pauses in breathing, a medical assessment comes first.
Therapy
Speech therapy, physiotherapy and osteopathy
Many practices in these fields work with the FaceFormer themselves. Therapy and training then go hand in hand.
Speech and language therapy
Speech therapy and myofunctional therapy
- What it does. Speech therapy works on speaking, language, voice and swallowing. Classic myofunctional therapy exercises the lips, tongue and face, usually without a device.
- How the FaceFormer fits in. Many speech therapy practices use the FaceFormer. The practice carries out the assessment, selects the modules and corrects how the exercises are performed. Articulation remains a separate part of speech therapy work.
- When combining. Speech therapy exercises and FaceFormer training can be done in parallel. Discuss with your practice how to fit both into your day.
You can read about the difference between the approaches further below.
Body and posture
Physiotherapy and osteopathy
- What it does. It works on posture, mobility, muscles and tissue, often on the neck, shoulders and jaw joint.
- How the FaceFormer fits in. Tongue position, swallowing and nasal breathing help set head balance. The training adds this part, starting from the mouth region.
- When combining. The two go well together. Let your practitioner know that you are training with the FaceFormer.
The practitioner directory shows practices that use the FaceFormer themselves.
Research
FaceFormer and myofunctional therapy
At the University Medical Center Hamburg-Eppendorf, 45 children and adolescents with functional disorders in the oral region were randomly assigned to two groups. 26 trained for six months with the FaceFormer, 19 with myofunctional therapy without a device. After six months, 30 of them were re-examined, 17 with the FaceFormer and 13 without a device; the percentages refer to these.
The two methods take different approaches. Myofunctional therapy exercises the strength and mobility of individual muscles. FaceFormer therapy works on the pattern by which breathing, swallowing and head balance interact, with the same exercise sequence for all three.
Lip strength increased in both groups; myofunctional therapy achieved its own goal there. In the airway and swallowing pattern, i.e. in what runs without conscious attention, the groups diverged. There was no difference in pronunciation. The study is small and makes no statement about long-term stability.
Mouth breathing
Faulty swallowing pattern after 6 months
Schwan M, doctoral thesis, University of Hamburg 2007. Korbmacher et al., Int J Orofacial Myology 2004. Randomised, 45 children and adolescents, six months, 30 re-examined (17 with, 13 without device).
Questions
Frequently asked
Does the training replace my current treatment?
No. It complements them. Do not stop medically prescribed treatments such as braces, a splint or a breathing therapy device on your own initiative; instead, discuss every step with the practice that prescribed them.
Can I use the FaceFormer with fixed braces?
Yes. ZERO and ONE can be used together with brackets, during the day and at night. A strip of dental wax on the brackets protects the mucous membrane and the FaceFormer. Agree on the routine with your orthodontic practice.
Can I wear a splint and the FaceFormer at night?
Not at the same time. We take a critical view of splints. The lower jaw is guided by muscles: by the tongue, lips, chewing muscles and neck. A splint imposes a position on it from the outside, but it does not change this guidance. It is precisely this guidance that we set with the training. During the day, you can train without restriction. Do not stop using a prescribed splint on your own initiative: discuss with your dental practice whether the FaceFormer should take its place at night.
Is it normal for the FaceFormer to fall out during the first few nights?
Yes, this is common at the beginning. At night, the lips alone hold the FaceFormer ZERO in the oral vestibule. While lip closure and nasal breathing are still settling in during sleep, it often slips out. How long it takes to get used to varies, from one night to a few weeks. Daytime training continues as normal during this time.
Can the FaceFormer replace my CPAP device?
Not on your own. The device keeps the airways open while it is worn; the training works on the pattern behind it. In the long term, the goal can be to review with your sleep medicine practice whether the device can be reduced or at some point no longer be needed, ideally after a follow-up measurement. Until then, never stop using it on your own initiative.
What is the difference between the FaceFormer and myofunctional therapy?
Myofunctional therapy usually trains the lips, tongue and face separately and without a device. FaceFormer therapy combines lip closure, tongue position, swallowing and nasal breathing in a single sequence. The FaceFormer indicates the direction rather than forcing the movement. Many speech therapy practices use both.
When can I start training after surgery?
Once the wound has healed and the practice that performed the surgery agrees. This applies to procedures on the tonsils, nose, jaw and tongue. After jaw surgery, it is best to clarify when to start with your practice beforehand, or with us on 02303 89991.
Does my practice need to know the FaceFormer?
It helps. You can find practices with FaceFormer training in the practitioner directory. The exercises are also explained on this website and in the app.
Sources
- Schwan M (2007): Evaluation einer innovativen apparativen Therapie zur Harmonisierung der orofazialen Muskulatur und Funktion. Doctoral thesis, University Medical Centre Hamburg-Eppendorf. Full text
- Korbmacher HM, Schwan M, Berndsen S, Bull J, Kahl-Nieke B (2004): Evaluation of a new concept of myofunctional therapy in children. Int J Orofacial Myology 30:39–52. PubMed
- Kahl-Nieke B, Korbmacher H, Berndsen S et al. (2003): Evaluation of a new concept of functional therapy supporting orthodontic treatment. 79th Congress of the European Orthodontic Society, Prague.
- Booth D, Kinzinger G (2021): Behandlung eines offenen Bisses mit einer Kombination aus Highpull-Headgear und Face Former. Kieferorthopädie 35 (Quintessenz). Case report.
- Berndsen K, Berndsen S (2023): FaceFormer-Therapie. Neurophysiologische Kausaltherapie bei CCDS. In: Langenhan J, Kopp S (eds.): Zahnärztliche Schlafmedizin. Thieme, pp. 285–302.
- Berndsen K (in preparation): Trust the Triad. Chapters: Limits of swallowing therapies, Form and stimulus architecture, Why it is worth looking at the triad.
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.