Therapy · For parents
Children practisethrough play.
Lip closure, tongue posture, nasal breathing and swallowing mature during childhood, at a time when the jaw and face are still growing. Here you can find out which signs to look out for, how children train with the FaceFormer and what you can contribute as a mother or father.
Children grow into their functions. And the functions grow with them.
The way a child breathes, swallows and holds their mouth is repeated many hundreds to thousands of times a day and at night. These patterns help shape the direction in which the palate, jaw and face develop. That is why it is worth taking a close look early on.
Development
Why the first years matter
Breathing, swallowing and head balance together form the triad, a functional circuit that is laid down even before birth. It matures during childhood, and during this time it is particularly malleable.
Practised before birth
Even in the womb, the child swallows amniotic fluid and practises breathing movements. Healthy newborns breathe through the nose and can suck at the breast without having to interrupt their breathing.
Matured in everyday life
Breastfeeding practises sucking, swallowing and breathing together. Around the sixth month the tip of the tongue becomes mobile, and in the course of the second year of life the transition to mature swallowing begins.
Malleable during growth
During growth, bone adapts to the forces acting on it day after day, and duration counts for more than strength. The tongue against the palate gives the upper jaw support and direction from within. Studies describe associations between mouth breathing and the development of the jaw and face.
Patterns become ingrained
A dummy, the thumb or a nose that is blocked for a long time can push a child into a compensatory pattern. The nervous system adopts it and often keeps it, even when the nose is clear again later. That is why the training works on the pattern itself.
This is what the pattern looks like
The lips rest loosely together, the tip of the tongue rests on the small bump behind the upper incisors, the papilla incisiva, and air flows through the nose. Klaus Berndsen calls this basic position the tongue reference position.
It does not need strength, but conditions that the nervous system maintains without attention. This is exactly the basic position a child should adopt again on their own, during the day while playing and at night while asleep.
Taking a look
How you can spot the signs
You know your child best. The following observations are not a diagnosis. They are a good reason to take a closer look and to ask at a practice whether the nose is clear and how the tongue and lips are working.
During the day
Your child’s mouth is often open while playing, reading or watching TV. Your child breathes audibly through the mouth, and the lips are dry. When sitting, they slump and the head moves forward.
At night
Your child sleeps with their mouth open, snores or sleeps restlessly. In the morning their mouth is dry, and during the day they often seem tired or unable to concentrate.
Habits
A dummy or thumb is still often in the mouth long after the second birthday. When speaking or swallowing, the tongue pushes between the teeth, and some S sounds sound lisped.
Frequent upper respiratory infections or recurrent middle ear infections can also be connected with mouth breathing. Mention such observations at your paediatrician’s or ENT practice.
How children train
A soft FaceFormer, a plan of their own
Children train with the FaceFormer ZERO. It has the same shape and size as the ONE, only the material is softer, and it is recommended for children up to the age of ten. Your practice tailors the plan to your child. With young children, the practice decides from when and in what form training takes place. In the shop: the ZERO children’s set with hygiene box, plush pouch and success book, or the ZERO on its own.
Children practise two exercises from the start. In the basic exercise, your child holds the lip wedge with their lips, bites down, swallows and then relaxes. In the pull exercise, the FaceFormer is gently pulled forward while the lips hold it. As this happens, the tongue rests against the palate and the air flows through the nose. This way children train nasal breathing and lip closure without having to think about their breathing.
Strength is not important here. What counts is that every repetition is done cleanly. Practice takes place no more than three times a day. The free FaceFormer app guides you through the basic exercises and counts along.
Day 1 to 14
Three times a day, 5 basic exercises and 5 pull exercises each time.
Day 15 to 28
Three times a day, 10 basic and pull exercises each time.
From week 5
Three times a day, 20 basic and pull exercises each time, if your child is keeping up well.
At night
After a few weeks, the ZERO is also used at night. If it falls out at first, that is normal.
This is what the gentle start that practices use for children looks like. The youngest children don’t practise by numbers, but through play. From around the age of ten, the firmer ONE can be added for daytime training after a few weeks, while the ZERO remains in use at night. All steps in detail: basic exercise, pull exercise and night-time use.
Keeping at it
Praise, stamp, play
If you want to help your child break the habit of mouth breathing, you will quickly notice that reminders achieve little. A pattern that runs by itself cannot be controlled by willpower. It is relearned through many identical repetitions, and for that children above all need fun, and you.
If you want to support your child’s lip closure, what you need above all is regularity. It is more important than perfection. Alongside the ZERO, the FaceFormer ZERO children’s set contains a hygiene box, a plush pouch and a success book with a stamp.
Introduce it playfully
Introduce the FaceFormer as a butterfly or let a hand puppet join in. Show how it sits and let your child copy you.
Practise together
When Mum, Dad or siblings train along, the training becomes a normal routine and your child doesn’t feel different.
Count visibly
A stamp in the success book for every session, or a toothpick as a hedgehog spine in the ventilation holes of the storage box for every repetition. That way your child can see what they have achieved.
A little tug of war
Your child holds the lip wedge with their lips while you pull very gently. The pull exercise becomes a game, and the tongue rests against the palate as they do it.
Upright, with breaks
Practise standing at first, and later on a stool without a backrest so that your child doesn’t slump. Playing is allowed between the exercises.
Praise and reward
Praise every clean repetition and give a reliable reward, for example playing together, an ice cream or a trip to the cinema. Short sessions that work every day are better than long ones that create resistance.
Join in
Practising with video
Sit down in front of the screen with your child and join in together. The join-in videos on YouTube guide you through the basic exercise and the pull exercise.
5× basic and pull exercise (3 min)10× basic and pull exercise (6 min)
The short video suits the first two weeks, the longer one weeks 3 and 4. For you as a mother or father, a detailed information video explains how training with children is structured.
Working together
Braces, speech therapy and FaceFormer
The training complements what other specialities do. Please do not stop any treatments prescribed by a doctor or dentist on your own.
With braces. ZERO and ONE can be used together with removable and fixed braces, even at night. With brackets, a strip of dental wax protects the material. Discuss the routine with the orthodontic practice. The braces align the teeth, while the training works on the tongue, lips and breathing, which act on the teeth every day.
With speech therapy. FaceFormer therapy is used in many speech therapy practices as part of myofunctional therapy for children. If your child is already in treatment, ask there how the training can be integrated.
After adenoid or tonsil surgery. If the nose is blocked by enlarged adenoids, the airway is addressed first. After the procedure the nose is clear, but the learned pattern often remains. That is a good time to train nasal breathing.
In children, FaceFormer therapy is used, among other things, for switching from mouth to nasal breathing, for tongue dysfunctions, for giving up dummies and thumb-sucking, for functionally caused speech and language disorders and alongside the treatment of tooth misalignments and jaw anomalies. All areas: Where is FaceFormer therapy used?
Research
Studied in children
The most important study on FaceFormer therapy was carried out with children and adolescents. At the University Medical Center Hamburg-Eppendorf, 45 children and adolescents aged from just under four to seventeen were randomly assigned to two groups. One group trained with the FaceFormer, the other with myofunctional therapy without a device, each for six months. After six months, 30 of them were re-examined, 17 with FaceFormer and 13 without a device; the percentages refer to these.
The limitations are part of the picture. Lip strength increased in both groups. No difference was found in pronunciation. The study did not examine how stable the results are in the long term, and it is a single study with a small group. More on this: How does FaceFormer therapy work?
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 from parents
Frequently asked
From what age can my child train with the FaceFormer?
With young children, the practice decides from when and in what form they train. The youngest practise through play; children usually train with fixed numbers of repetitions from nursery age. You can find practices that work with children in the practitioner directory.
Can the FaceFormer be used with babies or very young children with feeding disorders?
Not on your own. For babies and toddlers with feeding disorders, the FaceFormer is only an option with expert therapeutic support, and whether and how it is used is decided case by case. As a general rule, children under four only train with expert support. Raise this with the practice that is already looking after your child.
Is there a child-sized FaceFormer?
No. All FaceFormers have the same shape and size. The ZERO is made of softer material and is recommended for children up to ten years of age. At first it feels unfamiliar to almost all children. If it hurts, call us on 02303 89991 before you change anything on the FaceFormer.
Is the FaceFormer a tongue trainer for children?
That is often how people search for it. However, it doesn’t train the tongue on its own, but together with lip closure, swallowing and nasal breathing. Swallowing creates a slight negative pressure, and the tongue rests against the palate.
How do I motivate my child to train?
With play, praise and fixed times, for example after brushing teeth. Practise together and use the join-in videos and the success book. If it just won’t work, a practice can take a lot of the pressure off you.
What might a first FaceFormer session with a young child look like?
Ideally playful, whether at the practice or at home. Your child can look at and touch the yellow ZERO first before it goes into their mouth, and you or the therapist demonstrate the exercise. This way your child gets used to the device step by step, without pressure and at their own pace.
Can my child use the FaceFormer with braces?
Yes, with removable and fixed braces, even at night. A strip of dental wax on the brackets protects the material. Discuss the routine with the orthodontic practice.
Can my child swallow the FaceFormer at night?
The lip wedge sits in front of the lips, the membrane in the oral vestibule in front of the teeth. If the nose is blocked, children usually push the FaceFormer out unconsciously in their sleep. It’s normal for it to be lying on the pillow in the morning at first. Only start night-time use once daytime training has been going for a few weeks.
Can my child wear the FaceFormer for many months and at night too?
Yes, the ZERO accompanies your child throughout the training period of several months, at night as a supplement to daytime training, not as a replacement for it. Watch out for signs such as pressure on the teeth, irritated mucous membranes or persistent restlessness during sleep. If so, take a short break and continue with fewer repetitions. If it persists, raise it with your practice or call us on 02303 89991.
Is the FaceFormer a replacement for a dummy?
No. It is a training device for short exercise sessions and for use at night according to plan, not a comforter. It is used when weaning children off the dummy and thumb-sucking because it guides the lips and tongue into the pattern that the dummy displaces. With thumb-sucking, it is also worth calmly redirecting rather than forbidding: during the day with something to keep the hands busy, and in the evening with a fixed bedtime routine.
Why can frequent dummy use restrict my child’s tongue?
The tongue needs freedom of movement when drinking, later when eating from a spoon, and with every swallow, so that it can find its way back to its tongue reference position on the palate. If a dummy rests on it for long periods, in our view it can, as a rule, no longer do this freely and looks for a detour when swallowing, which can become ingrained. So what matters is less the dummy itself than how often and for how long it is in the mouth.
Can sippy cups or spouted beakers with a drinking spout influence the pattern in a similar way?
In our view, as a rule, yes, if the spout is in the mouth often and for long periods. It then rests on the tongue much like a dummy and restricts its free movement when swallowing. An open cup or a lid without a spout gives the tongue more room.
My child has a cold. Should they keep practising?
A short break is not a problem. Carry on as soon as possible. If the nose is blocked for a longer period, have the airway checked by a doctor.
How long does the training take?
That depends on how long a pattern has already existed. Expect several months. Keep training, even if something changes early on, until mouth closure and nasal breathing happen on their own, even during sleep.
Does German statutory health insurance cover the costs?
German statutory health insurance does not usually cover the FaceFormer itself. More on this: Is the FaceFormer covered by German statutory health insurance?
Sources
- Schwan M (2007). Evaluation einer innovativen apparativen Therapie zur Harmonisierung der orofazialen Muskulatur und Funktion. Eine prospektive randomisierte klinische Studie bei Kindern. Doctoral thesis, University Medical Centre Hamburg-Eppendorf. PDF
- Korbmacher HM, Schwan M, Berndsen S, Bull J, Kahl-Nieke B (2004). Evaluation of a new concept of myofunctional therapy in children. International Journal of Orofacial Myology 30:39–52. PMID 15832861
- Abdel Hadi LA, Aburahma SK (2022). Effect of mouth breathing on dentofacial morphology, systematic review. PMC9498581
- Berndsen K-J, Berndsen S. FaceFormer Trainings-Therapie. Manual zur Methodik. 2nd edition 2024, chapter on children.
Read more
Knowledge on this topic
Where to go next
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.