Therapy · How it works
Breathing. Swallowing.Head balance.
Three basic functions you perform continuously. When they run in the right pattern, your whole body works more easily. FaceFormer therapy trains exactly this pattern.
What gets trained is the programme, not strength.
Through many identical, clean repetitions, your nervous system relearns the correct sequence until it runs by itself, during the day and at night.
The model
Three functions. One circuit.
Breathing sets the rhythm that allows safe swallowing. Swallowing maintains the tension of the mouth and throat muscles. Head balance organises the position in which the airway and the swallowing pathway do not obstruct each other.
Breathing
Through the nose, the air is filtered, warmed and moistened. At the same time, nasal breathing gives the nervous system a steady rhythm.
Swallowing
Many hundreds to a thousand times a day, even during sleep. Each time, the tongue rests against the palate, the lips close, and the muscles of the mouth and throat are activated.
Head balance
The head balances on the spine, held by a finely tuned network of muscles. Its position helps determine the width of the airway.
Each of the three functions supports the other two and is supported by them. Dr. Klaus-Jürgen Berndsen calls this the triadic functional circuit. Because the three are so closely interlinked, a function corrected on its own cannot maintain its sequence as long as the other two remain in the old pattern. That is why the FaceFormer always trains all three together.
Anatomy
Where everything meets
Air and food share a common pathway through the nose, mouth and throat. At its centre lies the hyoid bone, the only bone in the body without a joint connection, held solely by muscles and ligaments. It is raised during swallowing, and its position changes with every tilt of the head.
The drift
How a small deviation can become a symptom
When the interplay is disturbed, the body compensates. Basic supply remains secure, but the effort increases. Dr. Berndsen describes this development in four stages:
The pattern deviates
Breathing runs through the mouth, the tongue lies low instead of against the palate, the head is held forward. You don’t feel anything yet.
The body compensates
Other muscles step in, for example in the neck, to keep the airway open. Over time, the compensation becomes a habit.
Form follows
What runs this way for a long time leaves traces: a narrow, high palate, misaligned teeth, a changed posture.
Complaints appear
For example snoring, jaw joint or neck complaints. They are the visible end of a development that often began years earlier.
Sabine and Dr. Klaus-Jürgen Berndsen have described recurring combinations of such findings as Cranio-Cervical Dysfunction Syndrome (CCDS). It is a working model from practice, not a diagnosis from an international classification.
The approach
At the start of the chain
Breathing, swallowing and head balance secure oxygen, food and the body’s spatial orientation around the clock. All three are closely connected to the autonomic nervous system, which regulates heartbeat, digestion and immune defence. They therefore stand at the start of many causal chains, and many complaints can be related to them.
A first step, not a replacement
The triad belongs at the start of every assessment. It does not replace a diagnosis or any other treatment; it creates the foundation on which other measures can work better.
The body organises itself
As with a wound: the doctor cleans and dresses it, but the tissue has to heal itself. The training changes the conditions, and dependent systems can readjust to them. Klaus Berndsen calls this emergent correction.
What comes of it depends on many things
On how long a pattern has existed, whether structures have changed, and how regularly you train. Not every complaint is linked to the triad, and that’s fine.
You can’t do anything wrong
The training brings natural functions back to their original pattern. It works with what your body does every day anyway.
The principle
Strength or programme
The nervous system learns compensatory patterns through repetition, just like any other movement programme. After thousands of breaths and swallows, the compensatory pattern feels normal and the actually correct one feels unfamiliar.
More strength alone
If you only increase muscle strength without changing the pattern, you simply perform the old pattern more forcefully.
Relearning the pattern
FaceFormer therapy targets the control pattern: many identical, clean repetitions in short intervals. What matters is the pattern.
The device
Form and stimulus architecture
The lip wedge and membrane give the nervous system a clear starting impulse: where the movement begins, where it goes and across which surfaces the forces are distributed.
Drag to rotateLip wedge Oval and bevelled all round. It guides the lips towards the centre of the mouth without forcing the movement.
Seal The membrane lies behind the lips in the oral vestibule and seals the oral cavity at the front.
Negative pressure The lip wedge and membrane are joined without an opening. That is why a slight negative pressure develops when you swallow, and the tongue rests against the palate.
Guiding, not forcing
The lip wedge guides the lips towards the centre of the mouth and provides noticeable feedback without forcing the movement.
Negative pressure in the mouth
The membrane sits behind the lips, seals the oral cavity and creates a slight negative pressure during swallowing. The tongue rests against the palate.
Only the correct sequence works
Compensatory movements don’t work with the FaceFormer. The brain has to actively plan and correct the sequence, and that is exactly how it learns.
What makes it special
Five reasons why the pattern comes back
Returning rather than reinventing
The correct pattern is already built in. Breathing, swallowing and head movements are practised even before birth, and their basic circuitry lies in the oldest parts of the brainstem. Compensatory patterns overlay it, but it is not erased. The training leads back to it.
All three at once
Breathing, swallowing and tongue movement are controlled together in the brainstem. That is why lip closure has further effects: on tongue elevation, the soft palate, the nasal passage and head balance.
A fixed point of reference
The small elevation behind the upper front teeth, the incisive papilla, is densely supplied with nerve endings. It gives the nervous system a clear location for the tongue to orient itself to.
A clear signal
The lips and tongue are among the most sensitive regions of the body. The FaceFormer gives them a precise stimulus pattern that is always the same, from which the nervous system can learn.
Accuracy over quantity
An inaccurate exercise is not a weaker version of the correct exercise; it trains a different pattern. That is why every clean repetition counts for more than many quick ones.
In everyday life
Day and night
During the day you train consciously, three times a day for a few minutes. After a few weeks you also wear the FaceFormer ZERO at night, without practising. During sleep, old patterns such as mouth breathing assert themselves most easily, and that is exactly where the FaceFormer supports lip closure and nasal breathing.
The aim is for the correct pattern to run without attention, to outlast the training and to carry over into everyday life. The best test of this is the night.
Tests
How you can tell something is changing
A pattern counts as newly learned when it meets three conditions:
It runs without attention
Your mouth stays closed at night without anything holding it. Your tongue rests against the palate while you are thinking about something else.
It outlasts the training
Something that only exists during the practice phase is a training effect. A newly learned pattern stays.
It carries over
The many hundreds of swallows in a day follow the new pattern, not just the one swallow in the exercise.
Limits are part of it. If a space is anatomically too narrow, a better pattern improves the conditions but does not create room. Worn tooth substance or damaged joint surfaces do not regress; what can be changed is the load. And training that has to take place daily stands or falls with regularity.
Research
What studies show
In a randomised study at the University Medical Centre Hamburg-Eppendorf, 45 children and adolescents trained for six months, 26 of them with the FaceFormer and 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.
Lip strength increased in both groups, faster with the FaceFormer. No difference was found in pronunciation. The study 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, 30 re-examined after six months (17 with, 13 without device).
The exercises
All modules with 3D animation
Explained step by step, with a training plan and help if something is still difficult.
Questions
Frequently asked
Do I need a lot of strength for the training?
No. Strength plays no role; it is about the pattern: lips, tongue, swallowing and breathing working together in the right sequence. Start with a few repetitions and focus on accuracy.
Then why should I press the lip wedge firmly?
Pressing is not strength training. It gives the nervous system a clear signal that is always the same, which tongue elevation, soft palate, nasal passage and head balance follow along with. Effortless lip closure in everyday life is the result.
Does the training replace my current treatment?
No. FaceFormer therapy can be combined with many treatments, for example with braces or speech therapy. Please do not stop therapies prescribed by a doctor on your own; instead, discuss the process with your practice.
How long does it take?
This varies a great deal and depends on how long a pattern has already existed. The basic training is designed to last several months. Your practitioner will support you along the way.
Who is the training for?
For children and adults. For young children, the practice decides from what age and in what form training takes place. Children up to the age of ten train with the softer FaceFormer ZERO.
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
- Herget A, Ohlendorf D, Kopp S (2012): Auswirkungen der Face-Former-Therapie auf die Oberkörperstatik. Manuelle Medizin 50:204–210. DOI
- Jean A (2001): Brain stem control of swallowing: neuronal network and cellular mechanisms. Physiological Reviews 81(2):929–969. DOI
- Endo C, Sato T, Yajima T, Igarashi K, Ichikawa H (2018): Innervation of the human incisive papilla. Cells Tissues Organs 205(2). DOI
- Van den Steen L, Vanderwegen J, Guns C et al. (2019): Tongue-strengthening exercises in healthy older adults. PubMed
- Berndsen K (in preparation): Trust the Triad. Chapters Triadic pattern regulation, Direct regulation and emergent correction, Form and stimulus architecture.
- Berndsen K, Berndsen S (2023): FaceFormer-Therapie. Neurophysiologische Kausaltherapie bei CCDS. In: Langenhan J, Kopp S (eds.): Zahnärztliche Schlafmedizin. Thieme, pp. 285–302.
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 functioning of the basic functions of breathing, swallowing and head balance, with mouth closure and 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.
