U Concept

U Concept

What is the U Concept Bio Trainers?

They are silicone-based devices, that can effectively support the harmonious facial development, and adequate muscle function.

The Trainer is a functional educational device, designed to influence the development of jawbones through the dynamic balance of the muscle functions around the mouth, the resting position of the tongue and the exertion of force during function, as well as promoting the preferred nasal breathing. It can be used as a standalone therapy, or complementary method for children from ages of 3 or 4 years, facilitating the development of correct muscle and respiratory functions during growth. It helps to relieve existing excessive muscle tensions both in children, and adults, promotes the strengthening of weak muscles, and aids correcting established bad habits, such as: mouth breathing, tongue thrust swallowing, swallowing with pursed lips, low tongue position, mispositioning of the lower lip behind the upper front teeth, weak lip muscles, certain speech impediments etc.

It is not only extremely beneficial for its functions, but its great positive feature is that, thanks to its soft medical silicon material, wearing it is completely painless and comfortable, allowing even children to quickly adjust to wearing it.

Its rapid adaptability is also a decisive factor during the therapy process, there is no need for invasive intervention, or impression taking. After a brief evaluation of the criteria, we can instantly provide the patient with an appliance from our stock. Following a detailed assessment of conditions, young patients can receive the device that can help them, right from the first consultation.

Parts of the device

The devices feature specially designed elements that positively influence the development of soft tissue and muscles:

• assisting in guiding the tongue to the correct position
• training the labial muscles
• Promoting the correct placement of permanent teeth during the dental transition.
  
• Adaptable buccal shield: Positioned in front of the dental arches, it extends over the teeth and keeps the buccal tissues away from the dental arch, thus minimizing external compressive forces acting on the arch. Furthermore, by gently stretching the periosteum, it encourages additional bone growth on the buccal side of the alveolus, leading to an increase in the size of the dental arches. The buccal shield can be modified as necessary.
• Intermolar region, and molar guide: This is the thickened intermolar bite plane with a triangular slope. The molar guide fits into the grooves of the molars, aiding in the proper positioning of the emerging premolars and molars. The anterior design, together with the reinforced molar section, ensures that the lower jaw is in edge bite, while also lifting out and moving the condyle downward, thereby promoting the growth of the lower jawbone (with the exception of Class III devices). The appliances should extend at least halfway to the last tooth. If they are too long, they can be easily adjusted with scissors.
• Tongue guide: The design of the appliance on the tongue side assists guiding the tongue to the correct position. When the tongue rests on the palate, it provides support to the alveolar arch of the maxilla from within, thereby preventing the frequent stenosis of the upper dental arch or aiding in the resolution of existing stenosis.
• Tongue reminder: Assists in teaching and maintaining the proper position of the tongue.
• Lip bumper: This section of the buccal shield is located in front of the lower anterior teeth and is designed to alleviate excessive tension from the lower lip. By reducing the pressure exerted by the lower lip, it helps to prevent the onset or exacerbation of crowding in the lower front teeth. This feature is particularly beneficial in cases where the lower lip becomes trapped behind the upper front teeth (Class II/I).
• Breathing holes: The small openings at the front of the appliance help to decrease the vacuum formed during swallowing, making the adaptation phase easier.

General characteristics of the devices

The devices are made of sterilizable, biocompatible, odourless silicone with Shore hardness of 30 and 50. Due to their softness, the Shore 30 appliances are very comfortable to wear, which facilitates the adjustment period. However, because of their soft properties, they are more susceptible to damage from improper use, such as chewing, compared to the Shore 50 devices. According to the recommended protocol, treatment should begin with the Shore 30 appliances, and if necessary (due to frequent damage from chewing), the treatment can be switched to a Shore 50 device.

Speech therapy with trainers

Since we meet 3- and 5-year-old children during mandatory speech therapy screenings in early childhood, we can already observe changes and issues in these age groups for which treatment supplemented with the U Concept Trainer may be an option.

While weekly speech therapy may not be recommended in every case, but in many cases, treatment with the trainer can prevent future problems, assist in overcoming bad habits, and help harmonious development.

Trainers can be beneficial in the following areas related to speech therapy:

• overcoming harmful myofunctional habits (pacifier use, lip and tongue sucking, constant chewing on items like pencil, nail, textile)
• resolving issues regarding breathing (mouth breathing)
• correcting early signs of dental anomalies
• supporting the training of weak labial, and tongue muscles
• during the treatment of complex tongue thrusting, and pursed lip swallowing
• during the therapy of disordered articulation
• in the treatment of temporomandibular joint disorders (CMD-Craniomandibular disfunction therapy)

Speech therapy supported by myofunctional trainers

Examination

During exams, it is essential to consistently pay attention to the condition and function of the organs of speech. In the context of these exams, we observe and note the following:

• the breathing
• the muscle function
• the nose
• the lips
• the teeth
• the dental arches
• the tongue
• the jaws
• the palate
• the swallowing
• the vocalization
• the articulation

If we have access to documentation from previous doctor visits (diagnoses, discharge summaries, treatments, and examination reports), we can plan the therapy accordingly.

As speech therapists, we are often the first to meet young patients during early childhood. In this role, we can play a key part in referring our young "patients" to qualified specialists—such as otolaryngologists, oral surgeons, dentists, or orthodontists—when we observe anatomical changes that require further intervention.

If we choose to pursue trainer treatment within our scope of practice, we will select the appropriate device and may recommend further medical consultation if necessary.

Device selection

Based on the anamnesis, examination, and our observations, we can select the appropriate device with the help of the Trainer Selection Chart then try it in the patient’s mouth. The devices are organized in a selection table, by age, and Angle class.

The selection is based on the diagnosed deviation and the child's age, while also considering the patient's actual "mouth size" and dental status. Try the selected device in the patient’s mouth! If necessary, choose a smaller or larger trainer. If the device is the right size, but certain elements are irritating to the oral mucosa or gums, we must make adjustments immediately. A removable device that is painful to wear will not be worn by the patient, which could lead to significant motivation and confidence loss.

Always try in the appliance, and teach the child the correct positioning, and use. Based on our experience, most children will attempt to do it themselves or with the help of their parents at the first time.

During the trial let’s observe how the child reacts to the wearing of the device: breathes appropriately, lips are closed, is able to maintain correct tongue position, how long they can keep the device in the mouth, is it comfortable to wear (if necessary, we can adapt the appliance, but in most cases a properly selected device fits well).

Handing over the device

If the parents agree to the proposed therapy, and wish to utilize this effective device to support their child’s development, we should select the appropriate appliance. Allow the child to choose the colour. This will make the device more likable to them. It is practical to have multiple colours of each type of device on stock, but our fast shipping, ensures that ordered appliances can be delivered swiftly.

Choice of colours:

Before handing over the device and starting treatment, it is essential to assess how well the child breathes through the nose. This can be assisted by the Nasometer, developed by Dr. C. F. Gugino, which serves as an aid for evaluating nasal breathing and documenting progress through functional treatment and exercises.

If the patient is unable to breathe correctly through the nose due to any ENT related reason (year-round allergies, enlarged nasal and pharyngeal tonsils, severe nasal septum deviation, collapsing nasal passages during inhalation), this problem must be treated first. In such cases, it is also recommended to involve other allied professions (ENT specialists, allergists, dietitians, physiotherapists, therapeutic massage therapists, etc.).

When handing over the device, always emphasize the importance of clean nasal passages. It is crucial for the patient to be able to breathe through their nose. If necessary, encourage them to blow their nose until the nasal passages are clean and unobstructed.

Another important prerequisite is that the child must be able to place their tongue on the roof of the mouth. Tongue mobility should be checked in every patient. Limited tongue movement due to a short lingual frenulum should always be addressed, and surgical or laser release of the lingual frenulum should always be combined with exercises to promote tongue mobility.

After selecting the device, try it in the mouth, check it and adapt it if necessary. Show both the child and the parent the correct direction of insertion of the trainer and encourage them practice this together.

It is important that the device does not press or hurt the child's mouth anywhere. Inform the parents and child that if they have any problems while wearing the device, they should report them immediately and not wait until the next check-up, thus avoiding wasted months and possible loss of motivation. After placing the device in the mouth, ask the patient to close their lips. Explain the significance of this to the parent. At the same time, warn them that this device is FORBIDDEN to chew on and is FORBIDDEN to talk while wearing. Let the parent's attention be drawn to the jaw movements that will allow them to identify if their child is chewing the device.

Teach the patient to swallow while wearing the device as soon as there is enough saliva in the mouth (sometimes the mouth is dry for minutes). When swallowing correctly, only the area under the tongue should move. Indicate that hypersalivation occurs in the first days of wearing the device, this presents a good opportunity for the child to practice the correct swallowing technique (under supervision).

If necessary, we can provide additional functional educational exercises to the trainer, which should be used with or without the trainer in the mouth (breathing and swallowing exercises, exercises aimed at strengthening the perioral muscles, exercises to help stretch the sulcus mentolabialis area). Do not assign more than two sets of exercises at a time, practice the correct execution of the task before releasing the child.

The key to success lies in the use. The appliance can only reach its full potential when worn regularly, therefore it is crucially important to always connect the handing over of the device with a positive experience. Additionally, it is important that the treatment has to be acceptable for both the child and the parent, as regular wearing can only be achieved when both parties are on board.

To strengthen the child's motivation, we can utilize familiar pedagogical methods and reinforcement techniques, such as offering a sticker, writing their name or their sign on a box, or providing a drawing.

Instruction for use, informing the parents:

In the original packaging of the trainers a detailed instruction for use is included, which we always hand over to the parents. We also discuss any questions that may arise such as cleaning the trainer, recommended wearing times, suitable situations for use, actions to take in case of unexpected issues, control, and exchange opportunities. Clearly inform the parents and children not to chew, or speak, while wearing the device.

1. The correct use of the trainer:
   • Preparations:
     • clean/ blow the nose
     • wash hands
     • brush the teeth
     • have a clean trainer
   • Correct insertion of the trainer
     It is crucial to always insert the trainer into the mouth in the correct direction.
   • While using the trainer pay attention to:
     • keep the lips closed
     • place the tongue on the palate
     • gently close the teeth
   • Duration of use of the trainer:
     • Daytime: 3-5x15 minutes
     • Nighttime: continuously throughout the night
       (It is okay if in the first adjustment phase the trainer can’t be kept in the mouth throughout the whole night)
     • Wearing it only at night is not enough!
   • What is forbidden with the trainer in the mouth:
     It is prohibited to speak, jump, run around with the device in the mouth, as both the appliance and the child may be at risk of injury.
2. Keeping the trainer clean
   • To maintain the good condition of the device, it should be rinsed under running water after each use to remove any saliva residues. It is recommended to keep the plastic container of the device open until it completely dries.
   • Once a day clean the appliance with a toothbrush and toothpaste.
   • Once a week disinfection by boiling the trainer for 2-3- minutes.
3. Ideas for daytime use
   Here are a few activities, during which you can wear the device undisturbed throughout the day:
   • drawing
   • reading
   • studying
   • watching TV
   • playtime, while playing on computer

Controll

During speech therapy sessions, we can carry out a check concurrently: whether the child can place the appliance in the mouth on their own, is there visible use, are there any changes on the trainer, experiences.

For this purpose, it is advisable to maintain a record sheet in the form of a one-page document that can be inserted into a speech therapy exercise booklet. This allows everyone to track the trainer treatment: duration and frequency of wearing, and any difficulties/problems encountered. Additionally, we can list the steps for successful application here, such as achieving several hours or even overnight use.

If the patient's growth requires it, switch to the next size or design of device.

Cooperative treatment

Trainer supported therapy in the domestic healthcare system

Speech therapists come into contact with children from a very young age, families are often referred to us by paediatricians and public health nurses. This allows us to introduce and assist families with innovative prevention strategies, and if necessary, to improve therapeutic effectiveness by recommending therapeutic options from other specialists.

It is well-established that speech therapists work in close cooperation with specialists from other fields, and are mostly performing their daily tasks in teamwork. From the point of view of the harmonious development of children, it is essential to understand the work and tools used in different fields. There are increasing opportunities to expand interdisciplinary cooperation, especially in the fields of orthodontics and functional therapies. Of course, a non-negligible advantage of this collaborative teamwork is the ability to enhance the scope of patient care from all angles.

As speech therapists, we consider it our priority to present to parents with the most effective diagnostic and therapeutic options for early intervention.

It is essential for professionals to continually monitor therapies, and to research and apply domestic and international tools and methods that ensures a personalized development process.

It is important to us that individuals interested, can find therapists who are open to innovation, work with a similar approach to ours, even through Specialist Search platforms.

It is also important to consider the perspective of the parents, who naturally prefer painless, quickly accessible therapy options, that deliver remarkable results in the development of their child.

The U concept Trainer is a device which can be effectively used in speech therapy, and can provide valuable support for collaborative work with professionals from various fields.

Typically, the following professionals and helpers can effectively collaborate to create a client journey that adheres to ethical and professional protocols:

• paediatricians
• maternal-foetal medicine specialists
• ENT specialists
• oral surgeons
• dentists
• psychologists
• teachers, special education teachers
• physiotherapists
• kinesio therapists, manual therapist professionals
• orthodontists

What collaboration opportunities are available to speech therapists?

1. Cooperation with orthodontists
   • The U Concept Bio Trainer plays a role not only in speech therapy treatment, but also in supplementing orthodontic therapies. Today, it is no longer a unique case that specialists, with the knowledge of individual therapies, can jointly or in coordination with each other are developing the most appropriate therapeutic plan in order to achieve the most effective treatment and the best final result.
   • Orthodontic treatment combined with speech therapy can lead to faster and more effective results, as correct swallowing, and speech patterns support the optimal development of the jawbones.
   • The proper tongue position, improvement of tongue-thrust swallowing, and nasal breathing can decrease the risk of relapse after orthodontic treatment, thereby ensuring a more stable and long-lasting result.
   • Speech therapy exercises can support the effective functioning of orthodontic appliances, particularly in the case of functional devices.
2. Cooperation with paediatricians
   • Early recognition and treatment of oral function problems are particularly important in children.
   • Dentists and speech therapists can collaborate to help children develop good oral habits and maintain proper oral hygiene.
3. Involving physiotherapists, and manual therapists
   • Posture and the breathing mechanism are closely related to speech development. Therefore, physiotherapists and kinesio therapists often collaborate with speech therapists when addressing issues affecting the head, face, and neck region, or difficulties related to masticatory joint function.
   • In a complex therapy approach, speech therapy can be supplemented by kinesiotherapy.
4. Consultation with ENT specialists
   • In some instances, further specialist examinations may be necessary, such as in cases involving tonsil issues, lingual frenulum deviations, airway obstructions or difficulties with nasal breathing.
   • An appropriate specialist diagnosis can assist to achieve a more effective speech therapy.

The benefits of interdisciplinary approach for professionals:

• Broadening of horizon: Professionals from diverse backgrounds can introduce new perspectives into therapy.
• More effective treatment results: The complex approach can increase the success rate of treatments.
• Long-term professional relationships: Collaboration allows speech therapists to expand their professional network.
• Utilization of innovative devices: U Concept Trainers can help to increase the efficacy of speech therapy.

Patient benefits

• Faster, more effective development: Therapy supported by multiple professionals, can be more efficient.
• Broad treatment of health issues: It can have a positive impact not only on speech development, but on general oral function and posture as well.
• Better quality of life: Complex therapy approach can positively influence the patients’ quality of life, and confidence.

For speech therapists, the U Concept Trainer is an excellent tool that can not only assist their own therapeutic work, but also create an opportunity for interdisciplinary collaboration with other professionals. This cooperative approach benefits both professionals and patients and can contribute to even more effective treatment results. Therefore, it is worth opening up to cooperation and taking advantage of the opportunities presented by innovative tools!

Motivation

It is crucial to motivate both the parents and the child, to use the device appropriately, especially in the first weeks.

It is important to assess the motivation of both the child and the parents highlighting their roles and responsibilities in ensuring effective treatment. The parent's involvement is of paramount importance during the adaptation period. Continuous adaptation is essential for the successful use of the trainer. Until the child can correctly hold the device in their mouth for at least 1.5 hours during the day (keeping lips closed, breathing through the nose, avoiding chewing on or speaking with the device in their mouth, tongue positioned on the roof of the mouth, swallowing correctly), in many cases it cannot be expected that the device will remain in place throughout the entire sleep period.

Therefore, the active, supportive presence of the parent in the first 2–4 weeks is vital.

At the beginning of treatment, it is beneficial to provide the parents with a printed copy of the informational materials about the appliance, along with a small calendar, to track the time spent wearing the appliance during the adjustment period. Once continuous nighttime wearing is achieved, daytime use can be reduced to 2–3 times 15 minutes during the teething phase. Outside the teething period, it is sufficient for the child to wear the appliance only during sleep. If continuous nighttime wear cannot be achieved, daytime usage should be increased, and factors that may prevent the patient from wearing the appliance should be investigated. The most common reasons are insufficient daytime wearing and lack of motivation.

The child is responsible for their own health. While parents, the environment, the doctor and the "trainer" are all behind them to support them, it is essential for the child to understand that primarily they must take the initiative to have better looking teeth. They must focus on wearing the device for the recommended duration, maintaining proper posture, wearing of the device correctly, and completing the exercises.

In conjunction with speech therapy treatments, we provide weekly or biweekly check-ups, to assess the proper use of the device and offer guidance based on observations from parents and children. We aim to support regular wearing with an ideal reward system for the child, emphasizing their improvement of condition.

Join us!

Further information about the U Concept Bio Trainers, lectures, webinars, are available for speech therapists, therapists, and healthcare professionals. If you’d like to broaden your therapeutic toolbox, and making therapy more effective, try the Bio Trainer!

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