
Cranio Facial Kinetic Science
Orofacial disorder therapy

Cranio Facial Kinetic Science
Orofacial disorder therapy

Orofacial disorder therapy
Orofacial disorder therapy
Cranio Facial Kinetic Science
Thérapie des troubles orofaciaux
Cranio Facial Kinetic Science
Thérapie des troubles orofaciaux

Cranio Facial Kinetic Science
You are a health specialist: why collaborate with a craniofacial therapist?
The craniofacial therapist can work with diagnoses from different disciplines. It increases efficiency by reducing the number of multiple examinations and the resulting cost and comfort benefits for the patient are obvious.
But why should you work with a craniofacial therapist?

The therapists trained at the Faculty of Medicine at the University of Basel come from various professional fields. These are the same professions that may be concerned by interdisciplinary care. This approach requires an effort from all parties to work together to address the patient's problem. Interdisciplinarity should not be just a theory: it should also be experienced in reality (while respecting each discipline), not only through the transmission of information, but also through meetings regarding the patient's problem.
Areas concerned

MEDICAL FIELD
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Dental medicine
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ENT
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Maxillo-facial surgery
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Medicine
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Ophthalmology
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Orthodontics
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Osteopathy
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Pain therapy
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Pediatrics
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Physiotherapy
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Traditional Chinese medicine

HUMAN SCIENCE
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Art therapy
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Clinical Pschology
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Ergotherapy
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Logopedics
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Psychology
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Other recognized care therapies: hypnosis, Reiki, hippotherapy, reflexology, etc.

PEDAGOGY
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Children's education
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Specialized education
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Teaching
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Specialized teaching
Why is the training open to people who are not exclusively from the medical field? Because it is a holistic approach to the person, which includes, in addition to the scientific aspects (anatomy, manipulation), communication skills, development (of the child) and observation.
The work on fascias, particularly the one developped by Dr. Guimberteau (Strolling under the Skin), has shown that a trauma trauma - suffered by the body - in a particular spot has repercussions on the entire body because fascias are present everywhere, surrounding muscles, organs, nerves, etc. They form chains that interact with each other and also affect an individual's emotions.
We therefore understand the importance of seeing the body as a whole and no longer as "parts".
The main lines of a craniofacial therapy are based on the following scientific knowledge:
1. kost® according to Codoni

The k-o-s-t® (Körper-Orientierung-Sprach-Therapie or functional speech therapy - website in German) is a concept developed by Dr. h.c. Susanne Codoni to treat people with speech and expression disorders or various disabilities. This therapy is at the crossroads of traditional medicine, complementary medicine and pedagogy. It is not only restricted to speech therapists. To treat the patient's functional deficiencies, this holistic vision is based on the person's own resources. Interdisciplinary cooperation provides an overview and a treatment concept based on it. This approach is based on four pillars:
The craniofacial therapist begins by observing the posture and stabilizing it with the stimulation of the k-o-s-t®. They will rely on diagnoses made by other professionals or, if they are non-‐existent or if the weaknesses or gaps are too great, they will seek the help of a physiotherapist or an osteopath. Collaboration is important here to communicate what has already been done with the patient. The point of communication also applies to the patient-therapist relationship, otherwise the stimuli will not work.
The communication pillar is very important and is based on the knowledge of
neuro-linguistic programmin (NLP).
An orthodontist or a maxillofacial surgeon may also need to stabilize the patient's posture before or after treatment, and we will see this later, to relearn good swallowing and speech.
Observation
Diagnostic
Communication
Stimulation
It happens that patients suffer from reoccurrences after their orthodontic treatment. This may be due to general body hypotonia, where the tongue stays in a basal position and causes, with each swallow, pushes against the teeth.
Learning the resting point of the tongue as well as targeted toning bodywork (e.g. k-o-s-t® related to F-A-I-T-H-Kids, by Jens Hentschel - German) allows the patient who is undergoing or followed orthodontic treatment to maintain a good dental occlusion.
image courtesy of Jen Hentschel - Alschwill / Pratteln

The consequences of an imbalance of the pelvis and jaw on the spine

8.5 The Codoni model, reproduced with the kind permission of Dr. h.c. Codoni, all rights reserved. From "Funktionorienterte Logopädie" (2019) - 8 - P.130 - Ed. Spinger
Tensions in the jaw affect the entire spine, disrupting the lordosis of the lumbar vertebrae, which can cause neck, back or knee pain due to overload of the spine and muscle compensation.
The difficulty in making a diagnosis (which the therapist never does alone, especially if they are not a doctor themselves) is in discovering the root cause of the problems. Is it a functional or structural cause, related to constitution or genetics? As everything is linked in the body, we act on the pelvis by working on the jaw and vice versa. This is why craniofacial therapy will not necessarily be the first element of the medical care. Another specialist can be called in addition, while respecting the skills of each specialization.
A good case management system must be put in place to set priorities for the patient’s care.
2. FBL - Funktion Bewegungslehre

For their observations, the craniofacial therapist uses terms that physiotherapists trained in Basel know: the FBL (Funktion Bewegungslehre) of S. Klein-Vogelbach - website in German). This approach allows the therapist to analyze the static posture and gait and to measure the differences. The craniofacial therapist is not a physiotherapist (unless they have a Master's degree in physiotherapy). They use the terms of the FBL to observe and describe the situation. Depending on the observations made, they will offer body stabilization exercises (using, for example, ball exercises or k-‐o-‐s-‐ t®, see above). But if the differences are too great, he will need the help of a physiotherapist or an osteopath, or even a doctor. This knowledge allows the therapist to understand the physiotherapist's diagnosis.
These observations can be communicated to the specialist who will be responsible for erecting the patient's posture. This is an essential prerequisite for the work of a successful craniofacial therapy.
3. Myofunctional therapy: MFT

Swallowing: verification of the contact points of the tongue on the palate using an ultraviolet lamp

Myofunctional therapy (developed in the 1960s by Daniel Garliner in Florida) treats oro‐facial dysfunctions. Through exercises, it helps the patient to position their tongue in their mouth and find or regain a good swallowing pattern. This does not only concern children. Indeed, some adults keep an atypical swallowing all their lives. The low position of the tongue in the mouth can be the source of headaches, neck pain, breathing problems, poor speech, etc. Chewing is also not optimal and causes digestive disorders.
The MFT taught in Basel is called "Basler Lällekonzept der myofunktionellen Therapie". It is a holistic vision of goal-‐oriented patient care in interdisciplinary work.
Speech therapists may also use a craniofacial therapist as a complement to their therapy. The craniofacial therapist does not work on sounds or pronunciation, but on the muscles.
The face is an essential part of our identity. It reflects our emotions, allows us to communicate, to have a social life and to have self-‐confidence. This is why a psychologist may also need interdisciplinary work. Craniofacial therapy also treats scars (keloids or hypertrophics). Not only for beauty (an important social factor) and self‐image, but also because the skin is an important sensor of our proprioception. Any scar disrupts the fascias and the perception of the body in space.
Therapy can also be useful following operations or accidents. The surgeon may call upon a craniofacial therapist following his operation.
4. The medical approach
The Master Cranio Facial Kinetic science courses also include the study of anatomy as well as the nervous system, digestive system, embryology, skull development, pathophysiology of the stomatognathic system, cranio-mandibular dysfunctions, functional orthodontics, functional optometry, etc.
This knowledge allows the craniofacial therapist to understand and explain to the patient how therapy affects the body's functions to integrate new neurological functional patterns.

Non-exhaustive examples of possible collaborations based on your profession:

Physiotherapist
Osteopath
A patient who does not have a good swallowing pattern with a tongue position under constant pressure on the hyoid bone can benefit from craniofacial therapy at the same time as physiotherapy or osteotherapy. The success of the treatment will be reinforced. The effects will affect the entire posture.

Family doctor
A person with swallowing problems, an injured patient with scars, unexplained chronic pains (migraines, insomnia, digestion problems, etc.). These pathologies can be caused by poor posture caused by the position of the tongue in the mouth or by an atypical swallowing pattern.
A lack of lip tone can also lead to difficulties in drinking and retaining food, which will isolate the person socially.

Pediatrician
Children with plagiocepahlia (with helmets), cleft palates, mouth breathing, language difficulties, hypotonia, disabilities, bad habits such as: pacifiers, sucking their thumb, biting their nails, etc.
Stimulating posture often leads to significant improvements in expression. Learning to swallow as an adult allows correct jaw development and acts preventively on dental malocclusions.
Difficulties in reading, learning or concentrating can also result from poor posture or insufficient body tone and stabilization.

Dentist
Orthodontist
Maxillofacial surgeon
Craniofacial therapy follows dental, orthodontic or surgical treatments. It deals with scars, stimulates facial muscles, relieves tension, acts on stress and restores primary orofacial functions following operations.
It also acts on bad habits (pacifiers, sucking their thumb, ...) that disrupt a good development of the jaw and tooth location and is a source of treatment failure or recurrence of disorders.

ENT
Oral breathing does not allow filtration or heating of the air through the nasal passages, which results in more frequent infections. The therapy teaches the patient to position his tongue correctly in the mouth, and through exercises, to strengthen the lips in order to keep the mouth closed and move to normal nasal breathing. This can also have an impact on snoring.

Ophthalmologist
Optometrist
Since sight is one of the main sensors of posture, with the deep short muscles of the neck being closely related to the eyes, craniofacial therapy is welcome for tense, stressed patients who have constant pressure on the cervicals. Craniofacial therapy affects the entire posture and can be a complementary aid, just as functional optometry is for successful craniofacial therapy
It is important that the patient situate themselves in space in space to facilitate their daily life. To go further: Complex interactions between eyes and neck, (available in German and French only) by D. Barell

Logopedist
Children who lack muscle tone and do not have an aligned posture can benefit from craniofacial therapy, in addition to speech therapy, as well as those with mouth breathing, poor tongue position and persistent infant swallowing.
Therapy is also effective in getting children out of the habit of having a pacifier and other bad habits that disrupt postural alignment and interfere with speech therapy.
Myofunctional therapy is not only for the elderly or children with disabilities. There are many atypical swallowings in the adult population that have not been detected and that lead to unexplained chronic pains.

Psychologist
Recognized therapies
The k-o‐s‐t® is very useful for relaxing masseters and the cranio‐mandibular joint in case of bruxism for example. Anxiety and fears bring their share of tensions in the face and neck, which then become tensions throughout the body.
Working on posture and face is very useful to develop or restore self‐confidence. A good perception of your breathing relieves tension. A patient suffering from bruxism followed by a psychologist will need muscle treatment in parallel.

Educator
Teacher
The teacher or educator are important actors and should be part of any therapeutic network. Their observations are important for therapists: what are the ergonomics in the classroom, what is the student's behaviour, their dynamics, how is their development?
This should not be forgotten, as children spend a lot of time in school or in out-of-home care.
It is important to know a child's cognitive development to know what can be expected from them in therapy.
Literature: to go further, scientific sources
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Fascias :
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Informations about fascias on Tom Myers' website : https://www.anatomytrains.com/
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GUIMBERTEAU J.Cl. et ARMONSTRONG C. (2015) - Architecture of Human Living Fascia: The Extracellular Matrix and Cells Revealed Through Endoscopy - Handspring publishing
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ARTE sur youtube : Fascinants fascias : The mysterious world under the skin
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FBL : (German)
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SPIRGI-GANTERT I. et SUPPÉ B. (20014) - FBL Klein-Vogelbach Funktional Kinetics, Die Grundlagen, 7. Auflage (D) - Springer Verlag
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SPIRGI-GANTERT I. et al (20016) - FBL Klein-Vogelbach Funktional Kinetics, Ballübungen, 6. Auflage (D) - Springer Verlag
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MFT : myofunctional therapy (readings mainly in German) :
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CODONI S. - various publications to consult here (German)
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Amazing film to watch (German): the language as you have never seen it before!
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GARLINER D. (1976) - Myofunctional Therapy - Saunders publication
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CODONI et al. (2019) - Funktionsorientierte Logopädie: Der Einfluss von Haltung und Bewegung auf Schlucken, Sprechen
und Sprache (D) - Springer Verlag
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Scientific publications (German) : PDF to read
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Presentation films of the LWZ (Lippen-Wangen-Zunge Trainer) : LWZ films (brochure available in French, request by e-mail to: www.tcfjura.ch)
Useful links :
Association of craniofacial Therapists (German) : https://www.fksc-mft.ch/Verband/
Study informations : advanced studies unibas