Design characteristics of the K0

  1. 1. Active tongue tag to exercise the tongue muscles.

  2. 2. Tongue elevator raises tongue to correct position.
  3. 3. Mouth breathing aperture with MYOVOSA®.

  4. 4. Lip bumpers retrain the lip muscles to stop jaw being pushed back into the airway.
  5. 5. Thicker base over the back teeth to open the airway.

How the K0 works

MRC has developed the Myobrace® system to correct mouth breathing and myofunctional habits, which in turn promotes correct jaw growth and naturally aligns teeth. The system has always included evaluation of breathing as a priority and the first treatment goal for the last
30 years.
 
With the increased awareness of the prevalence of sleep-related breathing disorders (SRBD) in children, the World Dental Federation (FDI), the American Dental Association (ADA) and American Association of Orthodontists (AAO) have recommended screening all children for SRBD by Dentists and Orthodontists. This can be achieved by using the Myofunctional Orthodontic Evaluation (MOE) from MRC.
 
Children who have more severe breathing and sleep-related symptoms may have a restriction of their airway or, more commonly, an easily collapsible airway. Therefore, they need to be treated differently from a regular Myobrace® patient. 
 

Once the specific signs and symptoms have been identified, the priority is then to establish better airway function by opening the airway day and night, which has the subsequent effect of transitioning the child from mouth to nose breathing.
 
The first priority is to establish a better functioning airway so the child can breathe without restriction. The Myobrace® K0 is recommended as the first appliance to be used prior to starting on the rest of the program as the treatment priority is to establish a functional airway for the patient with dysfunctional breathing and sleep symptoms.
 
Myobrace® K0 establishes functional airways through the mouth and nose while allowing transition to nasal breathing. The K0 is available in Clear and Blue.
 
 

SCREENING AND EVALUATION FOR PAEDIATRIC BREATHING AND SLEEP DISORDERS

Parents may bring their child to the Dentist or Orthodontist with the intention of only having their orthodontic problem/s evaluated. However, the World Dental Federation (FDI), the American Dental Association (ADA) and American Association of Orthodontists (AAO) all now have a directive to:
 
•  Universities and national dental associations to provide students and dentists with basic knowledge regarding the important role of dentistry in preventing and treating SRBD, in particular early detection in children and prevention of late onset forms. This can include immediate management as well; World Dental Federation.
 
•  All dental and medical health forms to include questions about the patient’s sleep quality and related data to do the screening of SRBDs.
 
• Dentists to provide proper information to patients to understand the process of screening, treatment options and the role of the care providers involved; World Dental Federation
 
•  Dentists are encouraged to screen patients for SRBD as part of a comprehensive medical and dental history to recognize symptoms; American Dental Association.
 
• In children, screening through history and clinical examination may identify signs and symptoms of deficient growth and development, or other risk factors that may lead to airway issues. If risk for SRBD is determined, intervention through medical/dental referral or evidenced based treatment may be appropriate to help treat the SRBD and/or develop an optimal physiologic airway and breathing pattern; American Dental Association (https://www.ada.org/~/media/ADA/Member%20Cente/FIles/Role_of_Dentistry_in_the_Treatment_of_Sleep_1-5.pdf).
 
•  It is strongly recommended that orthodontists screen patients with regard to the signs and symptoms of OSA. A thorough history and clinical examination are critically important in that they establish the presence of pre-existing conditions, a basis for diagnosis, the need for referral, and a baseline for evaluating the effects of treatment.  American Association of Orthodontists (https://www1.aaoinfo.org/wp-content/uploads/2019/03/sleep-apnea-white-paper-amended-March-2019.pdf).
 
The K0 has a unique feature which allows mouth breathing and aids in the transition to nose breathing during the day and then at night. It also improves the airway during sleep while still allowing mouth breathing, which is an essential feature for children with sleep disorders. Treatment success is gauged when the child can progress comfortably to the Myobrace®K1.
 
 


 

HOW TO USE THE MYOBRACE® K0

The Myobrace® K0 assists the mouth breathing child to transition to nose breathing while improving airway function and is initially used as a daytime only appliance to allow mouth breathing. However, when closing down on the front the MYOVOSA® hole, breathing is transitioned to the nose. When the child feels they need to breathe through the mouth, they simply stop biting down and the MYOVOSA® aperture opens to allow mouth breathing. Repeat this step during the 1-hour daily use for 1-2 weeks and wear during the night while sleeping. Mouth breathing will be unrestricted at night and the airway will be kept open by holding the lower jaw forward as the thicker base opens the airway. Additionally, the tongue tag encourages the tongue to rest forward out of the airway.

Tongue press: The child can practise actively pressing their tongue against the tongue tag and holding for three breaths before relaxing to improve strength and positioning of the tongue. This exercise can be also be completed with the head tilt variation to improve the muscle strength in the pharyngeal area.

 
 
When the K0 is used while sleeping, it assists to open the airway and hold the mandible forward, while still allowing mouth breathing. The allowance of mouth breathing increases appliance retention while sleeping as chronic mouth breathers are able to continue habitually breathing through their mouth while sleeping and transition to nose breathing at their own pace.
 
In addition, the new patented tongue tag is used to improve tongue strength. Treatment protocol combines the K0 with Myotalea® and Myolay® to transition over 4-6 months to the Myobrace® K1 and the continuance of the Myobrace® System.
 

 
 

Appliance use

Designed For

• Children who have positive signs of possible sleep disorders from a Myofunctional Orthodontic Evaluation (MOE).

• Obstruction of the airway as evaluated or CBCT or ENT Evaluation.

• Paces and Nasal Breathing Test (NBTen) of 20 or less.

• Grade 2-3 Tonsils.

• Parents who prefer not to have ENT referral.

• Children who cannot keep the K1 in place while they sleep at night.


Next Appliance

Myobrace® K1

Habit correction and jaw development.

See this appliance