Just as it is important for the patients to understand and comply with treatment, it is important to manage parent expectations. This all starts from the first consult. You must make parents understand what your aim is with treatment as too often they’ll just be focused on the teeth.

  • The following points are important to consider in parent management:

Reiterate treatment goals

Be sure to remind them that you are addressing FUNCTION and that your measure of success involves seeing the patient improve their function over time. Dental alignment is also involved however only for the purposes of creating more room for the tongue.

  • Every appointment, you must remind the patient and the parent what you are trying to achieve and how you are undertaking this task
  • Reiterate compliance-based therapy
    This may be the most important thing to convey to a parent, this is a compliance-based therapy which means you will get out what you put in. The onus is on the child to change their habits. Picture this just as physiotherapist cannot make you perform your muscle rehabilitation exercises but can only instruct you. Or a physician cannot make you
    lose weight, only instruct you on how to undertake this task. This point must be repeated to the patient and parent every single appointment.
  • Compliance must be asked about, and the patient and parent must be reminded that any deviations from required compliance will result in a less than ideal outcome.
  • Don’t antagonise parents’ questions
    When parents show concern or ask questions regarding the treatment, do not ridicule them or act with hostility. It is of utmost importance that you listen to the patient/parent and acknowledge their concerns. If Myobrace is a new concept to many dentists, imagine what the parents must be feeling. Show tact and respect. This is a treatment methodology
    that involves a lot of patient education. You may have to repeat certain points multiple times. It is very similar to dietetics or physiotherapy whereby the practitioner uses their knowledge to prescribe certain actions and the patients comply if they want to achieve the desired result.
  • Show tact when talking about their children and also to the child
    • It is important to keep in mind that parents are very protective of their children and you must be very sensitive when speaking about the patient’s issues. Some parents do not like people saying their child’s face hasn’t developed correctly, so be very careful in your choice of words. If you want to say that the patient has a backwardly placed face, try using phrases like ‘deficient maxilla’ or ‘deficient mandible’.

Keeping parents on your side is very important to achieving good results as they serve as the chief motivator of the child when you aren’t there.
No other option to change patient’s habits Although this treatment does require a lot of cooperation from families, you must re-iterate that as yet, no other
method exists to change and correct poor muscle habits in children that doesn’t require compliance. Be sure to remind them that the amount of work they must put in is usually offset by the implications it has for craniofacial development, airways and overall patient health. It is, therefore, a struggle worth undertaking. A good parallel can be drawn between obesity and diet and exercise. Diet and exercise are the gold standard for weight loss and to return the body’s metabolism to its regular state. It also provides long term health and wellbeing for the patient. It is difficult but a worthwhile endeavour. Should this fail, there are other options like gastric sleeve surgery or pharmaceuticals, but both have significant risks and side effects.

Grinding or chewing of the appliance
Patients may from time to time chew through their appliances, especially the stage 1 appliances. As per instructions on the Myobrace® box, the patient should strictly be instructed not to chew on the appliance. If this reason has been ruled out, the next focus should be whether the patient is grinding in their sleep. We recommend this be independently assessed and appropriate measures taken to abate the grinding. Grinding can be a sign of sleep disordered breathing, so ask yourself whether the patient needs to see the ENT in order to assess for obstruction or whether the patient should undertake a Myosa® program.