Helping with short philtrum on young adult

Helping with short philtrum on young adult

Q:

Hi, I hope you can help clarify a few things for me.  I have an 18 yr old who has a short philtrum (12mm). Her upper lip sits on her bottom teeth and lips remain open all the time, even while eating most of the time. She is not able to do the Balloon Lip exercise very well. Is that exercise supposed to be done by isolating the air to the upper lip or is it alright for the air to be filling the cheeks simultaneously? 

Given the shape of this pt’s mouth and dentition (unilateral crossbite and overjet), is she someone who we would want to be seen by an ENT still to rule our airway constriction or no? 

A:

This is difficult for me to visualize because a “short” upper lip usually can’t even cover the upper teeth so how is it sitting all the way on her bottom teeth?  A photo or video would help me to answer this.  You noted that her lips remain open all the time, and that would make sense with lip incompetency. Depending upon the difficulty she is experiencing in closing her lips, the Balloon Lip exercise can be compromised since it requires a tight lip seal.  It is not as effective who the cheeks are filled as well since that exercise is meant to isolate the area under the upper lip. You can, however, start out with filled cheeks and work your way to a better execution of the exercise using small steps. .

You asked if she should be seen by an ENT to rule out airway constriction.  If you see symptoms of any airway issue, it is certainly a good idea to get her cleared by an ENT.

My best,

Sandra