Comprehensive management of mouth breathing and ankyloglossia in a child with malocclusion and persistent snoring

Abstract

Persistent mouth breathing, associated with ankyloglossia and myofunctional disorders, can alter craniofacial development and oral functionality from an early age. We present the case of a 4-year-old male patient with anterior and lateral crossbite, nocturnal snoring, and oral breathing. An interdisciplinary evaluation confirmed adenoid and tonsillar hypertrophy, functional ankyloglossia, lingual hypotonia, and atypical swallowing. The treatment plan included adenotonsillectomy, laser diode sublingual frenectomy, and the use of occlusal pads on the primary molars as functional stimuli, in addition to myofunctional exercises and active family involvement. After four months, progressive bite closure was observed, along with improved orofacial tone, proper tongue posture, and reestablishment of nasal breathing. Family adherence played a key role in the success of the treatment. This case highlights the importance of early interdisciplinary intervention to reverse oral structural and functional alterations, achieving significant clinical and functional outcomes in a short period.