The Myofunctional Rehabilitation of Atypical Swallowing in Children and Adolescents With Stress‐Related Detrimental Habits: Single‐Center Longitudinal Study in Ukraine

OBJECTIVES: War-related stress may exacerbate parafunctional oral/postural habits and hinder the normalization of swallowing in children. Evidence for low-burden myofunctional protocols remains limited, particularly in juveniles living in high-stressor settings. This study described short-term trajectories of swallowing rehabilitation status in Ukrainian orthodontic patients treated with a standardized FroggyMouth-based program during the wartime period. MATERIAL AND METHODS: This study used a single-center longitudinal observational design (March 2022-June 2024) with consecutive enrollment. In total, 120 orthodontic patients aged 6-17 years with atypical swallowing and oral/postural habits were prescribed FroggyMouth (15 min/day during a quiet activity). Reassessment was performed at ~5 (T1) and ~10 weeks (T2). Rehabilitation status (RS) was classified as RS0 (baseline), RS1 (engrammation), and RS2 (automation). Paired change in the three-level RS distribution between T1 and T2 was assessed. Habit profiles and anxiety were recorded (age-stratified STAI-C/STAI-Y) and summarized descriptively. RESULTS: Oral/postural habits were frequently observed: resting the head on the hand in 80% of patients; sleeping on the hand in 36.7%; watching TV with the mouth open in 25.0%; and mouth breathing in 41.7%. Non-nutritive sucking behaviors were uncommon. Anxiety varied across groups (means ~43-44 at ages 6-11 vs. ~50-55 at ages 12-17). RS distribution shifted toward later stages from T1 to T2 (RS0/RS1/RS2: 54.2%/25.8%/20.0% at T1 vs. 14.2%/22.5%/63.3% at T2). Age groups differed in the magnitude of within-subject RS change (p < 0.001), while RS2 proportions at T2 were broadly similar. CONCLUSIONS: In this uncontrolled clinic-based cohort, a standardized FroggyMouth-based program demonstrated a short-term shift toward RS2 between 5 and 10 weeks, reaching 63.3% (95% CI 54.1-71.9) overall at 10 weeks. These observational data quantify short-term change; longer follow-up and comparative designs are needed to establish persistence and relative effectiveness.