Diagnostic Criteria for Subtypes of Open Mouth Posture Syndrome (OMPS): An Interdisciplinary Framework

Objectives:
Open Mouth Posture Syndrome (OMPS) is an under-recognized condition associated with altered oral posture, impaired nasal breathing, and craniofacial adaptations. While a conceptual classification of OMPS subtypes has recently been proposed, standardized diagnostic criteria are lacking. This study aims to develop and systematize diagnostic markers for OMPS subtypes to improve clinical applicability and interdisciplinary communication.

Methodology:
An interdisciplinary approach was employed, combining a structured literature review with expert-informed synthesis from orthodontics, otolaryngology, sleep medicine, and myofunctional therapy. Based on the previously defined OMPS subtypes (obstructive, habitual, anatomical, sleep-disordered breathing–related, and tongue-related), specific diagnostic domains were identified. These domains include clinical observation, functional assessment, structural evaluation, and patient-reported indicators. A preliminary diagnostic framework was then constructed, linking observable signs and measurable parameters to each subtype.

Results:
The analysis resulted in a subtype-specific diagnostic matrix that highlights both distinct and overlapping features of OMPS. Obstructive subtypes are primarily characterized by compromised nasal airflow and compensatory oral breathing patterns, whereas habitual subtypes show persistent open mouth posture without clear structural obstruction. Anatomical subtypes are associated with craniofacial morphology, including maxillary constriction and vertical growth patterns. Sleep-disordered breathing–related subtypes demonstrate correlations with nocturnal symptoms and impaired sleep quality. Tongue-related subtypes are defined by altered tongue posture and function, including reduced palatal contact and dysfunctional swallowing patterns. Across all subtypes, shared features suggest a self-reinforcing feedback mechanism.

Implications:
The proposed diagnostic framework provides a structured basis for identifying OMPS subtypes in clinical and research settings. It supports more precise phenotyping, facilitates interdisciplinary collaboration, and enables targeted therapeutic strategies. By introducing standardized diagnostic criteria, this work contributes new data toward the validation and refinement of OMPS classification and lays the groundwork for future prospective studies.

Keywords:
Open Mouth Posture Syndrome; oral posture; diagnostics; craniofacial development; interdisciplinary care