Orofacial regulation therapy (OFRT) was developed to improve orofacial function in patients with hypotonic oral musculature. The Castillo-Morales therapeutic concept involves multidisciplinary management of orofacial dysfunction. The dentist’s role within this team is the provision of palatal plate therapy (PPT), which aims to improve oral musculature function by stimulating the lip and tongue muscles and muscles of mastication and thereby improve hypotonia in these patients, and their overall oral function. This is paper two of a series, following critical appraisal of the current literature, regarding PPT in Down syndrome (DS) patients. Aim and objectives: To overview OFRT, including PPT, provided by the dentist, as part of the holistic multidisciplinary team, involved in improving orofacial function in DS patients and to demonstrate the effect of PPT as part of OFRT in management of orofacial dysfunction (OD), using evidence-based literature. Methodology: Sixteen articles involving the use of PPT therapy in DS patients were critically appraised and compared to obtain results on its effect on OD, as part of OFRT. Results: Improved facial expression, lip hypotonicity, tongue and mouth posture, with these positive trends remaining post-treatment. The worse the baseline values, the better the outcome. Compliance with the palatal plates decreased with age, mainly due to tooth eruption. Conclusion: Multi-centred research on OFRT, with good study methodology and design, is necessary for the future. The use of PPT in severe cases of OD is indicated, whilst management of mild to moderate OD may be better addressed using other aspects of OFRT, provided by the multidisciplinary holistic team. Parents or caregivers play a key role in OFRT, in particular assisting with compliance. PPT cannot be used alone and should be used, as required, as part of the holistic management of OD, using the OFRT concept
