I have been recently trained to offer a new modality of treatment called orofacial myofunctional therapy (OMT). “Orofacial Myofunctional Therapy is a neuro-muscular education or re-education of the oral facial muscles through a series of exercises, to assist in the development or develop the proper function of the mouth and face. It is a behavioral modification to eliminate dysfunctional habits.
It works with the muscles of the lips, tongue, cheeks, and face and their proper functions such as breathing, sucking, chewing, swallowing, and speech as well as the rest position of the tongue and cheeks.
Orofacial Myofunctional Therapy is about recognizing and treating functional disorders and habits. It helps to eliminate bad habits, which cause dysfunction like mouth breathing, low tongue rest position, improper chewing, swallowing, and breathing. It is based on scientific principles and can be very successful in:
- Improve lip seal
- Eliminating oral habits – e.g. binkies, nail-biting, thumb sucking, lip sucking, or licking
- Improve the tone and potions of the tongue
- Promote proper swallowing and chewing
- Stop Mouth breathing and Improve Nasal breathing
Goals of Myofunctional therapy:
The Four Main Goals of Myofunctional Therapy, and the corresponding Dysfunctions to identify
- Mouth breathing
- Tongue thrust swallowing
- Low tongue posture
- Open mouth posture ( lips apart)
Myo functional therapy can correct dysfunctional habits which may be linked to mouth breathing, grinding, clenching, tongue thrust swallowing, by teaching:
- correct lip seal
(open lip posture can lead to mouth breathing)
- Correct tongue rest position,
(Improper position can lead to orthodontic relapse, malocclusion, psychological, decay, periodontal disease, forward head posture, high narrow palate, TMD issues, and more.
- Establish nasal breathing and eliminate dysfunctional mouth breathing:
(Proper airway can lead to Obstructive sleep apnea,)
Mouth breathing leads to head forward posture, which leads to reduced Nitric Oxide levels in the blood, lower CO2 levels, reduced immunity, pain, and poor sleep;
There are very few offices that offer this service and patients
In the near future, more patients will desperately want to stop snoring and avoid CPAP machines
Treatment with Myofunctional Therapy has several stages:
- Habit Elimination (30 days)
- Intensive phase (eight weeks)
- Exercises for tongue release or General Maintenance (every two weeks for four months)
- General Maintenance (monthly appointments until year complete)
- Follow-up depending on goals, age, compliance, and consistency
Dysfunction needs to be recognized at home or in the dental chair, I believe that will be considered standard of care in the future.
Most orthodontic therapy can benefit from co-treatment with a myofunctional therapist. Fewer kids may need meds for ADHD in the future with OMT Treatments
Be aware. Know what to look for? Know what to ask
Look for the position of the tongue, lips, and teeth.
For example, every patient with an open bite has a tongue thrust, but not every patient with a tongue thrust has an open bite. (Proffit and Fields, 1986)
Chewing Function and Dysfunction
Chewing serves many purposes besides breaking food down. Appropriate chewing improves digestion, aids in facial bone growth, tooth alignment, provides a safety mechanism for accidental choking, and pressurizes the outer and middle ear.
Surprisingly, chewing can increase alertness and cognitive function.
Ideally, you should alternate chewing from side to side with the back teeth ( your molars), it is normal to have some unilateral chewing preference. Chewing 30-40 times per bite and well as different food types and textures can enhance function.
Soft diets can have negative impacts on bone growth, facial development, eustachian tube function, and increases sympathetic nervous system activity.
Swallowing Function and Dysfunction
Swallowing can be broken down into four stages:
- Picking what food to eat, saliva stimulation chewing and forming food into a bolus( a ball of chewed food)
- Controlling the bolus and transporting it to the back of the mouth before swallowing
- Initiating the swallow reflex (ideally 1 second)
- Pushing the tongue to the roof of the mouth swallowing the food enters the esophagus
You swallow 500-1000 times per day. With or without food.
Ideally, the tongue kept on the roof of the mouth and pushed up with minimal or light contact on the front teeth. There should little to no facial or neck muscle activity. The inability to maintain this tongue posture or pushing forward on the teeth when swallowing causes a tongue thrust and an open bite. (Where the teeth do not come together and the tongue pushes through the teeth when you swallow.
Assessing Orofacial Myofunctional Disorders
What to look for
- Open mouth swallow
- Lips apart
- Food falls out of the mouth
- Forward head position
- The bottom lip sticks out
- Lips pucker
- Dry Mouth
- Chapped lips
- Loud swallowing
- Presence of food residue in mouth after swallowing
- Sleep disturbances
- Scalloped tongue
- High narrow palate
- Allergies or congestion
- Poor sleep quality, fatigue, concentration
- Restless leg syndrome
- Daytime sleepiness
- Frequent awakenings to go to the bathroom
- Dark circles under the eyes
The signs and symptoms of children are:
- Mouth open when sleeping
- Can not stick tongue out
- Chin tucked back
- Difficulty falling asleep at bedtime
- Frequent awakening or bedwetting
- Mouth breathing
- Loud snoring
- Excessive movement during sleep
- Difficulty waking in the morning
- Falling asleep during the day
The best time to start myofunctional therapy is in children that earlier that we can catch a problem, while the muscles and bone are developing, the easier it is for the muscles to resolve the problem.
Lip seal, Tongue posture, and nasal breathing are the big three to a healthy mouth and a life.
Orofacial myofunctional disorders have wide-ranging negative effects on overall health, including posture, sleep, chewing, breathing, and swallowing.
Examples of Orofacial Myofunctional Disorders include one or a combination of the following:
- Thumb and finger sucking habits
- A routine habit of resting with the lips apart
- A forward resting posture of the tongue between or against the teeth
- Tongue Thrust
- Other harmful oral habits
Orofacial Myofunctional Disorders are often related to, or can contribute to a variety of medical and dental disorders. These disorders can include:
- Malocclusion (improper alignment of the teeth)
- Periodontal disorders
- Orthodontic relapse
- Changes associated with abnormal jaw growth and position
If you or a loved one have any of the above and you would like more information I offer
a free 15-minute consultation click the link below to schedule a time to chat.