Today we are going to talk about oral myofunctional therapy! What is it? What do we do as oral myofunctional therapists?
Why would you even need an oral myofunctional therapist?
Great question! The short answer: You should not need one. If you breathe through our nose all day and all night. Myofunctional therapy is a physical therapy-type exercise for the muscles of the face and muscles of the tongue, swallowing, breathing, and everything surrounding the oral cavity. The goal is really simple, yet so many of us breathe through our mouths now, especially with wearing masks.
There are four goals of myo functional therapy.
- You have to breathe through your nose all day and all night.
- You have to have your tongue in the top of your mouth, called the roof, all day and all night.
- You have to have your lips together so your mouth closes to get a good lip seal.
- You have to swallow correctly and that includes chewing and eating and drinking liquids and swallowing saliva.
Here’s the thing, all of these exercises seem so simple in theory, they’re very very simple, and accomplishing those goals, Sounds easy… right? We all should just do this normally and naturally if you think about it. You should not need an oral myofunctional therapist if you can do this on your own.
However, what we’re trying to do through teaching these exercises is really restoring normal function in our patients, so it’s normal, natural, and healthy to breathe, just taking a patient from being a chronic mouth breather to a consistent nasal breather during the daytime and at nighttime, will dramatically improve their overall health.
- If you breathe through your nose constantly all night. You’ll be amazed at how much better you sleep and there’s a ton of reasons for why that is. Basically, the idea of this number one reason is just changing simple habits, the simple functions of our soft tissues and breathing can help with our sleep which helps our immune function, our dental health, our mental health through better sleep, and better recovery. It helps with our full-body health and wellness in so many ways.
- I was alluding to this earlier, and it is a really big statement but patients, who have sleep apnea, also have myofunctional issues, really think about that for a moment, there are so many patients with sleep apnea and sleep-disordered breathing and that includes snoring, upper airway resistance syndrome, grinding and even just mouth breathing at night, but all of those patients were kids, typically, who started off with mouth breathing and/or being tongue-tied. A Lot of these soft tissue dysfunction start as toddlers. The very interesting thing is that we are just now getting more and more research around mouth breathing and it’s the connection to what happens as an adult if it is left untreated.
What really is mind-blowing, is that the children we see with these myofunctional soft tissue and breathing issues. Over time, if these issues are not corrected the soft tissues and the breathing influence the way the hard structures grow and develop, and these kids, which means, the kids who mouth breathe and are tongue-tied are the adults that we see with compromised airways and c-pad machines.
They have compromised smaller jaw structures. They have narrower palates, they have less space for their tongue, and because of that, they’re more likely to mouth breathe and have sleep-disordered breathing. These patients are really one and the same and I think it’s so important that we include myofunctional therapy as part of the treatment that our adult patients to get optimal results in their sleep apnea treatment, and it has to be thought of in a prevention-oriented way for your child so all the kids that we see, we really have to look at the look at them through this lens of prevention and address these issues young enough so that we can literally guide growth, development and shape their jaws faces and airways through correcting the soft tissue dysfunction as they age. Not wait till they are seven or eleven and have all of their permanent teeth in.
- What I talked about a lot ..is prevention. Yes, we can prevent dental issues, airway issues, and sleep-disordered breathing in our kiddos by addressing the soft tissue and breathing dysfunctions early and guiding growth and development. And that is a really big deal.
But what about just day-to-day dental issues? I think we need to look at that as well so for our patients with myofunctional symptoms like mouth breathing, tongue tie, low tongue posture. These patients have an increased risk for gingivitis, periodontal disease, and/ or tooth decay, and they have a lot of the problems that we see with clenching and grinding and chronic pain and headaches, neck shoulder tension, especially if they are tongue-tied. I don’t mean can’t stick their tongue out I mean posterior tongue-tied and compensating that is so subtle it goes unnoticed.
So it’s very interesting to realize that if we can just address tongue ties and tongue function at the earliest age possible, release them, and then help those patients develop optimal oral functioning. This is a really big deal that I think is very unknown and most people don’t fully understand it and we’re only just now getting research connecting tongue tie and TMJ pain and clenching and grinding, but there is a big link because the patients who have tethered tongues develop compensations. Our body is amazing at compensating and we do not even realize it!
- The accessory muscles and the extrinsic muscles of the tongue, neck, and shoulders are compensating to help talk, eat and do everyday functions with their mouth. So, by prevention and by focusing on the soft tissue assumption and breathing problems with mild functional issues, We can really help prevent so many bigger issues, and it’s not just the airway issues.
It is the common dental issues that we see every day in clinical practice, that bring patients in, these habits that are simple to change lead us to refer to an oral myofunctional therapist is really taking things to the next level which is not so common.
I can definitely say that for a dental practice to be doing this, checking tongue functions, compensations, mouth breathing, referring for treatment, it really is the future, forward-thinking, cutting edge, because it’s not common, but it will be.. I can guarantee you this will be the standard of care in the next 5-10 years. Hopefully, we don’t have to wait 20 years but in the future, addressing these root causes, and prevention will be an integral part of going to the dentist.
- I am not making this stuff up or being kidnapped by aliens, everything that I talked about, everything that I do has been referenced and recognized by not only people hundreds of years ago. But in ancient cultures and civilizations, there’s a record of them talking about breathing through the nose, getting the tongue and the palate and so much more.
Two people that I want to acknowledge are George Catlin who was an adventurer and explorer, and he spent a lot of time observing and writing about indigenous populations and how they were all nasal breathers and how they had street teeth, compared to what you call those modern civilized people who were often mouth breathers. And as he noted chronically ill and chronically fatigued, were considered to be more civilized and he couldn’t understand why the more civilized populations had more illness and sickness, and he really believed that the root cause of a lot of modern problems was not breathing through your nose, so he wrote this book, shut your mouth and save your life. In the 1830”s and he was probably one of the first people, although he didn’t know it at the time to document sleep-disordered breathing and sleep apnea, so I’m just going to read a quote from his book he says that “man knows not the pleasure of sleep, he rises in the morning more fatigued than when he retired to rest takes pills and remedies for the day and renews his disease every night, he was talking about mouth breathing at night.
He has some really interesting stuff. In the early 1900s, Edward H. Angle developed his classification of malocclusion.. using the relationship between the first molars of both arches as the key factor in determining occlusions and this is something that has been lost in time, I’m just going to read this quote because I find it so fascinating. Edward Angle says we’re just beginning to realize how common are the vicious habits of the lips and tongue. His emphasis was they are in causing and maintaining malocclusion which is difficult they are to overcome, and how hopeless success in treatment, unless they were overcome the habits that cause them This was over 100 years ago, and we’re still using the angles classification for malocclusion to this very day, but we don’t understand the root causes of why he developed it, and what he was observing back over 100 years ago! None of this stuff is new information. It is just not talked about as much.
- We see these signs every day with the majority of your patients, which include dental crowding and crooked teeth, tongue-tie, narrow palates, and vertical growth because of mouth breathing. And the reason all of this is changing so much and why it’s so common, is because back in the Industrial Revolution during George Catlins times these problems were just beginning. Well now we’ve had, eight, maybe even nine generations of people with these dysfunctions who’ve been passing along the traits, and the epigenetic changes so now we’re at the point where almost 97% of the population has some degree of soft tissue dysfunction of dental crowding of all of the problems that George Catlin was observing, back in, those days.
It’s very interesting to see how this all influences our dental populations of patients today and all of the dental problems that we’re facing. There’s a great book by Dr. Sandra Kahn and Paul Ehrlich, called JAWS and it really kind of encapsulates all of these issues that I’m describing. But there is so much more to it and it’s incredible, but it’s in reality very unavoidable to work in dentistry and not have to deal with the symptoms on some level.
- We now have legitimate research in the field of myofunctional therapy, which I absolutely love so I’ve listed several studies here, these are very new, we’ve only really had credible validated legitimate research since around 2010 Dr. Christian Guilleminault, who spent the last 10 years of his life from about 2009 to 2019, researching the connection between myofunctional symptoms, mouth breathing, sleep-disordered breathing and sleep apnea, which was really his life’s mission so he is the man responsible for coining the term obstructive sleep apnea and upper airway resistance syndrome, and he is actually responsible for creating the field of Sleep Medicine. So we have new research that’s only been around in the past five-ten years at the most, and it’s very new, but now we have it.
- This leads us to point number eight, the field is now getting standardized and it’s only been since 2017 that we’ve had a standardized protocol, and a way of measuring the function of the tongue, not just the length of the frenum which we’ve had traditionally but the function of the tongues’ ability to move for speech, eating, drinking, and resting posture in the palate. So, this is very new. But the good news is, it’s just the beginning. We’re now creating more standardized ways of measuring tongue ties and myofunctional symptoms in our patients.
- Why you should be working with a myofunctional therapist and I think this is a really big one. Basically, a myofunctional therapist will help you so much. Something that I like to do as a myofunctional therapist when I work with patients are offered support, as a coach or a guide, and all things mouth-related. I want to help my patients have consistent oral care, know what to look for, and have regular dental visits. I want to help them troubleshoot and find out why they should have regular checkups with their primary care physician and I really want to be an advocate for that patient and whatever they need. I am trying to guide them to go get the help that they, really should. So really, for me, the myofunctional therapist like the quarterback for the dentist, Or a Traffic Director where I see a patient needs certain things. I might not be able to help them with everything they need, but I can definitely point them in the right direction and support them along the way.
Alright, and last but not least, when you work with a myofunctional therapist we’re able to start addressing the root causes and asking what they are experiencing and the reasons why a patient has symptoms, why are they having problems, why they keep getting cavities, why they keep breaking their teeth, why they sleep so poorly, why they wake up in the middle of the night to pee, why they have such a high risk for periodontal issues and why they are having so many health concerns? incorporating oral myofunctional therapy is just one part of being able to provide high-quality care, I think it’s such an important part and support them along their way, to feel good about the results, because you know that you’re coming from that place of trying to help them with the bigger picture. As an oral myofunctional therapist we can provide our patients with the treatments needed, that will help address the root causes and get that high-quality treatment that you deserve.
Okay, we’re almost done.
- Don’t take my word I have learned so much from the leaders in this field Sarah Hornsby, Dr. Zaghi and The Breath Institute, and Dr. Kevin Boyd. I’m a myofunctional therapist, speaker, mentor, and entrepreneur. I’m dedicated to changing the status quo in healthcare and dentistry through education and action. My own health journey has inspired me to create a community of passionate and like-minded professionals.
Sarah Hornby started myofunctional therapy training after dental hygiene school she began helping patients and learning more about her own orofacial myofunctional symptoms, which made her increasingly interested in holistic health and wellness.
She wanted to understand the root cause of not only oral myofunctional problems but poor health in general. This interest became a passion that drove me to investigate how the airway, craniofacial development, breathing, and the tongue are linked to our overall health, sleep, and wellbeing. Where she met Dr. Zaghi.
Dr. Zaghi is particularly interested in studying the impact of tethered-oral tissues (such as tongue-tie) and oral myofascial dysfunction on maxillofacial development, upper airway resistance syndrome, and obstructive sleep apnea. He is an invited lecturer, author, and journal reviewer for topics relating to the diagnosis and management of sleep-disordered breathing and tongue-tie disorders.
Dr. Boyd is diagnosing and treating what may be interfering with a child’s normal growth of the teeth, jaws, face, and breathing.
He grew up the son of a dentist, when ‘children’s dentists’ were rarely found. He set his sights not on just following his father into the profession, but helping children. Schooling included a master’s degree in Human Nutrition, where he studied dental caries, then dental school and specialty training at the University of Iowa. That program had an aggressive approach to ‘interceptive orthodontics.’ where he learned to pay attention to jaw shapes and developing arches, but, like nearly every program, there was no airway focus back then.
One of his professors, Dr. Samir Bishara, emphasized growth and development from an early age.
In the early 1980s, Dr. Boyd was using his training to help kids get bigger arches for better smiles and easier orthodontic care – and began to notice parents were thanking him for other results. Widening the arch was being credited for better breathing, halting teeth grinding, even resolving bedwetting! Who knew at that time that early therapy was having an airway effect?
Treating adult airway problems is challenging, rewarding, and necessary. Treating children when you have a chance to allow them to grow without the compromise of a poor airway is life-changing – for you, for the parents, and for our next generation.
These are just a few of the leading experts in the field that work with Oral Myofunctinal therapists. All of which lecture and train other health professionals like me so we can get the information into the hands of the patients that need it. This is life-changing for our kids. Early intervention and diagnosis are key.
A lot of the information for today, I hope I have inspired you to understand the importance of working with a myofunctional therapist.
I hope these 10 top reasons have helped you get excited about connecting with a myofunctional therapist. If you have any questions or you’d like to get in touch with me and learn more about what I was talking about, please feel free to get in touch.
You can find me at dentalhygiene411.com or the Healthy Mouth Movement Send me an email, shereewertz@comcast.net
I’m happy to find the help you need.
Additional Reading:
Stanford
