Orofacial Myofunctional Disorders (OMDs) are atypical adaptive patterns of oral and facial muscles as it relates to speech, dentition, chewing/bolus collection, swallowing, and overall mental and physical health. The prefix “myo” means muscle so our primary work begins with the muscles of the face, lip and tongue.  

We work with children, teens and adults to improve oral habits. With myofunctional therapy we work on facial and tongue exercises to improve oral rest posture (making sure your tongue, lips and jaw are correctly placed

Areas Myofunctional therapy can help:

• Improving noxious oral habits (thumb sucking, nail biting)

• Open mouth posture

• Tethered Oral Tissues (TOTs)

• Drooling

• Low and forward resting tongue

• Dental malocclusions

• Tongue thrust

• Dental malocclusions

• TMJD/TMJ pain 

• Sleep apnea

Persistent non-nutritive sucking behaviors and noxious oral habits, encompassing the use of fingers, thumbs, blankets, clothing, or pacifiers, can become chronic habits. Prolonged and consistent sucking can lead to an improper tongue position beneath the inserted object and pushed forward against the anterior teeth. This incorrect tongue resting posture, often accompanied by parted lips, can foster the development of a tongue thrust swallowing pattern.

Furthermore, continual forward and upward pressure exerted by the thumb, fingers, or pacifier against the hard palate can lead to the alteration of the desired wide dental arch, resulting in the reshaping of the palatal vault into a narrow and elevated form. This may manifest as a crossbite or an anterior open bite. Failure to cease the sucking habit in a timely manner can perpetuate this distortion of the palate and dental arches, potentially leading to permanent changes. Typically, a palatal expander is employed to rectify and broaden the width of the dental arches, restoring them to a more optimal configuration. Eliminating the sucking habit prior to the age of five increases the likelihood of the bite naturally closing, with the teeth gradually returning to their neutral alignment.

A tongue thrust is the most common Orofacial Myofunctional Disorder.  In the general population, the prevalence is from 30-40% from childhood throughout adulthood (source: IAOM).  It occurs when the tongue moves forward, between or against the sides of the teeth, rather than moving vertically against the roof of the mouth while swallowing saliva, liquids or solids.  

An incorrect position of the tongue is another common Orofacial Myofunctional Disorder.  When the tongue rests against the front, sides or in between the teeth, it no longer supports proper orofacial development.  This light continuous pressure of the tongue against the teeth with lips parted and the jaw hinged open can cause the bite to open up, referred to as an open bite. If this occurs after braces are removed then this is referred to as ‘ortho relapse’.  

More precisely, the tongue serves as a scaffold for the hard palate, facilitating the proper formation of dental arches. As such, the foundational focus of an Orofacial Myologist's practice involves instructing and establishing correct resting positions for the tongue and lips. This pivotal aspect remains central to our approach, emphasized at the outset and consistently throughout the program.

Tongue-tie, also known as ankyloglossia, can contribute to the development of a tongue thrust. This condition occurs when the frenum restricts the range of motion of the tongue. Consequently, the tongue tends to sit low in the mouth, hindering its effectiveness during activities such as sucking, eating, and clearing food debris from the teeth in preparation for swallowing.

Moreover, this vertical restriction impairs the tongue's ability to assume the optimal resting posture against the palate, which is essential for maintaining a wide dental arch.

Many experts concur that a constrained lingual (tongue) or labial (lip) frenum can serve as a precursor to various dental, speech, skeletal (jaw growth), and myofunctional issues. This restriction may lead to malformation of the palate and dental arch, as well as adversely affect speech production.

When a restricted lingual or labial frenum is suspected, the Orofacial Myologist may recommend referral to an oral surgeon or an Ear, Nose, and Throat (ENT) specialist for frenum release. This procedure aims to enhance the range of motion of the lips and tongue. Following the operation, the Orofacial Myologist may prescribe home-based exercises to mitigate scarring and maintain the length and flexibility of the tongue or lip.

Infected and enlarged tonsils and adenoids can occupy space in the posterior oral cavity and upper pharynx, competing with the tongue for room. This spatial constraint often forces the tongue forward, leading to parted lips and an open mouth. Consequently, individuals may experience obligatory mouth breathing due to the compromised posterior airway space. This scenario presents another opportunity for the development of a tongue thrust swallowing pattern.

Upon the surgical removal or natural shrinkage of the enlarged tonsils and/or adenoids, the Orofacial Myologist can address the tongue thrust and work to strengthen and tone the oral and facial muscles. This intervention aims to restore the appropriate resting posture of the lips and tongue, thereby ensuring a normal dental freeway space within the oral cavity.

Sleep apnea, a condition characterized by pauses in breathing during sleep, can significantly impact your health and quality of life. Myofunctional therapy addresses the underlying muscular issues contributing to sleep apnea, offering effective treatment and improved sleep patterns.

We will work collaboratively with your team of healthcare providers to better manage or eliminate your sleep apnea. Orofacial Mhyofuntional Therapy (OMT) can also help increase the compliance and efficiency of your CPAP or oral appliance therapy. Orofacial Mhyofuntional Therapy (OMT) has been proven to strengthen the muscles in the oropharyngeal space that collapse during sleep, making Orofacial Mhyofuntional Therapy (OMT) an effective treatment in reducing the severity of OSA and snoring.

We also work alongside leading experts in the field getting to the root cause of the issue, underdevelopment of the jaws. Structure and function go hand in hand. Your tongue and lips should be your body’s natural retention system.