What is Orofacial Myofunctional Therapy?
Orofacial Myofunctional Therapy (Myo for short)is all about correcting head and neck muscle dysfunction. It addresses how to properly breath, swallow, chew and speak. Yes, there’s a correct way to do these functions, and unfortunately, many people actually do them incorrectly! This therapy strengthens and retrains your mouth to swallow and chew correctly, breathe through your nose and stabilize your Temporomandibular jaw (TMJ) joint.
It is a patient-specific neuromuscular behavior modification program that works by re-education or re-patterning of the facial muscles using therapeutic exercises and techniques to assist in proper function, growth and development, and aesthetics
These therapeutic exercises are designed to create a harmonious pattern between the muscles of the throat, face, and mouth. When your muscles are working correctly, they are in a more relaxed state and It can take the strain away. Therapy can range from one month to 12 months, depending on the myofunctional disorders.
What are Orofacial Myofunctional Disorders? (OMD’s)
Myofunctional disorders are disorders of the muscles and functions of the face and mouth:
- Open mouth posture (mouth breathing)
- Low tongue position (tongue rests on the floor of the mouth)
- Mouth breathing
- Restrictive frenums such as tongue and lip ties (the tissues under the tongue that connects the tongue to the floor of the mouth, or tissue that holds to lip to the jaw)
- Tongue thrust swallow
- Para-functional habits (such as sucking on thumb, digits, hair, clothes, cheeks, pacifiers, as well as nail biting)
- Orofacial and pharyngeal muscle hypotonia (poor muscle tone which affects breathing and feeding)
- Poor or excessive chewing
- Vaulted palate (roof of the mouth)
- Malocclusion (crooked teeth)
- Obstructions/restrictions of the airway (allergies, sinus issues, tonsils)
- Bruxism (clenching and grinding teeth)
- Tempomandibular joint disorders (jaw joints)
- Orofacial pain
OMD’s originate with insufficient nasal breathing or oral (mouth) breathing. The muscles re-adapt and the orofacial functions create these OMD’s. Correct swallowing depends on a proper relationship between muscles of the face, mouth and throat. Swallowing improperly causes many of the above problems. For true health and wellness – address the cause.
How do OMD’s Affect the Body?
OMD’s directly or indirectly affect:
- Sleep apnea
- Facial skeletal growth and development – Long Face Syndrome
- Tempomandibular joint movement
- Oral hygiene/oral health
- Stabilization of orthodontic treatment/orthodontic relapse (tired of wearing that retainer or wires? Retrain your tongue!)
- Facial esthetics
- Restricted frenulums (tongue and lip ties)
- Head-forward posture
What are the Goals of Myofunctional Therapy?
The goals of therapy are to eliminate the open mouth breathing, the improper swallow, and the incorrect chewing patterns. We call these parafunctional habits. Learning where the tongue belongs and keeping the mouth closed creates harmonious muscles.
- Promote lip seal
- Establish nasal breathing
- Promote a palatal tongue rest posture
- Repattern chewing and swallowing
- Optimize craniofacial (head/mouth) growth and development
- Correct dysfunctional habit patterns
- Keep hands and objects away from face
- Create muscle harmony in the head/neck
What are the Benefits of Myofunctional therapy?
- Enhance orthodontic treatment and improve malocclusions
- Provide relief from orofacial pain, bruxism, and tempomandibular joint disorders
- Improve swallowing/digestive issues/stomach aches/reflux
- Improve headaches
- Improve some oropharyngeal symptoms of sleep disordered breathing
What does Myofunctional Therapy Entail?
- Parafunctional habit elimination (such as Thumb sucking)
- Learn nasal cleansing and nasal breathing
- Series of exercises to teach tongue rest posture and establish a lip seal- these exercises stretch, tone and develop proper neuromuscular proprioception (awareness) of the facial muscles
- Introduction of proper chewing and swallowing
- Development of proper head and neck posture
- The habituation phase which reinforces correct muscle memory patterns
- Mini-myo for the younger child
- A program for patients with special needs
Myofunctional exercises are painless and relatively simple to do, but daily practice is vital for successful therapy and muscle memory to take place. It is a time commitment for both the patient and the family.
What Ages Benefit from Myo Therapy?
All ages benefit! From the very young all the way through adulthood. It certainly benefits children by developing positive growth patterns and eliminating negative growth pressures. It prevents habits and problems before they become entrenched. The bones of children are softer so change happens remarkably fast. However, even senior citizens can improve their tongue posture and chewing patterns. Facial features won’t change as drastically for adults as they do in children but the health benefits are there for all ages.
Cosmetic muscle toning for facial fitness- with more than 40 facial muscles all interconnected, these muscles can be toned and tighten, much like when we go to the gym to workout. Why not exercise your face – bring a friend!
Orofacial myofunctional therapy can also benefit adults with stroke related dysphagia (difficulty swallowing).
Current research in Brazil shows that OMT exercises can reduce moderate obstructive sleep apnea by 39%. [Gulimaraes, Drager, Genta, Marcondes, Lerenzi-Filho. Effects of Oropharyngeal Exercises on Patients with Moderate Obstructive Sleep Apnea Syndrome. American Journal of Respiratory and Critical Care Medicine, Vol 179, 20089] Myofunctional therapy can assist with orofacial exercises and better breathing patterns so adults can improve their sleep.
Oral dysfunctions create overall dental and medical issues. A myofunctional therapist can help make major life enhancing changes that affect the entire body.
Signs and Symptoms of Patterning Problem with Orofacial Muscles:
- Do you have chronic headaches?
- Do you have an open mouth rest posture?
- Do you have flaccid lips
- Do you have dry mouth?
- Did your teeth move after orthodontic treatment was completed?
- Do your front teeth have an open bite?
- Do you have jaw joint or neck pain?
- Is your tongue in the way when you get your teeth cleaned?
- Is your tongue scalloped along the edges?
- Do you have oral habits such as thumb or finger sucking, nail biting, lip licking, or hair chewing?
- Do you lisp when saying “s” sounds?
- Do you see your tongue come forward against the teeth when you swallow?
- Do you have gingivitis along your front teeth?
- Do you clench or grind your teeth?
- Do you have chronic stomach aches, burping, drooling, or hiccups?
- Do you have head-forward posture?
- Is your tongue tied?
- Do the sides of your tongue have a chronic irritation?
- Do you have a high vaulted palate?
- Do you have a long, narrow face?
- Do you have elevated nostrils?
- Do you have a gummy smile?
- Do you have sleepy or droopy eyes?
- Do you have a small lower jaw?
- Do you have problems chewing? Are you a slow eater or a messy fast eater?
What happens if You Don’t Do Myofunctional Therapy?
Obstructive Sleep Apnea and all the problems that causes
Tempomandibular jaw joint pain
Yes, you have compensated all these years. Isn’t it time to really get healthy and address the cause?
Myofunctional (Not so Fun) Facts to Know
From Rosemarie Van Norman’s book Helping the Thumb-Sucking Child
60% of malocclusion is caused by prolonged digit (finger/thumb) sucking
10% of Six to 11 year old’s suck digits
85% of digit suckers exhibit an open bite
Open bites many times lead to TMD due to shifting of the jaw in order to chew
49.9% of orthognathic surgery patients experience an open bite relapse
59% of digit suckers experience atypical root resorption (the root of the tooth dissolves away from the inside)
40% of digit suckers had learning and behavior problems in school
Why have I never heard of Orofacial Myofunctional Therapy before? Is this new?
Myofunctional therapy has been around a very long time. In the United States, it began in the late 1800’s and early 1900’s with the grandfather of orthodontics- Dr. Edward Angles. He recognized tongue rest posture, mouth breathing and oral habits influence occlusion. He noted that mouth breathing was the chief cause of malocclusion. Then, Dr. Alfred Rogers, another prominent orthodontist, suggested corrective exercises would develop proper muscle tone and function, and thereby influence proper occlusion. Unfortunately, myofunctional therapy got lost in the shuffle of modern orthodontics and was only rediscovered in the 1960’s with Daniel Garliner and the Myofunctional Institute in Florida.
How I found Myofunctional Therapy
I had never even heard of myofunctional therapy until about four years ago. It was not mentioned in any of my dental hygiene text books or dental magazines, or even continuing education courses. My colleagues never mentioned it. Nothing, zip, nada… until I happened to take a course from one of my mentors and she off-handily mentioned that breathing incorrectly caused facial growth changes. Then, my youngest daughter started burping- super big and painful burps. I realized I knew nothing about proper swallowing, chewing or breathing, and I had no idea why this was occurring to her. After unsuccessfully trying other treatments, I went on a quest to help my daughter and thus literally stumbled into this field. It opened my eyes to real health and wellness. Why no one ever talked about this was a mystery to me. Something so simple as tongue position and nasal breathing can have such a profound effect on your health and life! It was a EUREKA moment for me! Email me for a comprehensive evaluation, and we can arrange a time to chat and see if myofunctional therapy can help you, too!