WHAT IS OROFACIAL MYOFUNCTIONAL THERAPY?
Let's break the name down first:
OROFACIAL: relating to the mouth and face
MYO: relating to muscle
FUNCTIONAL: having a special activity, purpose or task; relating to the way in which something works or operates
THERAPY: treatment intended to relieve or heal a disorder
Myofunctional therapy is an exercise-based treatment. Think of it like doing physiotherapy for symptoms and conditions related to the face, mouth and jaws. If your tongue is low in your mouth, or if you tend to breathe through your mouth - it is likely that you are in need of OMT. While OMT services are related to the orofacial complex, they are not an extension of any dental hygiene services and should be considered an entirely separate treatment. Myofunctional therapists are not regulated by any dental board or association.
What are the 4 goals of myofunctional therapy?
NASAL BREATHING
Breathing through the nose is the way we are meant to breathe. It filters, warms and adds moisture to the air. Healthy Nitric Oxide is also released into the body when we breathe through the nose.
PROPER LIP SEAL
Our lips should rest naturally and comfortably together. When your mouth is closed, you sleep better at night and have a lower risk for getting tooth decay and gum disease.
TONGUE POSTURE
The tongue is meant to fill up the entire roof of the mouth. When it does, it provides an internal support structure for the upper jaw. If your tongue is in the right place, your teeth will grow in straighter and your face will develop properly. The tongue plays an amazing and important role in our facial appearance. Correct tongue posture and lip seal with force nasal breathing.
SWALLOWING PATTERN
If your tongue pushes forward when you swallow, you have a tongue thrust swallowing pattern. This makes you more likely to swallow small amounts of air when you eat and drink, and you may experience digestive issues such as acid reflux, stomach pain, gas, and bloating.
TONGUE-TIE/RESTRICTION
Tongue-tie (ankyloglossia) is a condition in which an unusually short, thick or tight band of tissue (lingual frenum) tethers the bottom of the tongue’s tip to the floor of the mouth. Some tongue restrictions are obvious just by looking at the tongue, and some are not.
General signs and symptoms of tongue restriction include:
Tongue-tie may cause the following symptoms in infants:
In young children, tongue-tie symptoms may include:
MOUTH BREATHING VS NASAL BREATHING
Nasal breathing is the proper, naturally designed way to breathe.
BENEFITS OF NASAL BREATHING:
CAUSES OF MOUTH BREATHING
The primary cause of mouth breathing is due to a partially or fully blocked nasal pathway (nasal obstruction). Risk factors of a blocked nose include the following:
COMMON SIGNS AND SYMPTOMS OF MOUTH BREATHING:
SLEEP DISORDERED BREATHING
Sleep disordered breathing (SDB) refers to a wide spectrum of sleep-related conditions including increased resistance to airflow through the upper airway, heavy snoring marked reduction in airflow (hypopnea), and a complete cessation of breathing (apnea).
Symptoms of SDB include:
Current literature demonstrates that OMT decreases AHI (Apnea Hypopnea Index) by approximately 50% in adults and 62% in children. Lowest oxygen saturation, snoring, and sleepiness outcomes improve in adults.
ORAL HABITS
- Poor oral habits include a wide variety of habits such as thumb sucking, finger sucking, blanket sucking, soother/pacifier use, lip sucking, lip licking, mouth breathing and nail biting,
- These habits can alter the normal muscle balance in the face, resulting in an OMD, which can have a negative impact on facial growth.
- Thumb sucking is the most recognized oral habit that is widely understood to negatively affect the growth of the jaws and teeth.
- When the thumb is in the mouth, it displaces the tongue so it is not resting fully on the palate.
- The light forces of the lips and the cheeks pulling in, back and down on the upper jaw are no longer opposed by the light force of the tongue on the palate, resulting in a high and narrow palate.
- The long term side effects of thumb sucking pushes the upper front teeth forward and the lower front teeth backward.
- A variety of negative effects on the growth of the jaw can occur with different oral habits.
- Finger sucking, blanket sucking, soother use, mouth breathing and other poor oral habits can displace the tongue from its normal resting position on the palate, with associated negative effects on facial growth.
TMJ PAIN/BRUXING
OMT can help expand your airway to alleviate breathing problems and contribute to healthy sleep - without bruxism. The benefits of OMT for bruxism have been documented and shown to reduce the episodes of bruxism by more than 50%.
Clenching is closing the teeth tightly, often for prolonged periods of time. The habit of clenching damages the teeth and the temporomandibular joint, causing chewing muscle dysfunctions and pain.
Bruxing is grinding of the teeth, usually at night and it is a sign of sleep disordered breathing.
OMT provides awareness of the habit to the person who clenches; helps identify the connections between stress and clenching as a stress management parafunction; provides strategies to reduce or eliminate clenching; identify some symptoms of disordered nasal breathing, which is often the main contributor to bruxing, or other symptoms of OSA (obstructive sleep apnea) and make the appropriate referral.
Targeted muscle exercises for the face and mouth as well as postural exercises work to correct irregular muscle patterns that are contributing to the oral dysfunction. Attaining the main goals of OMT will work to set the stage for successful results. Clients often find that OMT exercises are a great non-invasive option to help with jaw pain. They find relief from jaw pain and headaches if the underlying issues are muscle and tongue related.
ORTHODONTICS/ORTHODONTIC RELAPSE
Proper tongue function is necessary for success with future braces. The tongue will be trained to function like a natural retainer that can minimize aggressive orthodontic work and relapse. Clinicians should seek to answer the question of why the teeth became crooked in the first place. The reason that the orthodontic relapse occurs is because the underlying oral myofunctional disorders that caused the issues in the first place have never been corrected.
Unresolved myofunctional conditions, such as tongue-tie, lip-tie, airway obstruction, and unusual swallowing patterns, can all indicate that the tongue, lips, and mandible aren't resting properly. In addition to reversing the effects of previous orthodontic treatments, these disorders also come with other unpleasant symptoms that a patient may want to reduce. Obstructed airways can often lead to sleep apena, which is characterized by difficulty breathing when sleeping. A patient will find multiple health benefits to resolving the issue.
The tongue is often where the problem actually lies. It should rest in the top of the mouth, filling the palate all the way from the front to the back. Also, the mouth needs to be closed, and the lips together, and the swallowing pattern needs to be correct, without a tongue thrust that causes the tongue to push forward against the teeth, each and every time we swallow.
If the tongue is in the wrong place (resting low and flat against the bottom of the mouth), and there is a tongue thrust swallowing pattern - then we have a problem! Also, if the tongue is not providing an internal support for the maxilla (upper jaw), then over time, the maxilla will narrow and collapse. In this situation, there's no way to stop the teeth from moving once the braces or orthodontic appliance are removed.
Another factor to consider is that if there are underlying OMD's, orthodontic treatment can take far longer than it should - this is because the orthodontist is basically fighting against the muscular forces that are pushing against the teeth. Of course, the orthodontist will eventually win that battle, but some time after the braces are removed, the teeth will again be under pressure and will begin to shift.
After OMT, the tongue posture will be correct and the muscles of the orofacial complex will be in balance, making way for a much higher chance that the orthodontic treatment will be stable over the long-term.
