Orofacial
Myofunctional
Disorders

Correct breathing occurs through the nose as the nasal passage cleans, warms and humidifies the air we breathe. When a person habitually has their mouth resting open, it typically results in mouth-breathing. Mouth-breathing does not support healthy development and function of the orofacial complex as the tongue is incorrectly resting in the floor of the mouth instead of on the palate (roof of the mouth). This can lead to a number of concerning issues such as chronic gingival inflammation, increased risk of dental caries due to xerostomia (dry mouth), snoring, stunted horizontal facial development, loud/messy eating, malocclusion and more. It also influences the levels of oxygen and carbon dioxide in the body, which can lead to chronic fatigue and/or hyperactivity.

Tethered oral tissues (TOTs), more commonly known as tongue-tie, is when oral tissues have a more pronounced tissue attachment (frenum); which can impact function, range of motion and impede muscle development and tone. It is not limited to the tongue and can also involve the frenums along the inside of the lips and cheeks. However, the tongue is commonly the prime suspect and can not only cause great difficulties with feeding and speech but also result in breathing/airway concerns, malocclusion, digestive issues, associated tension and/or pain in the temporal mandibular joint (TMJ), neck, upper back and shoulder regions. This is also a main reason why the tongue may rest improperly in the floor of the mouth and have similar clinical presentations to other dysfunctions. 

Orofacial myofunctional therapy (OMT) is not speech therapy. Having said that, OMT may aid articulation concerns in certain circumstances as it helps to develop and train the muscles that are required for correct articulation. OMT can assess the reason why you or your child may have tried speech therapy in the past and did not have the long-term, desired success you were hoping for. Speech therapy and myofunctional therapy greatly compliment one anther and can be the missing link to long-term success. 

Noxious oral habits are habits such as nail biting, thumb/finger sucking, lip biting, etc., that negatively influence the development and function of the orofacial complex. One of the most anatomically altering habits is thumb/finger sucking due to the frequency and duration of internal positive pressure on the palate and anterior dentition (teeth). It forces the palate into a narrow/vaulted shape and flares the anterior teeth into a maloccusion of open-bite. It also inhibits the mouth from resting properly; forcing the tongue into the floor of the mouth, beneath the thumb/finger. Noxious oral habits are addressed prior to initializing a myotherapy program as they inhibit sucess of reaching myofunctional therapy goals. 

There are various reasons why you may experience pain in the temporal mandibular joint (TMJ). The area where OMT can help is determining if the root cause of the pain is related to an OMD. It is often seen clinically that bruxing, snoring, and sleep apnea present in trios; coincidingly preventing you from having a sound, restful sleep. It has been normalized to think that bruxing can be resolved with a night-guard. While a night-guard can bring temporary relief and immediate protection to your teeth, it does not address or correct the root cause of why you are bruxing and/or clenching. 

The tongue is very strong and when it rests in the floor of the mouth, it tends to thrust forward during speaking and swallowing. This dysfunction, over time, leads to malocclusion of anterior open bite as it pushes the anterior teeth into a flared position from the frequency and duration of the force of the tongue. The main cause of this is related to low rest tongue posture as the tongue "takes-off" or moves to form sounds and/or swallow from the rest position. This can lead to habitual open mouth rest posture, delayed eruption of permanent anterior teeth, malocclusion, articulation issues, difficulty incising food, and more. 

Having a narrow, high palate is typically the result of having habitual low rest tongue posture as the tongue is the body's natural palate expander. When the tongue is functionally unable to reach the palate due to a tongue-tie or other functional concern, it allows the maxilla (upper jaw) to develop vertically while slowing horizontal growth. This can lead to a palate that is too narrow and vaulted to accommodate the tongue; leaving the floor of the mouth as the only option for the tongue to rest. Concerns resulting from this dysfunction include but are not limited to, low rest tongue posture, narrowed nasal passageway, snoring, malocclusion, ​loss of horizontal orofacial dimension and mouth-breathing. 

Apart from the aesthetic concern of having crowded teeth, it can cause multiple functional concerns such as open mouth rest posture, poor oral hygiene, gingivitis, breathing concerns, messy/loud eating, and articulation concerns to name a few. Often people with misaligned teeth will seek out orthodontic treatment. When orthodontic treatment is completed without myofunctional disorders being addressed, it can prolong orthodontic treatment or be a cause for orthodontic relapse. Ideally, if there are OMDs present, myofunctional therapy is completed prior to or in conjunction with orthodontic treatment.

OMT does not provide sleep studies or sleep therapy. How sleep concerns are connected to OMT is that it assesses the anatomy and physiology of why you or a loved one might be suffering from sleep-disordered breathing (snoring/sleep apnea) from an orofacial functional perspective. OMDs are often a root cause for sleep-disordered breathing and can help improve the quality of sleep through addressing orofacial myofuncional dysfunctions. It is important to note that simply because something is common, does not make it healthy or normal. For example, snoring is widely accepted due to the commonality of it. However, it is literally the sound of the body choking an anatomical obstruction for enough air. It is not heathy and should not be how we view normal breathing during sleep.