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Myofunctional Therapy

What is Myofunctional Therapy?

Myofunctional Therapy is a program used to correct the improper position and function of the tongue and facial muscles used at rest, for chewing and swallowing. Orofacial Myofunctional Therapy addresses many of the causes of swallowing abnormalities and improper resting posture of the tongue. Orofacial Myofunctional Therapy is painless, and the exercises are relatively simple. When certain muscles of the face are activated and functioning properly, other muscles will follow suit until proper coordination of the tongue and facial muscles is attained. For success in this therapy, consistent daily exercise is necessary until the patient has corrected their improper muscle pattern. It also takes commitment by the patient and family (in the case of caring for children) – and time. Treatment usually consists of a regular program of exercises over a 6 – 12 month period, although treatment length may vary. 

How Does Orofacial Myofunctional Therapy Incorporate a Multi-Disciplinary Approach to the Health of Your Mouth?

A myofunctional therapist is one member of the team that will successfully treat an Orofacial Myofunctional Disorder. We collaborate with dentists, orthodontists, and osteopaths to ensure that the patient’s needs are addressed and handled appropriately. Frequently, incorporating a variety of approaches can contribute to the success of treatment.

What Should You Expect When Undergoing Myofunctional Therapy?

With myofunctional therapy, a patient can regain the joy of eating, speaking, breathing, and even sleeping more soundly. Cosmetic improvements can help restore confidence and self-esteem. We believe that everyone deserves to understand myofunctional disorders and be treated for Orofacial Myofunctional Disorders. We endeavor to increase awareness of Orofacial Myofunctioanl Therapy amongst the medical, dental, and academic communities to promote this multidisciplinary treatment. 

What are Orofacial Myofunctional Disorders (OMDs)?

Orofacial Myofunctional Disorders are disorders of the muscles and functions of the face and mouth. OMDs may affect, directly and/or indirectly, breastfeeding, facial skeletal growth and development, chewing, swallowing, speech, occlusion, temporomandibular joint movement, oral hygiene, stability of orthodontic treatment, facial esthetics, and more.

What is the Most Common and Most Overlooked OMD by Health Care Providers?

Most OMDs originate with insufficient habitual nasal breathing or with oral breathing. The subsequent adaptation of the muscles and the orofacial functions to a disordered breathing pattern contributes to the development of many OMDs.

What are the Negative Effects of a Mouthbreathing Habit and Other Myofunctional Disorders?

Mouth breathing or constantly open lips may be a cause and/or signal of tongue thrust and low tongue rest posture. Mouth breathing can occur when the tongue is positioned low in the lower jaw due to nasal congestion, resisted nasal breathing, a tongue-tie issue and at times, allergies. In a growing child, as the tongue positions low in the mouth, it no longer creates the pressure up on the palate to promote development of a wide palate and bringing the mid-face forward and promotes a narrow and high palate. See Figure XX image of the high narrow palate. When this occurs, the high portion of the narrow palate moves upward towards the nose, which can promote develpoment of a deviated septum and permanently restricted nasal breathing. If the nose cannot breathe properly, the mouth must stay open to breathe.

Improper oral muscle function may additionally promote TMJ dysfunction, headaches, stomach distress (from swallowing air), airway obstruction, and other health challenges. Many children have had issues with improper swallowing, which can cause a fluid build up in the ear and contribute to the need for ear tube surgeries. Proper use of the tongue, function in the mouth for chewing and swallowing and resting position on the palate can help minimize swelling of the adenoids, tonsils or reduce the need for ear tube surgeries.

What Treatments Would a Person with OMD Have Difficulty With?

Orofacial Myofunctional Disorders may impact treatments recommended by orthodontists, dentists, dental hygienists, speech-language pathologists, and other professionals practicing in the orofacial area.  Many orthodontists work with myofunctional therapists and understand the function of the tongue. Failure to consider the resting posture of the tongue and its relationship to the palate will affect proper relaxed lip seal during treatment, which can promote the need for braces more than once in the child or adult’s life, which is costly and frustrating.  If you have been told that you or your child needs braces again, consider a myofunctional therapy consultation for tongue tie, low tongue posture, mouth breathing, improper chewing and swallowing habits.  

If you are recommended for braces, ask additional quesetions about why the teeth and bite are developing this way.  The tongue, lips and teeth help create the mouth’s natural braces and they can be influenced by a compromised airway, shallow chest or mouth breathing pattern, tongue-tie, allergies promoting a low tongue posture, or improper positioning of the tongue for swallowing.

Each of these issues listed also promote forward head posture, which might be the most obvious sign you can see of an orofacial myofunctional disorder.

Additionally, if your child has been referred for treatment with a speech-language pathologist, inquire regarding his or her training in identifying tongue tie.  A tongue tie can contribute to problems with articulation and tongue positioning on the palate.

How Does an Improper Swallowing Pattern Affect a Developing Child?

Correct swallowing is dependent upon the relationship between muscles of the face, mouth and throat. To swallow properly, the muscles and nerves in the tongue, cheeks and throat must work together in harmony. When a person swallows normally, the tip of the tongue presses firmly against the roof of the mouth or hard palate, located slightly behind the front teeth. The tongue acts in concert with all the other muscles involved in swallowing. The hard palate, meanwhile, absorbs the force created by the tongue.

Because a person swallows 1,500-2,000 times a day, improper swallowing can promote a variety of problems and the resting position of the tongue is even more impactful because it is constant.  When a person swallows incorrectly, the tip and/or sides of the tongue press against or spread between the teeth. This is commonly called a tongue thrust. Constant pressure from resting or incorrectly thrusting the tongue away from the hard palate creates pressure on the teeth that may later prevent teeth from erupting (breaking through the gum).  

In many cases, a tongue thrust swallow promotes an anterior open bite.  The constant pressure of the tongue against or between the teeth will not allow the teeth to bite together and creates an this open bite.  Occasionally, there is a lateral tongue thrust swallow which promotes a lateral open bite in patients.  Many patients, adult and children, perform swallowing with facial tension, grimacing, and/or neck craning and are unaware.  See image that demonstrate an anterior open bite.

Do Renaissance CranioFacial Group Physical Therapists Train the Swallow of Patients with Myofunctional Disorders?

The focus of the physical therapists practicing at PhysioPartners Renaissance CranioFacial Group is not swallow training, which is appropriately addressed by Speech-Language Pathologists.  Our clinicians focus on the oral preparatory phase (phase 1) of swallowing, the resting position of the tongue up to the palate, and the proper tone and strength of the tongue to support the soft palate and airway.  Physical therapists trained in myofunctional therapy prepare the muscles to attain the competence in this very important initial stage one of swallowing, and we collaborate with Speech-Language Pathologists in treatment.

Do Renaissance CranioFacial Group Physical Therapists Train the Speech Disorder for Patients with Myofunctional Disorders?

Our physical therapists do not provide speech therapy, which is most appropriately addressed by a Speech-Language Pathologist. We collaborate with and can refer you to a speech-language pathologist.  Our clinicians focus on the resting position of the tongue up to the palate, and the proper tone and strength of the tongue to support proper articulation.  While treatment may include activities such as reading out loud, this is not treatment for speech disorder.  

Do You or Your Child Eat Sloppily or Always Have Food on Their Face?

Those who have difficulty keeping their lips closed during chewing benefit from learning proper lip seal and nose breathing while eating.  Our physical therapists can help restore proper chewing and eating habits, as well transform your or your child's ability to sit in good alignment with efficient use of the mouth, lips and teeth.

For those who cannot travel to our clinics, the physical therapists of PhysioPartners Renaissance CranioFacial Group can provide treatment virtually via telehealth.  Myofunctional therapy and GOPex postural retraining can be provided very effectively virtually for both children and adults. 

Please call (773) 665-9950 for more information or schedule an onsite or virtual appointment.

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