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Orofacial Myofunctional Therapy (OMT) is the neuromuscular re-training of the oral and facial muscles. Orofacial Myofunctional Therapy treats Orofacial Myofunctional Disorders (OMDs).

Orofacial Myofunctional Disorders (OMDs):

These are disorders of the muscles and functions of the face and mouth. Some signs and symptoms of OMDs may include:
  • Improper swallowing: A tongue thrust occurs when the tip and/or sides of the tongue press against or spread between the teeth. This may result in an anterior open bite. A facial grimace occurs when the muscles of the cheeks, chin and lips purse and tighten on swallowing, resulting in the over-development of the chin (mentalis) muscle.
  • Improper lip seal: Constantly parted lips due to weak oral muscles and/or mouth breathing. This may result in anterior gingivitis.
  • Dull, sluggish facial appearance: Indicative of incorrect oral posture when muscles are not operating properly.
  • Forward Head Posture: The head is held in a forward position and may cause neck and shoulder pain.
  • Retruded chin: This may result from the lower jaw moving back to meet the narrowed upper jaw for batter occlusion.
  • Malocclusion and/or orthodontic relapse: Most likely due to persistent improper tongue position.
  • Difficulty articulating sounds: Incorrect oral muscle patterns may prevent sounds of normal speech from forming. When the muscles in the tongue are incorrectly postured, this may result in a lisp, for example.
  • TMJ dysfunction, posture problems, neck and shoulder pain: These may be linked and will be discussed in detail below.
  • Headaches: May result from mouth breathing (less oxygen to brain and muscles).
  • Stomach distress: May result from swallowing air (chewing food with open mouth because of mouth breathing), the improper chewing of food due to malocclusion.
  • Airway obstruction: Improper tongue position may be unable to support airway. This may contribute to sleep apnea.
  • ADHD: Children who have undiagnosed sleep apnea are likely to be sleep deprived. They may try to stay awake during the day by being or becoming hyperactive. Many sleep deprived children and children with ADHD have the same behavioural challenges. More research needs to be done in this area.

Causes of OMDs:
  • Habitual oral breathing
  • Improper tongue position
  • Habitual thumb, finger or tongue sucking: This pushes the tongue into an incorrect position and leads to an improper functioning pattern.
  • Prolonged use of pacifiers and/or sippy cups: This has a similar effect as thumb/finger/tongue sucking.
  • No-chew diet: The jaw joint and muscles are not fully developed, and the tongue loses its proprioceptive sense.
  • Enlarged adenoids or tonsils: This may be caused by allergies. This may also be caused by mouth breathing because of allergies-- a vicious cycle.
  • Inherited oral patterns, such as mouth breathing, thumb sucking or tongue posturing (when the tongue seems “busy” and pushing around in the mouth frequently).
  • A tight frenum (tongue tie) which holds the tongue down.
 
Why is tongue position so important?
The proper place for your tongue is up against the roof of your mouth, with your teeth apart and lips together. Your tongue on the roof of your mouth creates a suction force which keeps it up there, and, together with a proper lip seal, supports your facial muscles. If your tongue is up, it acts as an “oral splint” to support your upper palate so that the pressure from your cheeks does not push your upper teeth in.

If you have a low tongue position, the roof of your mouth may become high, narrow and vaulted (from your upper teeth being pushed in). This may result in a deviated nasal septum; it buckles from being pushed up. Having a narrow upper palate may also result in your lower jaw moving back to meet for your teeth to occlude. (This may give you an appearance of a “too small” jaw or a retruded chin). When this happens, you may have jaw pain as your jaw joints are now “jammed” together. Here is a good clip to watch: https://www.youtube.com/watch?v=CBYwxndys2E

At the same time, because your lower jaw is now in a relatively posterior position, your airway becomes compromised, so you end up holding your head in a forward position in an attempt to open up your airway. This may cause tension and soreness in your neck and upper back as these muscles work to hold your head out front. For every inch that your head is forward, it weighs 10 pounds heavier: more weight for your muscles to hold up. http://erikdalton.com/forward-heads-funky-necks/


A compromised airway could also contribute to sleep apnea.  If your oropharyngeal muscles are not strong enough to support your airway, when you fall asleep, your muscles relax and have even less tone. This obstructs your airway, giving rise to snoring and sleep apnea.

Why is nasal breathing important?
When you breathe through your nose:
  • The inhaled air is warmed and moistened, and does not irritate the sensitive airways.
  • The inhaled air is filtered through turbinates so that any allergens, dirt, dust, microbes, etc, stick to the mucous lining of the airways and destroyed by enzymes and anti-microbial gases.
  • You are not mouth breathing. Mouth breathing may cause the gums to dry out and cause cavities and gum disease by increasing the acidity in the mouth.
  • It encourages good facial development and straight teeth with a closed mouth and proper tongue position.
  • It may help reduce snoring and sleep apnea.
  • It helps to regulate the volume of air breathed to effectively match the body’s oxygen needs.
  • You are not as likely to blow off too much Carbon Dioxide (CO2). Lower than normal CO2 levels may result in narrowed airways and blood vessels. A certain concentration of CO2 is necessary for the release of oxygen from haemoglobin to supply the brain and muscles. (Bohr, Hasselbalch, Krogh. "Concerning a Biologically Important Relationship - The Influence of the Carbon Dioxide Content of Blood on its Oxygen Binding")
 
Orofacial Myofunctional Therapy:
  • Is painless.
  • Is a program of simple exercises over a 6 – 12 month period (length of treatment may vary by individual).
  • Helps to activate specific muscles to function properly for proper coordination of tongue and facial muscles.
  • Helps to retrain and correct poor swallowing habits.
  • Supports orthodontic treatment to help retain proper occlusion.
  • May improve facial aesthetics by improving tone and function of facial muscles.
  • Is the re-patterning and normalizing of oral and facial muscles and building strong pathways between the brain and these muscles.
  •  Is employed in conjunction with other treatments or therapies to successfully overcome OMDs.
  • May reduce the symptoms of sleep disordered breathing (such as snoring), and ameliorate mild to moderate OSA (obstructive sleep apnea). Camacho M. et al. Myofunctional therapy to treat obstructive sleep apnea: a systemic review and meta-analysis. SLEEP 2015;38(5):669-675.
 

If you think you have an OMD and/or are interested in OMT, please Contact Us or Book An Appointment so we can help.

If you are physician or dental staff, please find the referral form download at the bottom of this page.
 

 

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