Evaluation for Myofunctional Referral

Please refer to the following points to help you determine if your child would benefit from seeing one of our specialists.

  • Any of the following may be an indicator:
  • Mouth Posture is open, mandible dropped
  • Lack of muscle tone in the lips and face
  • Tight upper lip, large lower lip
  • Open bite
  • Chapped lips-lip licking
  • Lower lip wedged under upper teeth
  • Pursing of lips for swallowing
  • Lack of molar contact
  • Mouth breathing
  • Nail Biting
  • Short Lingual Frenulum
  • Interdentalized articulation (L,S,Z,SH,CH,J)
  • Mandibular thrust (S,Z,SH,CH,J)
  • Hyper or Hypo-nasality

Therapy consists of exercising facial and tongue muscles to achieve the correct tongue position for swallowing with the molars closed.

The therapy is similar for myofuntional patients, thumb or digit-suckers, denture patients and TMJ disorders in that repositioning of the tongue and the strengthening of facial and neck muscles is essential for them all.

What is Orofacial Myology and how does this differ from my dental or orthodontic treatment?

Orofacial myology is a specialized professional discipline that evaluates and treats a variety of oral and facial muscles along with posture and function while eliminating habit patterns that may disrupt normal development. The principles involved with the evaluation and treatment of orofacial myofunctional disorders are based upon dental science tenets; however, orofacial myofunctional therapy is not dental treatment. Dental evaluations and treatments focus primarily on providing health and stability of teeth in occlusion, or contact. By contrast, myofunctional therapy is concerned with orofacial functional patterns and postures when teeth are apart, which they are for over 95% of each day and night.

What are myofunctional disorders and how are they corrected?

An oral myofunctional disorder includes a variety of negative habit patterns, postures, and functional activities. Such disorders can lead to abnormal growth and development of your teeth. Speech articulation patterns may also become distorted. The temporomandibular joint apparatus can become impaired or damaged from abnormal oral functional patterns. Orofacial myofunctional therapy may be recommended. A major treatment goal of correcting or improving resting tongue and lip relationships can aid in the development of normal patterns of dental eruption and alignment. The elimination of tongue thrusting and lip incompetence can have a positive effect on cosmetic appearance.

What causes an orofacial myofunctional disorder?

It is often difficult to identify a single cause for an orofacial myofunctional disorder (OMD). Poor oral habits such as prolonged thumb or finger sucking, cheek/nail biting, tooth

clenching may be a root cause. Other causes may be related to restricted nasal airway, structural or physiological abnormalities such as a short lingual frenum may also limit the patient’s ability to achieve the necessary muscle function for correction. Most disorders involve a combination of factors that may include:

  • An airway restriction from enlarged tonsils or adenoids, allergies, or anatomical deviations involving the nasal cavity or pharynx.
  • Improper oral habits such as thumb or finger sucking, cheek or nail biting, teeth clenching, or grinding.
  • Neurological and sensori-neural developmental delays or abnormalities.
  • Structural or physiological abnormalities such as short lingual frenum (tongue-tie).
  • Hereditary predisposition to any of the above factors.
At what age should therapy begin?

Age five years is usually a good age to initiate therapy or to refer a patient for medical evaluation of airway interference issues. However, resting posture problems of tongue and lips, and other functional problems such as tongue thrusting are not usually indicated for treatment until age eight or nine. Orofacial myofunctional therapy is also appropriate for adults. Therapy for adult patients is typically 80-90% efficient (1992; Hahn & Hahn). Adults of all ages are capable of achieving success in treatment.

What is Orofacial Myofunctional Therapy?

Therapy involves an individualized regimen of exercises to re-pattern oral and facial muscles. Exercises are used to correct tongue and lip resting postures as well as to develop correct chewing and swallowing patterns. Certified Orofacial Myologists (COM) are trained to help patients eliminate harmful habits by using positive behavioral techniques. They also provide therapy to eliminate oral noxious habits such as: prolonged pacifier use, thumb and/or finger sucking, fingernail biting, cheek or lip biting, tongue sucking, and clenching or grinding of the teeth.

Who should treat OMD?

Orofacial Myologists who are certified by the International Association of Orofacial Myology (IAOM) have the appropriate training to provide treatment. The IAOM is the only international professional accrediting organization of this therapeutic specialty. Those members who have had additional training and successfully pass a written and clinical proficiency examination, earn the credential of Certified Orofacial Myologist (COM).

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