Myofunctional Therapy

  • Many people are still unaware of the existence of Myofunctional Therapy. What is it? What does it resolve? Many times patients are looking for a natural and more holistic approach to myofunctional disorders that can affect: sleep, breathing chewing, swallowing, growth and development, behavior, school performance, and some speech issues. While the demand is present, the understanding and development of solutions still remain limited. Generally myofunctional disorders generally affect children, but it absolutely can affect adults as well. It is best that these symptoms are best approached as early as possible in a person’s life, however many patients are frustrated that these symptoms could have been resolved sooner. The goal is to be able to offer a way for parents & patients a way to seek help, find resources and to make well informed decisions on their health care goals.

  • Myofunctional therapy was originally dated back to the 1900s, focusing on the development of facial muscles. This focus specified on how the proper tongue positioning in the mouth can help jaw growth, nasal breathing and facial appearance. It wasn’t until the late 60s that the exercises were developed to help with atypical swallowing. Since this start, therapy has dramatically increased. The reason for the increase in study was that many pediatric sleep experts concluded that this therapy was a viable option to help irregular breathing during infant sleep patterns. This was specifically enhanced when in 2012 a study was conducted on children from 6 months to 7 years who were plagued with snoring, obstructive sleep apnea, and mouth breathing contributed to ADHA, behavior problems and an increased aggressive nature.  

  • With the presence of myofunctional disorders becoming more present in the world, we encourage parents to address symptoms early. Strong signs that indicate a myofunctional disorder in a child can include open mouth posture, mouth breathing, crowded teeth, narrow palate, small jaws, a protruding tongue, visible at rest, during eating and during speech. If you feel that your child may have and Orofacial myofunctional disorder, the best place to start is with your pediatrician or a sleep physician.

  • Symptoms of Orofacial Myofunctional Disorders

  • Symptoms

    •Congestion/mouth breathing
    •Open mouth posture at rest
    •Allergies
    •Low tone
    •Dental crowding/crossbite/open bite
    •High and narrow palate
    •Tongue-tie
    •Drooling
    •Dark circles under the eyes
    •Thumb or object sucking
    •Nail biting
    •Bedwetting
    •Open mouth chewing/sloppy eating

    Habits

    •Thumbsucking/digit sucking/object sucking
    •Nail biting/cuticle biting
    •Hands or objects in mouth
    •Lip licking, lip sucking, lip biting
    •Tendency to chew on everything
    •Mouth Breathing
    •Nose picking
    •Skin picking, hair pulling
    •Eyebrow/eyelash picking
    •Skin biting
    •Frequent throat clearing
    •Coughing in the absence of illness
    •Jaw popping
    •Neck adjusting
    •Knuckle cracking
    •Blanket sucking
    •Excessive gum chewing

    The Nose

    •Nasal congestion that encourages mouth breathing
    •Loud audible breathing
    •Overbreathing/hyperventilation
    •Excessive yawning
    •Sniffling
    •Frequent sighs
    •Visible movements of upper chest/shoulders when breathing

    The Lips

    •Open mouth posture-lips that are parted most of the time
    •Dry, chapped, cracked lips
    •Flaccid, low tone
    •Large, rolled lower lip
    •Lip Licking
    •Lip Biting
    •Lip Sucking
    •Visible saliva at corners of mouth
    •Excessive drooling and inability to control saliva

    The Tongue

    •Visible at rest
    •Visible during speech
    •Tongue Thrust
    •Appears large and in the way
    •Scalloped edges
    •Tongue-tie

    The Mandible (Lower Jaw)

    •Jaw tendency to shift left, right, or forward
    •Jaws that don’t fit together
    •Headaches/facial pain
    •Jaws that appear to be mismatched
    •Clicking, popping, or noise
    •Ear ringing
    •Unable to open wide
    •Sudden change in the bite
    •Excessive gum chewing
    •Excessive leaning on the hands to support postures

    Daytime Breathing

    •Audible breathing
    •Predominate mouth breathing during speech, eating and daily activities or
    •When concentrating
    •Large tonsils and adenoids that block the airways

    Sleeping

    •Snoring
    •Noisy breathing
    •Grinding or clenching of the teeth
    •Witnessed apnea (when the child stops breathing)
    •Sweating Recurring nightmares
    •Bedwetting
    •Restless sleep or excessive movement
    •Open mouth posture
    •Hyperextended neck posture
    •Difficulty waking up in the morning
    •Daytime sleepiness or irritability
    •Moodiness and behavior issues
    •Hyperactivity and cognitive problems

  • There has been a high connection to oral habits within children and myofunctional disorders. With myofunctional disorders, children tend to have habits such as digit and object sucking, bruxism (teeth grinding), nail biting, and tongue thrusting. These habits, if continued, will inhibit the teeth from coming into place properly within the child’s mouth. This can lead to overcrowding, crooked teeth, a bad bite pattern and possible facial growth. These habits, if caught and treated properly, can be prevented to help encourage the proper growth of the dental structure.

  • Myofunctional therapy is described as a therapy that helps to improve oral and facial muscle function and tone, to help increase nasal breathing and to improve craniofacial and oral rest postures. Many studies and through extensive research by Stanford, myofunctional therapy is becoming a more prominent way to create a treatment to help breathing issues during sleep, as well as a way to help encourage optimal craniofacial development and prevent orthodontic relapse.

  • Breathing should be carefully monitored while a child is sleeping. It has been found that daytime symptoms can be correlated to the type of sleep the child is receiving. Behavioral issues such as inattention, hyperactivity, anxiety, depression, peer problems and conduct problems have evidence in a study, at the Albert Einstein College of Medicine, showing that this can be related to a sleep disordered breathing problems. Signs that the child may have a breathing problem during sleep are snoring, long pauses between breaths, audible breathing through the mouth, grinding/clenching of sleep, difficulty sleep and dry mouth in the morning. If these symptoms are present, it may be time to investigate further.

  • Breathing is not the only habit to carefully monitor with your child. Any type of habit that can interfere with a child’s relationship with their tongue or oral development can be an issue. While thumbsucking is a normal activity for a child, anytime it becomes a habit that can not be stopped after the age of 4 will create big problems! Thumb sucking, object or digit sucking after the age of 4 can cause muscle tone decrease that can affect chewing, swallowing and dental and craniofacial development.

  • We have mentioned how the structure of the mouth and jaw muscles are so important. But why? Humans are made to chew! Because of the ways we have advanced in processing food has allowed us to process food with less chewing. If you have a salad, how much do you chew before you swallow compared to a peanut butter? Because of our food changes, we have naturally started to adapt to have smaller jaws and airways. This can cause a multitude of breathing issues. Starting a child off with proper chewing techniques creates a foundations of strong jaw muscles allowing better development for the child.

  • Jumping to the mouth, many people are not aware that tongue tied is not just an expression, but a cause to a myofunctional disorder! Being tongue tied in a medical field means that the soft tissue on the underside of the tongue is too tight or attached improperly affecting movement of the tongue. This soft tissue is called the frenum. This is what attaches the tongue to the bottom of the mouth! If the frenulum is too tight, it can cause a restriction causing the tongue to be improperly placed in the mouth which contributes and causes myofunctional disorders. This can be corrected with a frenectomy procedure. The following therapy is generally used to prevent the tongue from healing in the same structure as before the surgery. Think of it as physical therapy for your tongue.

  • While every patients case is different, it is best to contact a qualified professional with an in depth evaluation. Doing your research beforehand can help avoid inaccurate information and frustration. If you have any other questions, concerns, or want to schedule a consultation, please feel free to reach out!

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  • Source: Dr Richard Baxter, Book “Tongue Tied”