Information

Orofacial Myofunctional Therapy (OMT)

What is Orofacial Myofunctional Therapy (OMT)?

•  Orofacial Myofunctional Therapy (OMT) is a neuromuscular re-education program targeting the orofacial muscles to address Orofacial Myofunctional Disorders (OMDs) within the regions of the mouth, face, and neck. This therapy involves a series of personalized exercises.

• OMT plays a crucial role in the prevention, evaluation, diagnosis, and treatment of individuals experiencing Orofacial Myofunctional Disorders (OMDs).

Who can provide OMT? 

• Professionals qualified to provide OMT are part of an interdisciplinary team supporting the stomatognathic system. This team includes speech-language pathologists, otolaryngologists, orthodontists, dentists, dental hygienists, physical therapists, occupational therapists, kinesiotherapists, and other relevant specialists. These professionals must undergo additional training in Orofacial Myofunctional Therapy and adhere to local laws in their respective countries.

Who would benefit from OMT?

• OMT is suitable for individuals of all ages, including infants, toddlers, children, and adults who have experienced Orofacial Myofunctional Disorders (OMDs). 

How long is the OMT for?

•  The duration of Orofacial Myofunctional Therapy varies based on the severity of the case and patient compliance, typically ranging from 6 to 12 months, and in some instances, extending to 18 months.

Mouth breathing

What is mouth breathing?

• Mouth breathing refers to the predominantly oral performance of breathing, wherein the individual either does not use the nose at all or uses it minimally for inhaling and exhaling air.

• Mouth breathing can impact facial structures and functions, influencing mandibular posture, palate width, and various craniofacial growth patterns. 

The common causes of mouth breathing are:

• • Allergies

  • Chronic nasal congestion 

  • Enlarged adenoids or tonsils

  • Habitus: thumb or finger sucking

  • Low tongue posture

  • Respiratory infection

  • Tongue-tied

Signs and symptoms of mouth breathing may present as:

• • Dark circles under the eyes

  • Forward head posture

  • Long face syndrome

  • Open mouth posture

  • Sagging cheeks

  • Snoring

  • Wheezing

How can an OMT help?

• OMT is designed to retrain all the muscles involved in nasal breathing, including the tongue, lips, and cheeks, to function optimally. By addressing the underlying causes of mouth breathing, OMT aims to promote proper nasal breathing and mitigate the associated adverse effects on facial and craniofacial development.

Children whose mouth breathing remains untreated may experience abnormal facial, dental, and neurological development. In many cases, consultation with an otolaryngologist (ENT) or allergist is recommended to address and manage the specific causes of mouth breathing effectively.

Snoring and Obstructive Sleep Apnea

What is snoring and Obstructive Sleep Apnea?

• Snoring is defined as a partial obstruction of the upper airways, causing noise and vibration produced by certain muscles of the mouth and throat during sleep, including the tongue, throat, soft palate, and uvula.

• Due to the constant vibration, the muscles of the mouth and throat may increase in size, width, and thickness, contributing to the potential occurrence of total or partial obstruction of breathing during sleep, known as sleep apnea.

What are the treatments?

• Oral Sleep Appliance: A custom-made dental appliance designed to reposition the lower jaw forward, creating airway space.

• C-PAP/A-PAP: Medical devices that consistently deliver positive air into the nose and mouth to push the tongue and other tissues out of the airway, thus creating airway space.

• Surgeries: In some cases, surgical interventions may be necessary to correct structural problems leading to sleep apnea.

How can an OMT help?

• Snoring and the presence of Obstructive Sleep Apnea are typically addressed by a multidisciplinary team, including a sleep specialist. Within this team, a myofunctional therapist can contribute by directing and performing specific exercises to strengthen the muscles of the mouth and throat, thereby improving oral rest posture.

• Numerous studies have demonstrated that myofunctional therapy can lead to a significant reduction in the apnea-hypopnea index (AHI), with approximately a 50% decrease observed in adults and a 62% decrease in children (refer to studies listed under the Resources tab for more information).

Tongue Thrust

The most common cause of Tongue Thrust is mouth breathing

• The primary cause of Tongue Thrust is often associated with mouth breathing, wherein the tongue tends to rest or move forward and statically exert pressure against the teeth. During swallowing, rather than pushing up to the palate as normal, the tongue may move forward or laterally, leading to anterior, bi-lateral, unilateral, or bi-maxillary tongue thrust patterns, referred to as dynamic thrust. 

• A static tongue rest position that is consistently forward may result in abnormal development of the palate, contributing to restriction. 

The signs and symptoms of Tongue Thrust

• Open bite

• Speech concerns, with difficulty pronouncing "T, D, N, and L," affecting voice quality, clarity, and overall articulation and speech rate.

• Thumb/finger-sucking habits

• TMJ or Facial Pain

How can an OMT help?

• OMT plays a crucial role in helping patients retrain facial muscles and eliminate tongue thrusting habits. By gaining control over muscular habits, OMT can contribute to improved facial muscle coordination and promote a more optimal tongue posture, addressing the root causes of Tongue Thrust.

Normal swallow with liquid - Video

Tongue Thrust Swallow - Video

Ankyloglossia (Tongue-tied)

Ankyloglossia, commonly known as "tongue-tied," is a condition where a small piece of tissue called the lingual frenulum, which connects the tongue to the floor of the mouth, is unusually short or thick. This restricts the tongue's range of motion.

Key points about Ankyloglossia:

• Development: This condition occurs during pregnancy when the tissue that should normally recede before birth remains attached to the base of the tongue.

• Genetic Influence: Ankyloglossia can run in families, so it may be worthwhile to check other family members if an infant is born tongue-tied.

• Impact on Breastfeeding: In infants, being tongue-tied can make it difficult to latch onto the nipple during breastfeeding, causing pain for the mother and an unpleasant feeding experience.

• Impact on Chewing and Speech: As children grow, being tongue-tied can also affect how they chew food and may alter their speech development, potentially leading to difficulties with pronunciation and articulation.

• Treatment: In some cases, a minor surgical procedure called a frenotomy may be necessary to release the tongue, allowing it to move more freely. This can improve breastfeeding, chewing, speech, and other tongue-related functions.

Early diagnosis and intervention are important to prevent potential feeding issues, speech difficulties, and other complications.

How to assess Tongue mobility?

 To assess tongue mobility, various measurements can be employed, including:

• Kotlow Free Tongue Measurement: Determining how far the tongue can extend.

• TRMR TIP - Tongue to Incisive Papilla: Assessing mouth opening when the tongue tip touches the incisive papilla (located just behind the upper front teeth).

• TRAMP LPS - Lingual Palatal Suction: Evaluating mouth opening when the entire tongue is suctioned to the roof of the mouth.

• Intra and extra-oral compensations: Examining whether the floor of the mouth elevates during the previous assessments, and if there are any contributions from neck or facial muscles.

• Tension: Identifying tension in the lingual frenum, neck muscles, or facial muscles.

How can an OMT help?

• Orofacial Myofunctional Therapy (OMT) plays a crucial role in addressing ankyloglossia and enhancing overall tongue function. By employing targeted exercises and interventions, OMT can effectively alleviate restrictions, promote proper tongue mobility, and contribute to improved orofacial health. Professional assessment and tailored OMT interventions are key components of managing and addressing ankyloglossia-related concerns.

Thumb Sucking and Pacifier Overuse

TMJ Disorders

What is Temporomandibular Disorders (TMD)?

• Temporomandibular Disorders (TMD) encompass conditions affecting the jaw muscles, temporomandibular joints, and the nerves associated with persistent facial pain.

What causes TMD?

• TMD can be attributed to various factors, including changes in dental occlusion (such as tooth loss, wear, or ill-fitting dentures), unilateral chewing, mouth breathing, lesions from trauma or TMJ degeneration, muscle strains induced by psychological factors like stress and anxiety, and poor habits like nail biting, resting a hand on the chin, or teeth grinding during sleep. Additionally, forward head posture resulting from low tongue posture can contribute to TMD.

What are the main signs and symptoms of TMD?

• Common signs and symptoms of TMD include pain around the temporomandibular joint (TMJ), which may radiate to the head and neck, earache, tinnitus, ear fullness, sounds during mouth opening and closing (such as popping, clicking, or other noises in the TMJ), and pain or difficulties when opening and closing the mouth, moving the jaw, or chewing.

How can an OMT help?

• OMT plays a vital role in restoring the muscles and joints to their normal function by addressing proper tongue posture and a correct swallowing pattern. The treatment of TMD typically involves a multidisciplinary approach, with collaboration among various professionals such as TMJ specialists, physical therapists, massage therapists, dentists, and more. Chronic pain often results from a combination of the aforementioned issues.

For further insights into the relationship between TMJ problems and breathing, refer to the YouTube video provided.