Orofacial Myology

    What is Orofacial Myology?

"The study and treatment of oral and facial muscles as they relate to speech, dentition, chewing/bolus collection, swallowing and overall mental and physical health" -Sandra Holtzman, 2014

Orofacial Myology Disorders (OMD's) are the abnormal resting postures and functions of the oral and facial muscles. "Myo" means "of muscle" or "relating to muscles". As Orofacial Myologists, our focus is the muscles of the tongue, lips, jaw and face. While Orofacial Myology is a multi-faceted therapy, the main focus is to help the patient achieve and habituate a desirable resting posture of the tongue, lips and jaw.

    What Are Orofacial Myology Disorders?

Tongue Thrust
A properly moving tongue moves vertically against the roof of the mouth while swallowing. When the tongue moves forward, between or against the sides of the teeth, it can contribute to improper orofacial development and misalignment of the teeth.

Incorrect Resting Posture
A tongue that rest against the front, sides or between the teeth does not support proper orofacial development. Research has shown that light, constant pressure of the tongue resting against the teeth is more influential in malocclusions (for example, open bite) than an incorrect swallowing pattern (tongue thrust). Consistent pressure of the tongue against the teeth at rest can slow orthodontic treatment and reverse the changes made with orthodontics.

Non-Nutritive Sucking Habits
Constant, prolonged sucking of one's thumb, fingers, pacifiers, clothing or other non-nutritive items places the tongue and lips in an undesirable position. While sucking, the tongue rests under the inserted object and forward against the teeth while the lips and jaw remain open. This creates the perfect environment for a tongue thrust swallowing pattern to develop. These habits can also contribute to a high, narrow palatal vault or cross bite.

Tongue Tie or Ankyloglossia
"Tongue tie is restricted tongue mobility as a result of a short and/or tight lingual frenulum" (A. K. Hazelbaker, 2010). A tongue tie can cause a tongue thrust. Restricted tongue mobility can negatively impact sucking, eating and clearing food from the teeth to prepare to swallow. It can also impede one's ability to achieve a desirable resting posture with the tongue against the palate. Restricted lingual frenulum can be a precursor to disordered speech, feeding or dentition. If a tongue tie is suspected, an Orofacial Myologist will refer the patient to a dentist, ENT or oral surgeon for release of the restricted frenulum with post-operative therapy to follow.

Enlarged Adenoids or Tonsils
When adenoids or tonsils are enlarged or infected they can cause the tongue to compete for "freeway space" in the oral cavity. The tongue assumes a low, forward posture with the lips and jaw open, creating an improper rest position. Mouth breathing can occur. Tongue thrust can develop. If enlarged adenoids or tonsils are suspected, the Orofacial Myologist will refer the patient to an ENT for evaluation. Once the condition is resolved, therapy can be effective in eliminating the tongue thrust or improper rest position that may have occurred.

Who should see an Orofacial Myologist?
A child or adult exhibiting one or more of the following symptoms may benefit from the expertise of an orofacial myologist:
* Oral habits such as thumb or finger sucking, extended pacifier use, fingernail or lip biting
* Open-mouth, lips-apart posture
* Low, forward tongue resting posture
* Thrusting of the tongue in speaking and swallowing
* Excessive mouth breathing
* Tongue protrusion against or past the front teeth upon production of the following sounds: s, z, t, d, n, l, sh, j
* Noisy or messy chewing and swallowing
* Diastema or improper spacing between teeth
* Drooling
Why is Orofacial Myology Important?
Orofacial Myology disorders can negatively impact one's appearance, speech intelligibility, swallowing, dentition and oral health. Over time, these abnormal oral patterns can impede one’s ability to maintain a correct oral rest posture. Incorrect positioning of the tongue at rest may contribute to improper orofacial development and malalignment of the teeth. In addition, speech patterns may become imprecise or misarticulated due to the incorrect habitual resting posture of the jaw, lips and tongue.

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