What Is Myofunctional Therapy?

Are you curious about what myofunctional therapy is and if you child would benefit from it? Well you are in the right place! But first let’s discuss orofacial development, what myofunctional disorders are, red flags and then we can dive in to what it is.

Orofacial Development

Orofacial development in babies and toddlers encompasses the growth and maturation of structures related to the mouth and face during the early years of life. This period is critical for the establishment of functions such as breathing, feeding, swallowing, speech, and facial expression. We at Fx Therapies are certified in treating all of these functions. Parents and caregivers can support healthy development by providing a nurturing environment, encouraging exploration and play, and maintaining good oral hygiene practices.

Let’s talk about some major processes to be aware of:

• Facial Development: During the first three years of life, the brain achieves approximately 90% of its growth and the face reaches almost 65% of its adult size.

• Dental Development: Between birth and three years of age the oral cavity changes form and function, replacing gum pads with a dentition composed of twenty primary teeth. By three years of age, all succedaneous teeth are developing as well as the first permanent molars.

  • Any noxious oral habits (including prolonged pacifier use, thumb sucking, digit sucking, tongue sucking, sippy cup use, etc) still occurring can impact the way in which their teeth, palate, jaw develop.

• Breathing Habits: Humans are considered to be obligate nasal breathers. Babies are born breathing through their mouth with their tongues suctioned to the roof of their mouth. Here is a cool video showing you this.

  • When constrained to breathe through their mouth in response to obstructed or closed nasal passages, the effects are pervasive and profound, and sometimes last into adulthood.

• Feeding Development: If you read our blog post “Feeding Development” you learned that by 3 years of age our oral motor skills for feeding are the motor skills we will have as adults. To learn more about the development of feeding skills you can find that blog post here “Feeding Development”. If you have any questions with what your child ‘should’ be doing at their age it will be able to help answer “what” is to be expected.

  • Anything that can impact the jaw, lips, cheeks, tongue from developing may lead to feeding difficulties.

• Speech Development: If you read our blog post “Speech Development” you will have also learned that by 5 years of age all speech sounds are ‘typically’ mastered. To learn more about the development of speech skills you can find that blog post here “Speech Development” . If you have any questions with what sounds your child ‘should’ be doing at their age it will be able to help answer “what” is to be expected.

  • Anything that can impact the jaw, lips, cheeks, tongue from developing may lead to speech difficulties.

All of these milestones are a ‘general’ rule of thumb and should be interpreted with caution as all children develop differently! However, we want to prevent any dysfunction from occurring educating you to what to look out for and potential risks that can interrupt these processes from optimally developing.

What Is A Myofunctional Disorder?

Now let’s dive in! Orofacial Myofunctional Disorders (OMDs) are patterns involving orofacial musculature that interfere with normal growth, development, or function of orofacial (mouth and face) structures, or call attention to themselves. It involves the disruption of the stomatognathic system primarily related to chewing, breathing and swallowing.

Causes

There is not a known, single cause of OMDs but may be caused by several factors:

• Blocked nasal passages due to tonsil size or allergies. When the nasal passages are blocked, people may need to breathe through their mouths instead.

• Anything that causes the tongue to be misplaced at rest or makes it difficult to keep the lips together at rest.

• Sucking and chewing/swallowing habits past age appropriate timelines (pacifiers, thumb sucking, etc).

Red Flags/Signs + Symptoms:

If your child demonstrates any of these signs and symptoms you may want to consider receiving a myofunctional evaluation to see if they would benefit from therapy!

• A child who breathes through the mouth or has difficulty breathing through the nose.

• Open mouth posture

• The tongue pushing past the teeth (anterior or lateral), even when a person is not talking or using the tongue

• Limited tongue movement or range of motion.

• Tongue tie, lip tie, cheek tie

• Atypical swallow

• Eating may be messy or difficult beyond age appropriate timelines.

• An overbite, underbite, and/or other dental problems (malocclusion)

• Narrow high vaulted palate

• Difficulty saying some sounds, like "s" in "sun," "sh" in "ship," or "j" in "jump."

• Drooling, especially beyond age 2.

• Difficulty closing the lips to swallow.

• Noxious oral habits (tongue, lip, pacifier, thumb, nail biting, lip licking, cheek biting, pencil biting, etc)

• Facial compensation to swallow (cheek, lip, neck, face grimacing)

• Enlarged tonsils / adenoids observed by doctor

• TMD

• Sleep disorders

• Grinding/clenching

• Low tongue resting posture

• Snoring

• Cavities gum disease

• Allergic shiners

• Ear Infections

• Infant feeding problems

• Forward head posture

Why Do We Treat?

The primary purpose of myofunctional therapy is to create an oral environment in which normal processes of orofacial and dental growth and development can take place, and be maintained.

What is Myofunctional Therapy?

Myofunctional Therapy treats the UNDERLYING orofacial myofunctional disorders of chewing, breathing and swallowing.

Myofunctional therapy focuses on using exercises/tools to:

• Promoting nasal breathing for optimal breathing and facial development

• Preventing tongue thrust at rest which can lead to dental, speech and swallowing difficulties

• Promoting lip seal for optimal facial development

• Identify and address restricted tongue, lip, cheek ties to prevent breathing, swallowing and speech difficulties

• Combination of speech & myofunctional therapy identify and target significant speech problems (developmental vs. hidden cause) in order to improve functional communication

So What Does Myofunctional Therapy Look Like?

1. Assessment and Evaluation: The first step in myofunctional therapy is typically an assessment by a certified myofunctional therapist to identify the individual's strengths, weaknesses, and orofacial myofunctional goals. The SLP will conduct various tests and observations to assess speech, breathing and swallowing abilities.

2. Goal Setting: Based on the assessment findings, the myofunctional therapist will develop personalized treatment goals in collaboration with the individual and their caregivers. These goals may target specific areas such as improving breathing, swallowing/chewing and speech habits.

   TREATMENT ALWAYS TARGETS THESE AREAS IN THIS ORDER: 1) Breathing 2) Suck/Swallow 3) Chew and 4) Speech.

3. Therapeutic Techniques and Activities: Myofunctional therapy sessions may involve a variety of therapeutic techniques and activities tailored to address the individual's needs. These may include:

   • Nasal Breathing Exercises

   • Tongue Thrust Remediation Exercises

   • Lip Seal Exercises

   • Pre/Post Op Care for Tethered Oral Tissues (tongue tie, lip ties, cheek ties) / Tongue Tie Release / Frenectomy

   • Oral Habit Elimination Programs (decreasing pacifier use or thumb sucking)

   • Combination of Myofunctional Therapy and Speech Therapy to correct speech errors.

4. Home Practice: Individuals will be given homework assignments or activities to practice between therapy sessions. Consistent practice outside of therapy can help reinforce skills and accelerate progress!

5. Progress Monitoring: Throughout the course of therapy, the myofunctional therapist will regularly assess the individual's progress towards their goals and make adjustments to the treatment plan as needed.

6. Collaboration and Support: Myofunctional therapy often involves collaboration with other professionals, such as dentists, orthodontists, sleep physicians, ENTs, primary care doctors, OT, PTs, chiropractors, etc. to provide comprehensive care and support. Family members and caregivers may also be involved in therapy sessions to learn strategies for supporting the individual's myofunctional development.

Overall, myofunctional therapy is highly individualized and aims to address the unique orofacial myofunitonal needs and challenges of each person receiving treatment. Sessions are conducted in a supportive and engaging environment to facilitate learning and progress.

So There You Have It!

Please let us know if you have any questions.

If you would like to set up a free consultation, an evaluation or mentoring you can connect with us here!

• References

  American Speech-Language-Hearing Association. (n.d.). Orofacial Myofunctional Disorders. (Practice Portal). Retrieved Nov, 11th, 2023, from www.asha.org/Practice-Portal/Clinical-Topics/Orofacial-Myofunctional-Disorders/.

  American Speech-Language-Hearing Association (n.d.) Speech Sound Disorders: Articulation and Phonology. (Practice Portal). Retrieved March, 24, 2022, from www.asha.org/Practice-Portal/Clinical-Topics/Articulation-and-Phonology/.

  Bernthal, J.E., Bankson, N.W., & Flipsen Jr, P. (2017). Articulation and Phonological Disorders Speech Sound Disorders in Children. New Jersey: Pearson Education

  Bonuck K, et al. "Sleep-disordered breathing in a population-based cohort: Behavioral outcomes at 4 and 7 years" Pediatrics 2012; 129: 1–9.

  Ranly DM. Early orofacial development. J Clin Pediatr Dent. 1998 Summer;22(4):267-75. PMID: 9796494.

  Sleep Wrecked Kids, Sharon Moore, 2018, McPhersons Printing

  Trabalon, M., & Schaal, B. (2012). It takes a mouth to eat and a nose to breathe: abnormal oral respiration affects neonates' oral competence and systemic adaptation. International journal of pediatrics, 2012, 207605. https://doi.org/10.1155/2012/207605