What are Orofacial Myofunctional Disorders (OMDs)?
On May 2014, the Speech and Hearing BC association posted on its website about "Tongue Thrust/Oral Myofunctional Disorder". It described how children's tongues develop from an immature swallow (also called a "tongue thrust" where the tongue touches the back of the teeth during a swallow) to a mature swallow (the tongue tip touches behind the upper or lower teeth during a swallow). There can be many reasons why this immature swallow pattern continues, for example: tongue and/or lip ties, enlarged tonsils/adenoids and obstructed airways and nasal passages. Thumb-sucking and pacifier use are also implicated in how these OMDs present and persist. Articulation of speech sounds, dental structures including teeth and palate, chewing/eating behaviors and overall facial appearance are also impacted as children develop and grow using these incorrect muscle patterns.
The picture below represents the roof of your mouth. The tip of your tongue is supposed to touch the X in this picture when you swallow and when it's at rest and the back part of your tongue should be lightly suctioned to the roof of your mouth. What does your tongue do?
OMDs can also cause Sleep-Disordered Breathing
Sleep-disordered breathing (SDB) encompasses conditions such as snoring, obstructive sleep apnea (OSA), and central sleep apnea (CSA) (Mohammadieh et al., 2017).
Orofacial myofunctional disorders (OMDs), including symptoms like mouth breathing, snoring, and teeth grinding, are often linked to factors like enlarged tonsils, allergies, or tongue ties. These issues can affect sleep quality.
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Orofacial myofunctional therapy (OMT) has been shown to be an effective treatment for improving symptoms of obstructive sleep apnea (OSA), particularly in mild to moderate cases. Studies have demonstrated that OMT strengthens and tones the muscles of the oropharynx and surrounding areas, which helps reduce airway collapsibility during sleep. This muscle strengthening is crucial for improving nasal breathing, repositioning the tongue, and reducing snoring and apneic events.
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Research, such as that conducted by Guimaraes et al. (2009), found that oropharyngeal exercises significantly reduced the apnea-hypopnea index (AHI) in patients with moderate sleep apnea. Similarly, Camacho et al. (2015) conducted a meta-analysis which concluded that OMT can improve snoring and reduce AHI, making it a complementary treatment alongside CPAP or surgery. If you or someone you know experiences symptoms of Sleep-Disordered Breathing, please contact me for an assessment.
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See below more information on Pediatric Sleep-Disordered Breathing.
Signs of Pediatric Sleep-Disordered Breathing include:
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Regular Mouth breathing (day or night)
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Snoring (at any age)
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Asthma
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Upper respiratory infections
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Ear infections
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Bed-wetting
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Nightmares/terrors
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Apneic episodes
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Headaches/migraines
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Neck, jaw, or ear pain
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Thumb or finger-sucking
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Poor academic performance
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Hyperactivity/aggressive behaviors
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ADHD-like/sensory symptoms
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Clenching/grinding teeth
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Restless sleep, multiple wake-ups
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Daytime sleepiness
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Delayed growth/obesity
Modified from @Kimberly White Speech & Myofunctional Therapy
OMDs can also be related to Oral Habits
What is an Oral Habit?
Oral habits are repetitive patterns of behaviors involving the oral cavity, including finger/thumb-sucking, soother use, lip sucking, tongue thrusting, nail biting, object biting (e.g. clothing, pencils, hair) and bruxism (teeth grinding/clenching), which can all have significant effects on your health¹.
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Many resources say that these habits don't need to be addressed until 5 years of age or later but there is evidence that early intervention can prevent long lasting effects on the size and shape of roof of the mouth (the palate), how the teeth come together (e.g. will your child develop an open bite, a cross bite and an overjet?) and an inappropriate swallowing pattern (i.e. tongue thrust)² ³.
Many orthodontists and/or dentists will offer to install appliances (e.g. tongue crib/rake, a habit appliance) to stop the finger/thumb from coming into the mouth or to prevent the tongue pushing against the teeth. Unfortunately once these appliances are removed, the child will often go back to the habit as the root cause of the habit hasn't been addressed.
Orofacial Myofunctional Therapy (OMT) can assess and address the root causes of these habits and support cessation of the habit with behavioral modification programs and positive reinforcement. For more information, contact me, Kaylene French, below. I am a pediatric Speech-Language Pathologist with training in orofacial myofunctional therapy and feeding.
Modified from: https://www.iaom.com/appliance-use-for-oral-habit-patterns/
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2. Influence of non-orthodontic intervention on digit sucking and consequent anterior open bite: a preliminary study. Boyen Huang, Carla Lejarraga, Christopher S. Franco, Yunlong Kang, Andrew Lee,John Abbott, Katsu Takahashi, Kazuhisa Bessho and Pongthorn Pumtang-on. International Dental Journal. 2015 Oct;65(5):235-41.
3. American Dental Association (ADA). Thumb sucking and pacifier use. The Journal of the American Dental Association. 2007 Aug; 138(8): 1176.
There are numerous podcasts and books available to help you learn more about tethered oral tissues (TOTs) and OMDs. Here are some of my favorites!
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https://podcasts.apple.com/us/podcast/the-tongue-tie-experts-podcast/id1605396014
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https://podcasts.apple.com/us/podcast/health-harmony-beyond-the-teeth/id1557269208T
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Tongue-Tied (book) by Richard Baxter (https://read.amazon.ca/kp/embed asin=B07FC4HZXX&preview=newtab&linkCode=kpe&ref_=cm_sw_r_kb_dp_CD2T6NF926P3TE5B3NAT)
Here are some additional links that will help you to explore and discover more about this area.​