Do I Need Orofacial Myofunctional Therapy?

Have you ever wondered whether your child's picky eating, crowded teeth, or mouth breathing are connected? Or perhaps you're an adult dealing with sleep apnea, teeth grinding, or ongoing breathing concerns and still searching for answers.

You might be surprised by how interconnected these issues can be.

As a speech-language pathologist (SLP) and orofacial myofunctional therapist (OMT), I assess how the tongue, lips, jaw, palate, and breathing patterns function together. I often see children and adults who have been dealing with symptoms for years without realizing that an orofacial myofunctional disorder (OMD) may be part of the picture.

So, do you need OMT? Not everyone with these signs needs therapy, but recognizing them can be an important first step.

What Is Orofacial Myofunctional Therapy?

Orofacial myofunctional therapy addresses the function and coordination of the muscles of the face, mouth, and tongue.

These muscles play a role in:

• Breathing and oral rest posture

• Tongue mobility and coordination

• Chewing and swallowing

• Speech and articulation

• Oral habits, such as persistent thumb-sucking or tongue thrusting

  
  

Ideally, the tongue rests comfortably against the palate, the lips are gently closed at rest when appropriate, and nasal breathing is possible when the airway is clear.

When these patterns aren't developing or functioning as expected, an assessment can help determine why and whether therapy may be beneficial.

OMT is not a standalone treatment for every airway, sleep, feeding, or dental concern. Medical, dental, orthodontic, or surgical care may also be necessary, depending on the individual's needs.

Why Are Breathing, Sleep, Eating, and Dental Development Connected?

One of the biggest misconceptions I encounter is that these concerns are unrelated.

A child might have crowded teeth, mouth breathing, and picky eating. An adult might experience teeth grinding and poor sleep alongside difficulties with tongue mobility or oral rest posture.

The tongue, lips, jaw, palate, and airway are closely related anatomically and functionally. For example, a high, narrow palate may occur alongside dental crowding and airway concerns.

Restricted tongue mobility may make it difficult to elevate the tongue or maintain tongue-to-palate contact. Nasal congestion may contribute to mouth breathing, making appropriate oral rest posture more difficult.

These relationships don't mean that one problem automatically causes another. They do mean that when several concerns occur together, it's worth considering the bigger picture.

I wish more people knew about these connections sooner. I've seen children reach their preteen years with multiple concerns already established, potentially requiring more involved and expensive orthodontic treatment. I've also seen adults searching for answers after years of symptoms and a sleep apnea diagnosis.

Early assessment cannot guarantee that future problems will be prevented, but it can help identify concerns and clarify appropriate next steps.

Signs Your Child May Benefit From an OMT Assessment

1. Mouth Breathing or Sleep Concerns

Does your child regularly breathe through their mouth, snore, sleep restlessly, wake frequently, or seem tired despite spending enough time in bed?

Other signs worth investigating include observed pauses in breathing, waking with a dry mouth, bed-wetting alongside other sleep concerns, and daytime fatigue or inattention.

These symptoms can have many causes. Persistent snoring, mouth breathing, or suspected sleep-disordered breathing should be discussed with an appropriate medical provider. An OMT assessment can complement this process by evaluating oral function, but it cannot diagnose sleep apnea or resolve an obstructed airway on its own.

2. A High, Narrow Palate or Crowded Teeth

If your dentist or orthodontist has identified a high, narrow palate, crowded teeth, or bite concerns, it may be worth looking at oral function, particularly if your child also mouth-breathes or struggles with tongue posture.

The tongue normally rests against the palate. If your child cannot comfortably achieve this position, an assessment can help determine whether tongue mobility, available space, breathing difficulties, or other factors may be contributing.

OMT does not widen the palate or straighten teeth. Orthodontic assessment may be needed alongside functional therapy.

3. Tongue-Tie or Restricted Tongue Mobility

Not every tongue-tie causes functional difficulties or requires release. What matters is how the tongue moves and functions.

Restricted mobility may affect tongue elevation, oral rest posture, swallowing, or particular speech movements.

An assessment can help determine whether therapy is appropriate and whether a tongue-tie release should be considered with the relevant healthcare providers. When a release is planned, I generally prefer to work on functional readiness beforehand when possible, followed by post-release therapy as indicated. Releasing the tissue doesn't automatically establish new movement patterns.

4. Picky Eating, Chewing Difficulties, or Speech Concerns

Picky eating can have many causes, including sensory preferences, developmental differences, and previous feeding experiences. However, some children also have difficulty chewing, moving food around their mouths, managing textures, or coordinating their tongue movements.

An oversensitive gag reflex or difficulty with particular speech sounds may also warrant further investigation.

As an SLP, I consider whether oral structure and function may be contributing to speech difficulties. OMT may be appropriate for identified functional concerns, but it isn't a replacement for speech therapy or specialized feeding and swallowing care when those services are needed.

Persistent thumb-sucking, finger-sucking, and tongue-thrusting patterns may also be worth discussing, particularly when they occur alongside other oral-function or dental concerns.

Signs Adults May Benefit From an OMT Assessment

Adults sometimes assume they simply have to live with their breathing, sleep, or oral-function difficulties. Others have seen several professionals but still wonder whether something has been overlooked.

An assessment may be worth considering if you have:

• Sleep apnea, snoring, or poor sleep: OMT may be an adjunct to appropriate sleep apnea treatment in selected cases. It does not replace prescribed treatment such as CPAP or medical follow-up.

• Teeth grinding, jaw concerns, or dental crowding: These issues have multiple possible causes. An assessment can identify whether oral rest posture or tongue function may also be relevant.

• A history of tongue-tie or release: You may still have difficulty with tongue elevation, tongue-to-palate contact, or coordinated movement after a release.

• Persistent mouth breathing or poor oral rest posture: Nasal obstruction and other airway concerns should be investigated before assuming mouth breathing is simply a habit.

OMT is not the answer to every symptom. The goal is to determine whether functional concerns are present and whether therapy could be a useful part of your overall care.

A Real-Life Example: Looking at the Bigger Picture

One of my five-year-old clients had a tongue-tie, a high, narrow palate, sleep-disordered breathing, inattention, low impulse control, and significant picky eating.

His treatment journey involved palate expansion to create more room for his tongue, followed by myofunctional therapy before and after his tongue-tie release.

Over time, his tongue developed the ability to rest comfortably against his palate without effort. His tongue mobility and function improved, his family noticed improvements in both the quality and quantity of his sleep, and his previously restrictive eating habits resolved.

This was a meaningful change for the child and his family. It also reinforced why I believe it's important to consider oral structure and function alongside other concerns rather than treating every symptom in isolation.

Of course, this is one child's experience. It doesn't prove that a tongue-tie caused his sleep or attention concerns, nor does it guarantee similar results for other children. It demonstrates the value of identifying individual needs and coordinating appropriate care.

Does Everyone With These Signs Need OMT?

No. Crowded teeth don't automatically indicate an OMD. Picky eating doesn't necessarily mean there is a tongue-tie, and not everyone with sleep apnea needs myofunctional therapy.

These signs are reasons to consider further investigation, not a diagnosis.

During an assessment, I look at tongue mobility, oral rest posture, breathing patterns, chewing and swallowing function, relevant speech concerns, oral habits, and medical and dental history.

The findings help determine whether OMT is appropriate, whether collaboration with other professionals is needed, or whether another service would be a better fit.

Sometimes therapy is recommended. Sometimes another provider needs to investigate a concern first. All of these outcomes can be valuable.

Not Sure Whether You or Your Child Needs OMT?

I wish more parents and adults knew what to look for before concerns became more entrenched. You don't need to arrive with a diagnosis or know exactly what's wrong before asking questions.

If your child has several of the signs discussed here, or you're an adult navigating sleep, breathing, or oral-function concerns, an assessment may help clarify whether OMT could be beneficial. You can explore my orofacial myofunctional therapy services offered virtually and in person throughout British Columbia.

I offer a free introductory phone call through Rossland Speech Therapy so we can discuss your concerns and determine whether my services may be a good fit. There's no pressure to book therapy if it's not what you need.

You can learn more or get in touch at Rossland Speech Therapy.

Sometimes the first step toward finding answers is simply recognizing the signs and knowing whom to ask.