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Orofacial Myotherapy

Karen Samuel, RDH, COM is a Certified Orofacial Myologist with over thirty years experience in clinical dental practice and has been a clinical dental hygiene instructor. She received her training in orofacial myology from the Coulson Institute of Orofacial Myology in Denver, CO and at the University
Of Southern California Davisson Center in Los Angeles. Karen is an active member of the International Association of Orofacial Myology, the American Dental Hygiene Association, the Texas Dental Hygiene Association and the Greater Fort Worth Dental Hygiene Society. She regularly attends and teaches continuing Education courses in both the dental and orofacial myology fields. She currently serves as Education Chair for the International Association of Orofacial Myology. Our website is www.northtexasorofacialmyology.com if you want to link to it.
(It is still underconstruction but has some info up.)

A Parents Guide to Myofunctional Therapy
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What is Orofacial Myofunctional Therapy?


The prefix "myo" stands for muscle. Orofacial Myofunctional Disorders (OMD) is often commonly referred to as "tongue thrust" because the tongue functions against or between the front or side teeth during swallowing rathering than lifting up into the palate (roof of the mouth). This disorder is generally accompanied by inappropriate function of the muscles of the tongue, lips, jaw, and face. There is frequently a low forward resting posture of the tongue and open lips. The basic problem is related to abnormal orofacial functions and postures. Just as the controlled forces of orthodontic appliances (braces) can move teeth, the abnormal functions and postures related to OMD can influence the development of dental malocclusion (incorrectly positioned teeth, an improper bite relationship between the teeth in the upper and lower arches, or a malformation of the bone of the dental arches).


tongue thrust swallow


During the act of swallowing, the tongue is thrust against and/or between the teeth. This is called a tongue thrust swallow. This child is holding a temporary cheek expander to reveal the teeth for the photo.


Why Be Concerned?


Orthodontists have been concerned about OMD since the early 1900's because the abnormal functions and postures of OMD can adversely influence dental growth, slow orthodontic treatment and can undermine the stability of the correction resulting in relapse.


Habitual open-lip resting posture (lip incompetence), which is common among individuals with OMD, removes the beneficial influence that closed-lips have on the development and maintenance of good dental arch form and can have a negative influence on eruption and drifting patterns of teeth.


open-lip resting posture


Research has revealed a high incidence of speech problems in those individules who exhibit OMD. The /s/ sound is the most common, others are /z/,/sh/, /ch/,/j/, /t/, /n/ and /r/. When there is a combination of OMD and related speech errors, it is often difficult to correct the speech problems through traditional speech therapy alone.


Individuals who exhibit OMD frequently have poor eating/chewing function and appearance in that they chew their food with lips open and often swallow foods whole because of inadequte chewing function.


What Causes an Orofacial Myofunctional Disorder?


All babies are born with a low forward (tongue thrust) swallowing pattern. With normal growth and development, the tongue begins to lift up into and against the palate (roof of the mouth), which is designed to absorb this pressure. Anything that adversely influences normal development of the dental arches or positions of the teeth can result in OMD because the oral and facial muscles must adapt to the oral structures to maintain a functional relationship. The adaptation can then contribute to making the dental and speech problems worse. Often, it is a combination of factors such as:


• Improper oral habits: such as prolonged thumb or finger sucking, cheek/nail biting, tooth clenching/grinding.
• Restricted nasal airway: due to enlarged tonsils/adeniods, allergies, sinusitis or a deviated septum, which promotes habitual open-lip posture.
• Structural or functional abnormalities such as a short linqual frenum (tongue-tie).
• Neurological or developmental abnormalities.
• Hereditary predisposition to some of the above factors.


How Prevalent Are Orofacial Myofunctional Disorders?


Recent research examining various populations found 38% to have orofacial myofunctional disorders and an incidence of 81% has been found in children exhibiting speech/articulation problems. (Kellum,1992;Maul et.al.1999).


What is Orofacial Myofunctional Therapy?


Therapy involves an individualized regimen of therapeutic oral and facial muscle exercises to develop correct chewing and swallowing patterns as well as tongue and lip resting postures. Many therapists also provide motivational therapy to eliminate harmful oral habits such as:


• Prolonged pacifier, thumb or finger sucking
• Fingernail, Cheek or lip biting, tongue sucking and clenching/grinding of teeth.


Who should Treat?


The International Association of Orofacial Myology (IAOM) is a professional organization that can help identify professionals in your area who have the appropriate and/or are certified to provide this specialized treatment. The IAOM founded in 1972, is a non profit organization that provides continuing education or approves additional training programs for professionals including speech pathologists, dentists, dental hygienists, and other allied health professionals who wish to evaluate and/or provide orofacial myofunctional therapy. The IAOM is the only international professional accrediting organization of this therapeutic specialty. Those members who have the additional training and successfully pass a written and clinical proficiency examination can become Certified Orofacial Myologists.


At What Age Can Therapy Begin?


There are several factors to consider before orofacial myofunctional therapy can begin. Most important is the patient's motivation to work with the therapist to succeed. Seeing an Orofacial Myologist early can reduce or minimize the structural damage and possibly reduce some speech articulation (pronunciation) problems.


Children as young as four can benefit from an in-office evaluation to determine if there are some causative factors that require early intervention to promote normal development. Age five, when intellectual and emotional skills are adequately developed, is an ideal age to begin treatment to help children discontinue thumb or finger sucking habits. With early elimination of these habits, there is often spontaneous improvement and/or correction of dental,speech and OMD problems.Children of seven or eight years of age are aften mature enough to receive complete training and teenagers and adults can also benefit from Orofacial Myofunctional Therapy.


Before and After thumb-sucking therapy



cheek expander




This child is holding a temporary cheek expander to reveal the teeth for the photo


How Effective is Orofacial Myofunctional Therapy?


Orofacial Myofunctional Therapy has helped literally thousands of individuals, in dozens of countries, for over 30 years. Numerous studies have demonstrated its effectiveness including a recent study done by Hahn &Hahn (1992), which revealed that treatment for orofacial myofunctional disorders can be 80-90% effective in correcting swallowing and rest posture function and that these corrections are retained years after completing therapy. Numerous studies have also demonstrated the efficacy of orofacial myofunctional therapy in facilitating speech therapy.


There are many factors that contribute to the success of the therapy program. It is truly a team effort. Effective communication and cooperation between therapist and the dental and medical communities is essential. In addition, successful orofacial myofunctional therapy depends on the patient's desire, dedicated cooperation and self-discipline to follow-through with therapy assignments. Parental involvement and encouragement are also important and necessary for children undergoing therapy to ensure optimum results.


If you are concerned that your child may have an oral facial myofunctional disorder or other harmful oral habit such as a prolonged thumb or finger sucking, click the directory link below to find an orofacial myologist in your area.


If you are concerned that your child may have an oral facial myofunctional disorder or other harmful oral habit such as a prolonged thumb or finger sucking, click the directory link below to find an orofacial myologist in your area.

 
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