Orofacial myofunctional therapy is useful in treating the causes and symptoms of a wide variety of health issues, like narrow airways headaches, temporomandibular joint disorders (TMD) and eating difficulties. The therapy includes facial and tongue exercises and behavior modification techniques to promote proper tongue position at rest, improved breathing, chewing and swallowing. Proper head and neck postures are also addressed. There is a lot of evidence that OMFT may contribute to resolve TMD problems and to prevent orthodontic relapse.
The functioning of muscles
Under normal physiological circumstances there is a strict balance between the functions of the intra- and extra-oral muscles, such as Mm. Orbicularis oris, Mm. Masseter, Mm. Buccinator and the intrinsic and extrinsic muscles of the tongue. The masticatory muscles, the tongue, the lips, the opening and closing muscles of the mandible; they all have their own functional forces onto the dentition. If some muscles do not function appropriately, this will mostly have direct consequences for the anatomical form of the dentition and the jaws. As a side effect we often see a disturbed articulation such as a lisp (sigmatism).
If there is just a deviate articulation, under normal circumstances regular speech therapy could solve the problem. But if we have a functional problem in such a way that the jaws, the teeth, the masticatory muscles and sometimes the TMJ are involved in the problem, classical speech therapy cannot reach a long lasting result. Since the cause of the problem, the muscular imbalance is not treated.
Goal for a speech pathologist, specialized in OMFT
Oromyofunctional therapy aims to bring all intra- and extra-oral muscles in harmony by training the involved muscles and to get rid of the wrong habits. So the therapy deals with the cause of functional problems and not only with the effect or result of muscular disharmony. After having created a oral muscular harmony, other therapies, such as articulation training, orthodontics or a surgical correction of the jaws will have a stable result.
Indications for OMFT
Generally spoken we can say that bad oral habits may cause many dental, orthodontic and speech disturbances. If you can recognize and treat these bad habits, you can prevent a lot of trouble for your patient, in terms of relapse of the deviate form and reduction of treatment time for orthodontics.
A non-physiological function of the tongue can have great consequences for the way a person grinds his food, shapes it to a ball and swallows it. The deviate swallow mostly goes together with a tongue thrust forwards and/or lateral. The consequence is almost always a change of the position of the teeth and/or the molars as well as a different shape of the jaws. There, where the tongue acts like an interference between the teeth, the upper and lower teeth cannot reach each other and we will see an anterior open bite together with a lisp. When the sounds are created laterally we often see a lateral open bite. Such open bites can possibly be closed by orthodontic treatment and the teeth can be perfectly aligned. But very often (in 26 – 38 % of the cases) after some time we see a relapse of the anterior or lateral open bite, because the cause of the open bite, in the case the deviate swallow and/or the abnormal rest position of the tongue, is not changed.
The nose has the function to moist, warm and clean the air that is inhaled. This good function is neglected when there is mouth breathing. The consequence can be: multiple infections in the throat, of the tonsils or ever recurring inflammations of the middle ear. With mouth breathing we often see that, because of the lack of pressure of the lips against the teeth, the front teeth will move forward. We also very often see a narrow gothic palate because the lateral pressure of the tongue against the lateral processus is missing.
Thumb sucking and long lasting pacifier abuse
It is well known that intensive thumb- or fingersucking gives a change of the position of the teeth and/or the jaws.
Wrong resting position of the tongue
The deviate function of the intra and extra oral muscles while swallowing is one thing, but the resting position of the tongue is even more important than the first one. If you have a wrong position of the tongue at rest, most of the time the tongue lies down in the oral cavity. You will have a remarkable change of the shape of the upper dental arch, the shape of the palate, the way you breath and the way your posture of the head and the body will mutate. Because the tongue lies at the bottom of the mouth, you will develop a very narrow, gothic, palate, with less space for the teeth. Crowding of the upper teeth will be the result. You will have mouth breathing instead of nose breathing, with all its consequences. In most cases the position of your head will be more in a forward position and quite often you will get a curved spine, hyperlordosis and hyperkyphosis. Changing the resting position of the tongue is one of the most important goals in myofunctional therapy, because it will completely change the development of the face and the occurrence of dental malocclusions.
All these wrong habits cause a disturbance of the balance between the intra- and extra-oral muscles (lips. masticatory muscles, tongue and its muscles). So the shape of the jaws (and the position of teeth and molars) will adapt to the deviate forces created due to the improper muscle-balance. In other words: the (in this case wrong) function of the muscles results in a (in this case wrong) shape of the jaws and/or a wrong position of the teeth. If we want to change the created form, we have to start changing the function of the involved muscles. That is what we call oromyofunctional therapy.