What are Orofacial Myofunctional Disorders (OMDs)?
Do you know anyone who snores, mouth breathes, avoids chewy/crunchy foods, has tension in their neck and jaw, or has difficulty with making speech sounds? They might have an Orofacial Myofunctional Disorder.
OMDs are maladaptive patterns of the orofacial complex that, overtime, can cause symptoms that disrupt breastfeeding, facial skeletal growth and development, chewing, swallowing, speech, occlusion, and temporomandibular joint (TMJ) movement. They can be found in children and adults.
So what are some of the symptoms?
Difficulty saying speech sounds, specifically: /r, l, s, z, sh, ch, t, d, n/, "tsh", and /j/.
Mouth breathing while sleeping or awake.
Waking up often throughout the night.
Teeth grinding.
The tongue thrusting out of the mouth when chewing and swallowing.
Picky eating.
Chronic thumb sucking.
Poor food collection in the mouth before swallowing.
Coughing or gagging when swallowing.
Overbite, underbite, or other dental problems.
Sleep-disordered breathing (i.e. snoring).
TMJ disorder (can be caused or exacerbated by an OMD).
Many of these symptoms can be cooccurring.
Why do they matter?
Correcting these symptoms is important for developing normal dentition, preventing cavities, gut health, breathing, cognition, attention, and sleeping patterns. If there are articulation errors due to an OMD, the errors are not developmental or phonological. The errors are due to poor oral placement and muscle development. A speech therapist who is trained in OMDs will be able to recognize which orofacial muscles need to be addressed alongside traditional articulation therapy.
The most common OMD is limited nasal breathing. Limited nasal breathing can be due to limited tongue strength, tongue tie, or a high arched palate. When a child is primarily mouth breathing, they are not getting enough oxygen for proper long-term cognitive development. It's not uncommon to notice signs of attention-deficit/hyperactivity disorder (ADHD) in children who mouth breathe chronically. Mouth breathing long-term changes the overall appearance of the face and the function of the facial muscles (e.g. jaw, tongue, lips).
What can be done?
If you or someone you know demonstrates symptoms listed above, it's recommended to talk to a functional dentist, ENT, or a speech therapist who has advanced training in Myofunctional therapy. Myofunctional therapy is an exercise-based treatment to increase strength and awareness of the mouth and facial muscles. Therapy is highly individualized for the patient, and may include exercises that normalize jaw movements, lip and tongue posture, and/or strengthening mid-face muscles.
There may be tethered oral tissues (e.g. tongue tie) that limit tongue or lip mobility for speaking, swallowing, and breathing. In this case, a functional dentist or ENT may recommend a frenectomy (i.e. tongue tie release). Treatment for OMDs is often multidisciplinary. Myofunctional therapy is an excellent, research-based, noninvasive method to improving overall structure and function of the orofacial complex.
References:
Homem, M. A., Vieira-Andrade, R. G., Falci, S. G., Ramos-Jorge, M. L., & Marques, L. S. (2014). Effectiveness of orofacial myofunctional therapy in orthodontic patients: a systematic review. Dental press journal of orthodontics, 19(4), 94–99. https://doi.org/10.1590/2176-9451.19.4.094-099.oar
Carrasco-Llatas, M., O'Connor-Reina, C., & Calvo-Henríquez, C. (2021). The Role of Myofunctional Therapy in Treating Sleep-Disordered Breathing: A State-of-the-Art Review. International journal of environmental research and public health, 18(14), 7291. https://doi.org/10.3390/ijerph18147291
Ray, J. (2003). Effects of orofacial myofunctional therapy on speech intelligibility in individuals with persistent articulatory impairments. International Journal of Orofacial Myology, 29(1), 5–14. https://doi.org/10.52010/ijom.2003.29.1.1
