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Orofacial Myology is the study and treatment of the orofacial and oropharyngeal muscles, their associated movements, and how muscle movement can directly and/or indirectly affect functions of respiration, breastfeeding, craniofacial growth and development, chewing, swallowing, speech, dental occlusion, temporomandibular joint movement, oral hygiene, stability of orthodontic treatment, facial esthetics, and overall physical and mental development.
Occurring in 38% of the general population, an Orofacial Myofunctional Disorder is a condition when muscles of the orofacial complex are in atypical patterns over a long period of time resulting in compensatory adaptions. These adaptions change muscular function, which in turn can result in structural changes. OMDs can include a myriad of different signs and symptoms; however, the most common OMD’s are an open mouth posture, noxious oral habits, ankyloglossia, tongue thrusting when swallowing or speaking, and the newest link, Sleep Disordered Breathing.
If we look for a common link between all OMD's we will notice that in all instances, the tongue is resting low in the mouth, the lips may be parted, and the jaw is opened beyond the normal freeway space, and the patient may or may not be practicing mouth breathing. In other words, there is a deviation from the normal resting position of the orofacial muscles, which leads to craniofacial structural changes, and altered function. When you are not chewing, swallowing, or speaking, the mouth should be at rest. The tongue should posture along the entire surface of the palate, the jaw should be closed, leaving 1-3mm of free way space between the dentition, the lips should be sealed without force, and the patient should habitually breathe through their nose. This posture at rest, is better known as the Proper Oral Rest Posture.
The goal of myofunctional therapy is to address the etiology of the OMD, restore the oral rest posture, and optimize oral function. These goals are sometimes accomplished through the utilization of an integrated team of practitioners, comprehensive medical-dental treatment plans, and restorative orofacial myofunctional therapy.
Orofacial Myofunctional Disorders are atypical, adaptive patterns that emerge in the absence of normalized patterns within the orofacial complex. The regular presence of these adaptive movements can often result in a variety of disturbances. It is often difficult to isolate a particular source as the sole cause of an Orofacial Myofunctional Disorder and in most cases, it can be result of a combination of factors. Many experts suggest that OMDs may develop, or can be the result of changes in orofacial muscle patterns attributed, but are not limited to the following:
MOUTH BREAHTING due to obstructed or restricted airway due to anatomical restrictions: small nasal cavity, deviated septum, enlarged turbinate, limited sinuses, enlarged adenoids & tonsils, chronic allergies and nasal congestion, and limited tongue space
POOR WEANING AND SOFT DIETS that eliminate the need for chewing. These topics fuel debates over breastfeeding vs bottle feeding, the introduction of pureed foods vs solids, and a diet high in processed foods.
STRUCTURAL abnormalities such as tethered or restricted oral tissues of the lip, cheek, and tongue, narrow, highly vaulted maxillary arch, mid-face deficiency or retrognathic mandible, and poor lingual-palatal accommodation
POOR ORAL REST POSTURE of the tongue, mandible, lips, and cheeks at rest
NOXIOUS PARAFUNCTIONAL ORAL HABITS such as prolonged bottle and pacifier use, spouted Sippy cup use, thumb sucking, blanket sucking, atypical swallowing patterns known as a tongue thrust, nail biting, cheek biting or high oral fixation chewing, clenching, and grinding of teeth, as well as smoking. Anything that disrupts the proper oral rest posture
NEUROLOGICAL OR DEVELOPMENTAL abnormalities such as Down’s Syndrome, Bell’s palsy, or after a stroke
GENETICS or hereditary predisposition
Orofacial Myofunctional Disorders interrupt normalized movement patterns. Orthodontists have documented their concerns about OMD’s since the early 1900’s, as soft tissue pressure placed the patient at risk for orthodontic relapse. Today, we know OMD’s impact much more. Failure to address an OMD can result in:
Long term mouth-breathing patterns that compromise overall healthy breathing, early delays in the area of feeding and swallowing, establishment of detrimental oral habits that impede further growth and development, picky eating patterns, and food aversions as a result of the lack of oral coordination, establishment of atypical patterns that impact chewing and swallowing, the improper development of jaw growth and facial structure, the improper development/alignment of the teeth, slowing the process of orthodontic treatment, undermining the long-term stability of orthodontic treatment, and potentially resulting in malocclusion relapse. One may see OMD's negatively impacting the stability and function of the temporomandibular joint (TMJ), episodes of tinnitus and vertigo, speech distortions, a variety of peripheral pain issues like chronic facial, neck and back pain, headaches; tooth grinding and clenching, improper tongue position has also been associated with some sleep disordered breathing patterns, as well as negatively affecting social relationships due to open mouth postures or noisy chewing and swallowing patterns.
The practice of Orofacial Myofunctional Therapy involves utilizing individualized exercise programs, with a specific focus on the health of the upper airway complex, to help the patient neurologically re-educate and re-pattern maladaptive muscle function to create and maintain a healthy orofacial-oropharyngeal environment. It is important that a patient is comprehensively evaluated, so individualized programs can be created to meet that patients’ specific symptoms, and or concerns.
With the customized programs created for our patients, we strive to:
When underlying behaviors and habits are identified and properly corrected, and when therapy goals are met, the patient’s troublesome symptoms start to disappear, and adjunct treatment plans such as orthodontics, speech therapy, TMJ treatment , and resolution of Sleep Disorders are easier to treat, will be more successful, and less likely to relapse.
Our practice offers a variety of myofunctional therapy programs ranging in price and duration. These programs are always combined with nasal hygiene, breathing re-education, sleep hygiene, as well as myofacial release techniques, all of which are tailored specifically to the patient's needs. During therapy, patients work through a carefully structured program, with each session progressively building on the one before it.
Our therapy programs start by building a stronger muscular foundation by rehabilitating individual muscles, and their use. If recommended, tongue tie restrictions, revision, and wound management is addressed during the first phase of therapy. The second phase of therapy addresses coordinated movement of a group of muscles, such as proper chewing, swallowing, and oral placement for functional speech. The last phase of therapy focuses on habituation, and integration of newly learned skills into one’s lifestyle. This phase is most often the hardest, as we will routinely monitor patient success for any potential relapse. As the patient reenters their native environment, it is easy for old muscle patterns, and habits to resurface that can potential hinder success.
All of our programs include 12-therapy sessions, and usually last six to eight months. More complex cases often require a longer-term approach. In these cases, a therapist may ask for a one-year commitment, and recommend a therapy program that includes 18 to 24 sessions. Appointments are held in-office or online via teleHealth. The patient will meet with a therapist for a 45-minute sessions that are reappointed every one to three weeks, depending on the patients goals and needs. Goal checks, as well as proficiency exams require more time. These sessions are scheduled for an 1-hour block. The daily time commitment for exercising is simple.
Here's the skinny- If you can commit to five to ten minutes, twice a day, for the duration of the program recommended, you will see a transformation.
Named after Russian physician, Dr. Konstantin Buteyko, The Buteyko Method was first introduced during the early 1990’s. Early on, this method was popular with adults suffering from high blood pressure, as well as children and adults suffering from asthma. Today, we know the application of the Buteyko Method is now helping hundreds of thousands of people resolve and relieve symptoms of dysfunctional breathing such as rhinitis, hay fever, COPD, anxiety, stress, mouth breathing, snoring, and different levels of sleep disordered breathing. Success can be accompanied by additional health benefits such as easier weight loss, greater energy levels, and restorative sleep.
The simple fact is that many people breathe too much, or are in a constant state of hyperventilation. The most common form of hyperventalization is mouth breathing. This chronic condition stimulates the sympathetic nervous system, and can alter the natural levels of gases in the blood; thus, leading to numerous health problems. While breathing is an involuntary activity, it is subject to change by the stresses of everyday life, processed foods, sedentary lifestyle, excessive talking, and other environmental factors. When the body is exposed to these perpetuating factors for extended periods of time, dysfunctional breathing patterns can be seen. If not properly addressed, the brain will adjust to the lower concentration of CO2 in the lungs, and consequently, the body will then continuously demand larger volume of breathing, resulting in compromised immune and nervous systems.
The Buteyko Method is simple. It has been designed to improve one's breathing mechanics, the rate of respiration, and the volume of breath that is consumed. When applied correctly, one feeds the body optimal levels of oxygen, carbon dioxide, and nitric oxide. The presence of these three molecules drive vital metabolic processes that can heal the body and mind organically. Our course focuses on patient education, behavior modification, and daily exercises to to specifically reduce over-breathing, and restore health.
The Goals of Therapy Include:
There are many factors that contribute to the success of the therapy program. Effective communication and cooperation between the patient, the therapist and the integrated wellness team is essential. This is why at iMyo, we unique guide patients and help with coordination of care. In addition, the patient’s desire, dedication, cooperation, and self-discipline are necessary. Support from others, whether its a parent or the therapist is vital. To ensure optimum results with children undergoing therapy,18-yrs or younger, parental involvement is a must; no exceptions. The bottom line is very simple- If one does not practice the recommended assignment consistently at home, they will not experience the full benefits of a program.
Orofacial Myofunctional Therapy continues to helped thousands of individuals all over the world. Numerous studies have been conducted demonstrating its effectiveness in the treatment of Orofacial Myofunctional Disorders. These studies have shown that Orofacial Myofunctional Therapy can be 80-90% effective in correcting oral rest postures, chewing and swallowing and other oral functions, and that these corrections are retained years after completing therapy. Current literature demonstrates that myofunctional therapy can decrease AHI by 50% in adults and 62% in children, with an improvement in oxygen saturation, snoring, and sleepiness. Myofunctional therapy is being heavily studied, and is often recommended as an adjunct to other OSA treatments.
For more information about all things iMyo, we personally invite you to visit our social media links, and or subscribe to our YouTube channel below. There you will find resources about Orofacial Myofunctional Disorders, and how myofunctional therapy can help you, or those that you love. If you would like to learn more about our myofunctional therapy programs, or if you have any questions or concerns, we would love to here from you. Simply schedule a Discovery Call using the scheduling link above.