Orofacial Myofunctional Therapy: Causes and Treatment

12 / 10 / 2020

A healthy smile is characterized by pearly white teeth, shiny pink gums and, perhaps unknown to most people, sufficient gap between the upper and lower teeth when in resting position. This gap is called the freeway space, or interocclusal space. A space of approximately 3.5mm on average is sustained between the teeth and this allows for breathing through the nose. Sometimes, children’s physiology or behaviour results in an interocclusal space that is bigger than normal. This can result from persistent thumb or finger sucking, mouth breathing or tongue thrusting (a potentially harmful habit where the tongue is forced against the teeth while swallowing).

In either of these cases, Orofacial Myofunctional Therapy can be used to correct poor resting posture in the mouth. The mouth is at resting position 23.5 hours per day. Poor practice in this capacity can result in orthodontic problems later in life. A poor mouth resting posture, where the tongue sits too low, causes teeth to shift. They can become misshapen and can cause problems in the respiratory system, muscles of the face, mouth and throat, especially during meals.

In patients suffering from Orofacial Myofunctional disorders (OMDs), the vertical dimension of the freeway space is outside the normal range. When too much space is present, teeth can erupt from the gums too much or in irregular positions. The root cause of the problem is poor positioning of the tongue – it sits too low in the mouth. This can alter the shape of the bite to an unwanted degree.

The low position of the tongue in people with Orofacial Myofunctional Therapy can stem from a range of factors. Airway obstructions such as enlarged tonsils or adenoids, or allergies, tongue and lip ties can all contribute to low tongue positioning. The tongue adapts to these circumstances by pressing against the teeth to remove any gap present before swallowing. This pattern is actually common in babies, but usually is replaced by the adult pattern before age four.

Dentists may recommend Orofacial Myofunctional Therapy when they notice a larger than normal freeway space. The therapy is also sometimes prescribed after orthodontic treatment to ensure the teeth stay in their improved positions following treatment. Orofacial Myofunctional Therapy aims to train the tongue to develop better habits. Muscular exercises, positive reinforcement and motivational techniques are implemented to achieve the desired improvements in mouth resting posture.

Treatment is generally divided into three phases – a multi disciplinary approach. Positioning exercises, swallowing exercises and repetition are all used alongside motivation techniques. Positioning exercises try to train the muscles of the tongue to shift up to the correct spot on the palate and to maintain proper facial muscle and lip strength. Swallowing exercises aim to get the tongue and mouth to perform swallowing in synchrony. Repetition is used to make sure patients get used to performing the new behaviours daily.

Orofacial Myofunctional Therapy tends to see results in a period of a few weeks. Therapy will finish completely in a few months. The treatment may require 15-17 sessions and has been shown as effective in treating a range of other problems. Oral health may deteriorate alongside habitual mouth breathing, tongue ties, large tonsils, a high, narrow palate or other dental issues. The therapy uses rewards like encouragement, positive reinforcement and cheering to remain as effective as possible.

Contact Big Smiles Dental today if you have noticed your child doing any of the following, contact us today:

  • Mouth breathing
  • Tongue thrusting
  • Thumb sucking
  • Improper swallowing
  • Irregular chewing or swallowing
  • Sleep disordered breathing

These can all lead to Orofacial Myofunctional disorders which can have a really detrimental impact on a child’s oral health. We’re open from Monday, Wednesday and Friday, 9:00am to 5:30pm and Tuesday and Thursaday 9:00am to 3:30pm, call us on (02) 9921 1799. Our dentists and orthodontists will be happy to refer you to our Myofunctional therapist who will be happy to arrange an appointment when you call.