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Orofacial Myology Therapy

also know as Orofacial Myofunctional Therapy (OMT)

Orofacial Myology is the art and science of the oral-facial musculature.
Orofacial Myology Therapy is the treatment of Orofacial Myofunctional Disorders (OMD).

The main focus of the therapy is on the musculature of the face, tongue, head, and neck along with the functional patterns. OMT helps to create a stable environment by improving muscle balance and tonicity to establish the correct functionality of the tongue, lips and mandible to enable normal growth and development.

What are Orofacial Myofunctional Disorders (OMD)?

Dr. Patras will thoroughly examine your child's mouth and study diagnostic records to determine if your child would benefit from this type of orthodontic treatment.

The first phase of treatment is initiated to:

  • Noxious oral habits and parafunctional habits, some of which are: thumb, finger, or lip sucking, pencil or clothes chewing, nail biting, and grinding or clenching teeth;
  • An inappropriate mouth-open lips-open resting posture;
  • Chronic mouth breathing;
  • Inappropriate thrusting of the tongue at rest and at function.
  • Inappropriate thrusting of the tongue at rest and at function.
  • Limited movement of the tongue due to tight frenums; Frenum is a fold or cord of soft tissue that helps to attach the tongue to the floor of the mouth. Also, frenulum are found inside the upper and lower lips and cheeks. They help to attach lips and cheeks to the gums.

What are the consequences of OMDs?

OMDs can create an interruption in the normal growth, development, and functionality of the face, teeth, head, and neck. Some examples are:
Malocclusions- upper and lower teeth do not touch in proper position;
Open bite-only some teeth touch;
Crowding- teeth overlap each other;
Changes in jaw growth and mobility (if no structural problems are present); 
Changes of the facial dimensions and appearance;
TemporoMandibular Joint (TMJ) muscular dysfunction- Dysfunction of the muscles attached to the jaw joint;
Grinding and chipping of the teeth;
Gingival Stripping-Trauma or pulling of the gums; 
Restriction in function of the tongue and lips;
Periodontal/Dental Risks:
Lack of self-cleansing, food impaction, excess saliva, poor food gathering/ trapping/transfer, poor bolus formation, bacterial introduction, pain, gingival recession, mouth breathing (open mouth posture) gingivitis, periodontal pockets.
Speech might also be affected.

Common causes of OMDs to look for:

1. Structural

Specialists such as orthodontists, oral surgeons, physicians, ENTs need to evaluate and treat the structural problems.
Airway evaluation is very important. Enlarged tonsils and adenoids, deviated septum are some examples of structural problems
A high narrow roof of the mouth is another example of a structural problem. It needs to be corrected by the orthodontist with appliances and OMT is initiated right after the expansion or during the expansion, based on orthodontist evaluation.

2. Functional

Incorrect muscle function, even when structures are within normal limits, can incorrectly position the jaw or the teeth.  For example, excessive grinding and/or clenching of the teeth may contribute to malocclusion or TemporoMandibular Joint (TMJ) muscle dysfunction (TMD).

3. Habitual

Habits like thumb or finger sucking and nail biting can create malocclusion.
The general rule in dentistry and pediatrics is that bad oral habits should be addressed and eliminated prior to the eruption of the adult front teeth, or by age six.

What Can Orofacial Myofunctional Therapy (OMT) Do about OMDs?

The goal of OMT is to support the orthodontic treatment (or other dental and medical community efforts) by eliminating bad habits, by achieving healthy function of lips, cheeks, and tongue at rest and during speaking, chewing, and swallowing.  The upper jaw and lower jaw relationship at rest or at function should be established in an equilibrated and harmonious environment.
OMT helps to correctly position the tongue while resting and to increase tongue tonicity
. This means:
The tongue is trained to rest on the roof of the mouth.
Lips are trained to stay be closed, teeth are positioned slightly apart, at rest.
Healthy swallow patterns are achieved.
Breathing is achieved primarily through the nose, not the mouth.
The jaw joint is supported by balanced, healthy head and neck muscles.

A variety of neuromuscular exercises are taught based on individual evaluation and treatment protocols.
Exercises will help to create muscle memory. 
The behavioral approaches and modifications by orofacial myologists are effective in eliminating thumb, finger, and other associated sucking habits.

Orofacial Myology Therapy/Orofacial Myofunctional (OMT) Therapy is Not Speech Therapy.

OMT corrects muscle function problems which influence dental occlusion including facial shape, chewing, swallowing as well as tongue, lip, and resting jaw posture. Not all individuals who have a tongue thrust have a speech problem and not all who have a speech problem have a tongue thrust.

What makes the teeth move or stay in a stable position either in malocclusion or normal occlusion?

Whether called balance, harmony, or equilibrium, it is absolutely essential to have a stable environment so the teeth can remain in a stable position. The balance depends on four factors.

  1. Intrinsic pressures – teeth are suspended inside a bone socket and are attached to the bone by threads called periodontal fibers. Teeth are also attached to the gums by threads called gingival fibers. Pressures inside this environment are called intrinsic;
  2. External pressures –pressures applied from outside such as habits, and orthodontics;
  3. Soft tissue pressures of the lips, cheek and tongue; and
  4. Tooth contacts – at rest or during speaking, chewing and swallowing.

If any of these forces overpowers the others, the equilibrium is disturbed and it can lead to an altered occlusion, or malocclusion.