What is Myofunctional Therapy?

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Orofacial therapy is a program used to correct the improper function of the tongue and facial muscles used at rest, for chewing and for swallowing.

The human body -- a wondrously complex combination of tissue, bones and chemicals. To keep this mechanical marvel operating at its best, the body needs to maintain a certain harmonious pattern. However, as with any complicated system, when an important function of the body is thrown off, problems may develop.

Correct swallowing depends on a proper relationship between muscles of the face, mouth and throat. The act of swallowing is one function that depends on the body's vital balance. To swallow properly, muscles and nerves in the tongue, cheeks and throat must work together in harmony. When a person swallows normally, the tip of the tongue presses firmly against the roof of the mouth or hard palate, located slightly behind the front teeth. The tongue acts in concert with all the other muscles involved in swallowing. The hard palate, meanwhile, absorbs the force created by the tongue.

Because a person swallows 500-1000 times a day, it's easy to see how improper swallowing can cause a variety of problems. But it is actually the resting position of the tongue that does the most damage because it is more constant.

Case Studies

Anterior Tongue Thrust with Oral Muscle Patterning Abnormality

Keywords: Masseter muscle weakness, overdeveloped mentalis muscle, orbicularis oris muscle flaccid and weak, maxillary arch narrow, low tongue rest posture.

Patient

Nine-year-old male presents with sucking habits, mouth breathing and tongue thrusting. He reports having severe headaches twice a week, sinus problems, allergies, daily stomachaches from air swallowing, and drooling. His teeth present in an edge-to-edge relationship and he exhibits a forward head posture and a frontal "s" lisp.

Service

After 4 months of active treatment for behavior modification of oral habits, the patient stopped his oral habits and his muscle patterning was corrected, This patient has reported that his headaches are gone, stomachaches are gone, sinus problems and allergies are 50% better, drooling has ceased and his bite has improved to a Class 1 occlusion. He is now nasal breathing.

Rationale

Eliminating the noxious habits has helped to reinforce proper mouth posture and self-esteem. Developing a lip seal has helped to guide the teeth in a more harmonious relationship. Introducing proper tongue rest posture has contributed to the palate widening thereby assisting the airway to expand along with behavior modification for reinforcing nasal breathing.

Notes

Patient understood the ramifications of NOT doing treatment. Orthodontics can now be done in phase 2 without relapse due to habits, swallowing or airway interference. This will lead to a more stable orthodontic result.

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Unilateral Tongue Thrust with Orofacial Muscle Imbalance

Keywords: Sturge-Weber Syndrome with seizures, facial muscle asymmetry, port wine stain, anterior and uni-lateral tongue thrust, low muscle tone, not able to move tongue in lateral direction, speech impediment severe for many years and not improving with traditional speech therapy, choking and swallowing disorder.

Patient

Seven-year-old male with many oral habits: such as tongue sucking, lip licking, chronic mouth breathing, chewing on clothing, etc., mouth breathing, tongue thrusting, and asymmetrical facial muscle patterns. His teeth were not able to erupt normally because his tongue was an impeding factor. Limited speech coherency.

Service

Working in a multi-disciplinary team with his dentist, Dr. Raymond Silkman, and his Osteopathic physician, Dr. Virginia Johnson, and after 4 months of myofunctional treatment and then a delay of one year, another 4 months of treatment was completed. His oral habits are gone, his teeth were able to erupt, his swallowing pattern and resting mouth posture has normalized, speech has improved, his facial muscle asymmetry has normalized, and his over all co-ordination has greatly improved. He is now breathing through his nose and he has not had a seizure for a year and a half!

Rationale

Eliminating concurrent noxious habits, introducing nasal breathing and neuro-muscular changes at a habitual level, establishing a normal chewing and swallowing patterns, and improving tonicity of the orofacial musculatures have helped aid in proper growth and development.

Notes

Patients' parents understood and supported successful therapy results. We shall continue monitoring results to assure normal growth and development. Many times, a multi-disciplinary approach is essential to success.

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