Donna Maxwell, MA CCC-SLP
Speech Pathologist, Feeding Specialist & Orofacial Myologist

An orofacial myofunctional disorder describes any irregularities in the form and function of the muscles or the face and mouth. This may also include dental or skeletal structures that could affect normal growth and development. OMDs can occur through the lifespan, and may present differently in different age groups. For the younger child, oral habits and/or difficulty with feeding or chewing may be seen. In children, adolescents, and adults symptoms may include: - persisting food aversions - mouth breathing, - tongue thrust swallow - improper alignment/ posture -improper jaw growth or malocclusion -sleep disordered breathing/apnea -impaired speech production -facial pain

A tongue thrust is one of the most commonly diagnosed symptoms of an OMD because most professionals can readily identify it. However, it may just be one symptom a patient presents with. A tongue thrust refers to the resting posture of the tongue against or through the teeth and the pushing of the tongue against the teeth during a swallow. Experts estimate that we swallow 1000 to 2000 times a day with between 4 and 8 pounds of pressure per swallow. This constant pressure can push the teeth out of place, causing an abnormal bite known as malocclusion. A tongue thrust is not only seen during the swallow but can be seen during speech and at rest as well. The improper posture of the tongue may cause difficulty with forming sounds of normal speech and may be present in the form of a lisp and/or other speech sound errors.

The constant, improperly placed pressure of the muscles of the face and tongue can have a lasting effect. They can cause significant problems with a person's dental health, speech, and cosmetic appearance. Misalignment of the teeth (malocclusion) can also cause patients to become more susceptible to periodontal disease or “gum disease.” Malocclusion also can cause “jaw joint” problems, facial pain, difficulty biting or chewing food, and excessive grinding of the teeth (bruxing).

Effectively correcting an OMD requires an interdisciplinary approach. The best results are almost always achieved by working with a team of experts that may include an orthodontist, dentist, pediatrician, ENT, oral surgeon, and physical therapist trained in orofacial myofunctional therapy. Even with the work of an orthodontist and dentist to correct problems that have already occurred, the habit at the root of the issue must be addressed to prevent further complications and promote long-term success with your orthodontic investments. Through orofacial myofunctional therapy (OMT). therapists work to re-train the muscles of the face and tongue for proper posture at rest, during speech and during swallowing. Patients are able to simply and effectively eliminate the long term problems associated with an OMD.

Usually there is not one cause of an OMD, rather several contributing factors may be involved. Some of these may include prolonged oral habits ( thumb, finger, pacifier use), airway obstruction either from enlarged tonsils/ adenoids or nasal cavity, allergies, structural abnormalities such as tethered oral tethers (TOTs), including a short lingual and/or labial frenulum, or a narrow, high palate.