Orofacial Myofunctional Disorders

photo of woman showing her tongue
Photo by Oleg Magni on Pexels.com

Oro = mouth Facial = face Myo = muscle

Definition

“Orofacial myofunctional disorders are disorders of the face, mouth, lips, and/or jaw. They can directly or indirectly affect skeletal growth development, dentofacial development, jaw stability, chewing, normalized swallowing patterns, developing speech patterns and oral hygiene.”

-Mary Billings, MS, CCC-SLP, COM®

General Information

Until 2020, orofacial myofunctional therapy (OMT) was not taught in graduate programs in speech pathology because it was not considered an evidenced-base practice.

However, OMT is an evidenced-based practice with research from the medical and dental professions.

SLPs have learned of this therapy from collaboration with other professionals and continuing education units.

Certification in orofacial myology is not required to treat OMD but can be earned through the International Association of Orofacial Myology (IAOM).

“Traditional” speech therapy may be considered treatment of a symptom rather than treatment of the underlying condition or problem. (Please note this is a professional opinion of NEATS).

After treatment of the OMD, traditional speech therapy may be necessary to correct speech sound errors.

Only a licensed SLP can treat a speech sound disorder as long as any underlying OMD has been treated.

Orofacial Myofunctional Disorders do not age discriminate, which simply means that no matter what your age, you may have OMD.

Many OMD require collboration with other professionals in multi-disciplinary team.

According to Dr. Richard Baxter, DMD, MS and others in their incredibly enlightening, easy to read book, Tongue Tied, the following are symptoms of OMD:

•Congestion/mouth breathing •Open posture at rest •Allergies •Low tone •Dental crowding/crossbite/open bite •High and narrow palate •Tongue Tie •Drooling •Dark Circles under eyes •Thumb or object sucking •Nail biting •Bed wetting •Open mouth chewing/sloppy eating

More specific symptoms related to the nose may be:

•Nasal congestion  that encourages mouth breathing •Loud audible breathing •Overbreathing/hyperventilation •Excessive yawning •Sniffling •Frequent sighs •Visible Movement of upper chest/shoulders when breathing

•Open mouth posture – lips that are parted most of the time •Dry, chapped, cracked lips •Flaccid low tone •Large rolled lower lip •Lip licking •Lip biting •Lip sucking •Visible saliva at corners of mouth •Excessive drooling and inability to control saliva

More specific symptoms related to the mouth may be:

Photo by Daniel Reche on Pexels.com

•Open mouth posture – lips that are parted most of the time •Dry, chapped, cracked lips •Flaccid low tone •Large rolled lower lip •Lip licking •Lip biting •Lip sucking •Visible saliva at corners of mouth •Excessive drooling and inability to control saliva

More specific symptoms related to the tongue may be:

Photo by Oleg Magni on Pexels.com

•Visible at rest •Visible during speech •Tongue thrust •Appears large and in the way •Scalloped edges •Tongue tie

More specific symptoms related to the mandible (jaw) may be:

•Jaw tendency to shift left, right, or forward •Jaws that don’t fit together •Headaches/facial pain •Jaws that appear to be mismatched •Clicking, popping or noise •Ear ringing •Unable to open wide •Sudden change in the bite •Excessive gum chewing •Excessive leaning on the hands to support posture

More specific symptoms related to breathing may be:

woman doing yoga inside a room
Photo by Valeria Ushakova on Pexels.com

•Audible breathing •Predominant mouth breathing during speech, eating •When concentrating •Large tonsils and adenoids that block the airway

More specific symptoms related to sleeping may be:

Photo by Pixabay on Pexels.com

•Snoring •Noisy breathing •Grinding or clenching of the teeth •Witnessed apnea (when the child stops breathing) •Sweating •Recurrent Nightmares •Restless sleep/Excessive movement •Open mouth posture •Hyperextended neck posture •Difficulty waking up in the morning •Daytime sleepiness or irritability •Moodiness and behavior issues •Hyperactivity and cognitive problems •bedwetting

More specific symptoms related to habits may be:

•Thumbsucking/digit sucking/object sucking •Nail biting/cuticle biting •Hands or objects in mouth •Lip licking, Lip sucking, lip biting •Tendency to chew on everything •Mouth breathing •Nose picking •Skin picking/hair pulling•Eyebrow/eyelash picking •Skin biting •Frequent throat clearing •Coughing in the absence of illness •Jaw popping •Knuckle cracking •Blanket sucking •Excessive gum chewing

More specific symptoms related to breast feeding for mom may be:

•Painful Nursing •Poor Latch •Cracked, creased, flattened nipples •Bleeding nipples •Lip stick shaped nipples •Poor breast drainage •Plugged ducts, engorgement, mastitis •Nipple thrush •Using a nipple shield •Feeling like feeding the baby is a full time job

More specific symptoms related to breast feeding for baby may be:

•Poor latch at breast or bottle •Falls asleep while feeding •Slides on and off the nipple when feeding •Poor weight gain •Biting/chewing the nipple •Pacifier falls out easily or won’t stay in •Milk dribbles out of the mouth when eating •Mou•Frustration at breast or with bottle •More than 20 minutes per feeding required after newborn period •Eating more frequently than every 2 to 3 hours •Cries often/fussy often •Reflux symptoms •Spits up often •Clicking or smacking noises when eating •Gagging and choking when eating •Gassy burps and toots•mouth breathing, snoring, noisy breathing •Short sleeping •Congested nose