What are Orofacial Myofunctional Disorders?

Orofacial Myofunctional Disorders (OMDs) are disorders of the muscles and functions of the face and mouth. OMDs may affect, directly and/or indirectly, breastfeeding, facial skeletal growth and development, chewing, swallowing, speech, occlusion, temporomandibular joint movement, oral hygiene, stability of orthodontic treatment, facial esthetics, and more.

For example, OMDs may be present when there is an abnormal lip, jaw, or tongue position during rest, swallowing or speech. You may also see this when there are prolonged oral habits, like thumb or finger sucking.

How common are OMDs?

OMDs are more prevalent than you think and can have long-term effects such as:

  • Dental malocclusion or teeth not closing properly
  • Atypical pattern of swallowing or tongue thrust
  • Difficulty chewing food (e.g. “sloppy eaters”)
  • Mispronunciation of sounds (e.g. lisp)
  • Cosmetic problems (development of a long face, retruded chin)
  • Jaw joint pain
  • Weak lips
  • Long term mouth-breathing patterns that compromise overall healthy breathing
  • Establishment of detrimental oral habits that impede further growth and development
  • Establishment of atypical patterns that impact chewing and swallowing
  • The improper development of jaw growth and facial structure
  • Slowing the process of orthodontic treatment
  • Undermining the long-term stability of orthodontic treatment, resulting in malocclusion relapse
  • Negatively impacting the stability and function of the temporomandibular joint (TMJ)
  • Negatively affecting social relationships due to open mouth postures or noisy chewing and swallowing patterns

Signs and symptoms of OMD

In children, some of the more common signs of OMDs are as follows:

  • Speech distortion – particularly a frontal lisp
  • Chronic open mouth positioning (e.g. mouth breathing)
  • Dental abnormalities – such as overjet & open bite
  • Tongue thrust – when the tongue pushes against or between the teeth during speech or swallowing.

Treatment for OMD

Treatment techniques to help both speech and swallowing problems caused by OMDs may include the following: 

  • increasing awareness of mouth and facial muscles
  • increasing awareness of mouth and tongue postures
  • improving muscle strength and coordination
  • improving speech sound productions.

The purpose of myofunctional therapy is to retrain the muscles and to obtain a normal resting posture of the tongue, lips and jaw. The approach to therapy emphasizes training in the correct resting postures of the tongue and lips all with the goal of facilitation proper nasal/diaphragm breathing.

However, it is important to note that other procedures and/or treatment may be required. A speech pathologist may be one of your stops along the way to dealing with an OMD but other specialists may be required.  Bloomington-Normal Speech Therapy works with a network of specialists that understand OMD and the proper course for recovery.  

Other signs and symptoms of OMD

  • Mouth breathing (when awake or sleeping)
  • Tongue position low and forward
  • Chapped lips
  • Lip licking
  • Chewing with mouth open
  • History of feeding difficulties (e.g. trouble attaching to breast)
  • Messy eating
  • Coughing when eating
  • Gagging
  • Slow or picky eating
  • Gulping food and drink
  • Preferring not to drink hot beverages
  • Preferring not to use a straw
  • Greeting cups and cutlery with tongue outside mouth
  • Difficulties with saliva management (dribbling or drooling)
  • Difficulty swallowing tablets
  • Over-jet or open bite (gap between teeth)
  • Cross bite
  • Fillings and receding gums
  • Adult teeth not descending
  • Halitosis (bad breath)
  • Scalloped or sore tongue
  • Headaches or migraines
  • Clicky or sore jaw (TMJ Disorder)
  • Restrictive lingual frenum (tongue tie)
  • Small lips
  • Deviated septum
  • Fatigue (particularly in the morning)
  • Attention difficulties
  • Darkness under the eyes
  • Snoring
  • Sleep apnoea
  • Postural difficulties
  • Neck or back pain

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