Orofacial Myology

OMDs are related to and can be contributing factors to the following:

OM disorders are related to and can contribute to many medical and dental disorders, including Malocclusion, Periodontal Disorders, Temporomandibular Joint Disorders (TMD), Dental Relapse, Sleep Disorders and Sleep Apnea, Tongue Thrust, Chronic Neck and Back Pain, Headaches, GERD, Tinnitus, Vertigo, Grinding, Clenching, or Speech Disorders

What caused that problem in the first place?

Habits, Sleep Posture, Nail Biting, Thumb Sucking can cause an OMD

Was it an orofacial myofunctional disorder?

Many oral structural changes and disorders are a result of atypical oral rest postures of the tongue and lips and atypically muscle function of the face and mouth. This is referred to as an orofacial myofunctional disorder (OMD). Underlying myofunctional disorders can contribute to malocclusion, and disorders of breathing, feeding, speech or posture.

OM Therapy:

Often the tongue is referred to as the antagonist muscle to the rest of the orofacial muscles and development.  Hostile tongues, which rest between or against the teeth, and incompetent, weak lips are examples of improperly functioning oral musculature. Harmful pressures during biting, chewing, swallowing, tongue thrusting, clenching, or grinding can also occur when there is an OM disorder.

OM Therapy utilizes neuromuscular re-education, stimulation and exercises to recapture a normal dental freeway space, eliminate abnormal muscular pressure on the jaws and teeth, and stabilize the muscles of the mouth and face.

OM Therapists Collaborate with Other Specialists:

Collaborative treatment with a variety of medical and dental specialists is highly recommended to attend to both the structural issues of the teeth, jaws, ears, throat, spine and back, soft tissue, as well as muscle function. As most orthopedic professionals would not treat a broken leg without doing physical therapy; dentists, pediatric dentists, orthodontists, periodontists, oral surgeons, and orofacial myologists should collaborate with each other to ensure proper use and function of the face, mouth and neck muscles to support the teeth and jaws that are properly aligned with the purpose of normalizing breathing, speaking, chewing, drinking and swallowing function.

Dental specialists, specifically orthodontists and pediatric dentists, work to promote alignment of the jaws and teeth in the dental arch, creating that perfect smile. The OM therapist works to promote the optimal exertion of inner and outer orofacial muscular forces, from the lips, cheeks, and tongue. OM disorders are greatly reduced when the teeth are in proper position and the muscles at rest and during function are stabilized.

OM therapy can compliment orthodontia in the following manners:

-Identify and eliminate orofacial noxious habits which interfere with stable orthodontic results

-Influence stable results and decrease risk of dental relapse by removing atypical muscular forces and patterns of the tongue which tend to resist that movement.

-Reduce the time in fixed appliances by facilitating movement of teeth by removing atypical muscular forces and patterns of the tongue

-Stabilize the dental freeway space (vertical dimension of the mouth) and normalize tongue rest posture against the palatal arch

-Teach nasal breathing and remodel the airway through behavioral modification and nasal cleansing when authorized by medical specialists

-Reinforce compliance with wearing rubber bands, functional appliances, and retainers

-Develop a healthy muscle matrix, teach proper chewing and swallowing patterns, and eliminate habits that contribute to TMD

-Identify and address forward head and neck posture problems with other specialists

OMT Can Also Prevent and Aid in the Following Areas:

-Improve stubborn Articulation Disorders

-Decrease severity and attempt to improve Breathing Disorders due to allergies or mouth breathing habits

-Treat the symptoms contributing to TMD when it is a muscle or habit related issue

-Decrease Digestive Disorders from not chewing properly or swallowing air

-Improve forward head postural problems relating to atypical tongue and mouth postures

-Assist with faster normalization of the facial muscles and neuromuscular facilitation post orthoganthic surgery

Why is a speech therapist concerned with your or your child’s airway?

A restricted airway is serious and can impact you or your child’s orofacial growth, development, breathing, attention, learning, sleep, and health (diseases related to or caused by airway disorders). Each individual is different and the consequences of a restricted airway manifest in a variety of manners, but there will always be an impact when the airway is restricted.

Implications, Associations, and Consequences of Airway Disorders

Dental Health: Dental malocclusion, periodontal disorders, Orthodontic Relapse, open bites, midline diastema (referring to the space between the two front teeth), grinding, clenching, receding chin, retruded upper and lower jaws, gummy smile, lower teeth smile, tooth pain, jaw tightness, restricted opening of mouth, worn dentition, scalloped tongue, lingual restriction, pain on face upon touch, increased sensitivity, and jaw shifting during chewing and speaking.

Anatomical & Physiological Changes: Long, narrow face, weak lip seal, open mouth posture, high, narrow palate, ear infections, clogged ears, facial asymmetry, hypertension, distended stomach, deoxygenation, poor circulation, collapsed palate, higher eye, slanted jaw, chronic neck pain, head and neck posture changes, winged shoulder blades, venous pooling under eyes, shiners or eye shadows, enlarged tonsils and/or adenoids, acute upper respiratory infections, insufficient orofacial muscle tone, excessive length of soft palate, beaked nose, restriction of nasal air flow, asthma, allergies, systemic inflammation, chronic sickness, throat infections, winged shoulder blades, and weight gain.

Please also see AAPMD and American Academy of Pediatrics for Characteristics of OSA in Children

Orofacial Myofunctional Disorders: Temporomandibular Joint Disorder (TMJD), atypical postures of the mouth and tongue, atypical breathing, decreased stability and coordination of the muscles of the face, head and neck impacting speech, chewing, swallowing, and breathing.

Speech Disorders: Articulation Disorders, vocal quality, tongue thrusting, lisping, drooling, poor dissociation of the tongue, jaw and lips, and many other sound distortions and errors.

Feeding Disorders: Poor breath support, poor coordination of oral and/or pharyngeal stages of the swallow, Dysphagia, decreased chewing skills, hypersensitive gag, choking on foods, texture sensitivities, inability to transition to solids, tongue, lip and cheek biting due to decreased room in the mouth for tongue when chewing and swallowing, digestive disorders from unchewed foods and swallowing air, and reflux.

Sleep Disorders: Sleep Disorders include, Snoring, Upper Airway Obstructions, Obstructive Sleep Apnea, Central Sleep Apnea, and associated Silent Airway Disorders. Symptoms of OSA are bed wetting, night terrors, snoring, periodical limb movements, circadian rhythm abnormalities, restless leg syndrome, limb pain, frequent awakening, significant neuro-cognitive deficits, including ADD and ADHD. These symptoms are present in both adults and children. Apnea is just ONE symptom of Sleep Disordered Breathing. Silent airway disorders are just as critical and debilitating as sleep disorders that are seen or heard. Children need SOUND SLEEP through the night!

Cognition & Learning: ADD, ADHD, impulsivity, executive functioning disorders, neuro-cognitive disorders, reading disorders including difficulty with reading comprehension, math concepts, social studies, difficulty with memory and attention, decreased safety awareness and problem solving, behavioral disorders, and Alzheimer’s.

Nutritional Concerns:  Craving sugar and carbohydrates and weight gain, and obesity

Will you take the Pledge?

Pledge to Protect the Airway to

Promote Overall Health, Development, and Learning

I pledge to be an advocate for myself or my child. I am now empowered to talk to professionals in the allied medical fields about the significance and relevance about protecting my/my child’s airway. I understand that failure to protect the airway can cause or be related to the concerns stated above:

Maureen T Grady, Speech-Language Pathologist, LLC & Grady Cooney Speech Partners, Ltd. evaluate and treat based on a medical model of intervention and work in collaboration with other medical specialists whose central focus is to protecting the airway and stabilize the muscles of the face, head and neck. Our practice is also involved in the prevention and treatment of orofacial myofunctional disorders and addressing the symptoms of airway disorders, through normalization of the orofacial muscles, establishing proper oral rest posture from infancy and early childhood to foster proper facial growth, and habit elimination from birth through end of life.

 What size airway is ok with you?

A Narrowed Airway can be the size of a cocktail straw.

A Restriction Free Airway can be the size of a garden hose.

If there is an airway restriction, specifically with the nasal cavity or due to enlarged tonsil and adenoids, ask your treating professional what is the plan of care to improve the airway concerns? It is your job to be an advocate for yourself or your child. Review the associated risks associated with a restricted airway. Understand the consequences and risks of NOT taking out englarged tonsils or adenoids. Understand that 1mm of airway restriction increases the effort of breathing 16 times. How will a restricted airway affect your or your child’s growth, development, and functional skills of the oral cavity.
A Case Study:

Here’s one of our patients, Jake. Here are photos taken pre-OM-treatment and the results after OM treatment:

Jake Before Treatment on the Left and After on the Right.

Jake Before Treatment on the Left and After on the Right


Jake Before and After Treatment - Side View

Jake Before and After Treatment – Side View

Jake Before Treatment During Swalloe

Jake Before Treatment During Swallow