11416 Slater Avenue Northeast, Ste 100A, Kirkland, Washington 98033, United States
Integrative Myo, Treating Orofacial MyoFunctional Disorder
Angela Zappone RDH, Cst-t, Your Integrative Health Hygienist
What are Orofacial Myofunctional Disorders (OMDs)?
Why is it important to treat Orofacial Myofunctional Disorders (OMDs)?
Why is it important to treat Orofacial Myofunctional Disorders (OMDs)?
Orofacial Myofunctional Disorders (OMDs) are any atypical patterns that develop, involving the oral and facial (orofacial) muscles that adversely affect normal function, growth, and development of the orofacial area (mouth, jaw, face, lips, tongue and airway). OMDs can be caused by multiple factors, like thumb sucking, genetics, tongue tie, tongue thrusting forward in swallow or speech, and improper resting position of the tongue. The most Influential etiology, is the inability to breathe through the nose.
Why is it important to treat Orofacial Myofunctional Disorders (OMDs)?
Why is it important to treat Orofacial Myofunctional Disorders (OMDs)?
Why is it important to treat Orofacial Myofunctional Disorders (OMDs)?
The Impact of OMDs are wide ranging and can significantly disrupt normal skeletal development of the face, jaws, and airway. OMDs may lead to problems with breathing and quality oxygen intake, latching and breast feeding, chewing, swallowing, nutrition, digestion, jaw and teeth alignment, facial aesthetics, TMJ pain and dysfunction, periodontal disease, and the outcome of orthodontic treatment.
Orofacial Myofunctional Disorders affect more than just the head and neck. There is a solid correlation between OMDs and Obstructive Sleep Apnea (OSA) in kids and adults, as well as chronic exhaustion, ADD/ADHD, digestive issues, forward head and neck posture -which can cause tension in the shoulders, head and neck, and potentially affect the entire spine, There can also be speech and articulation issues, which can affect communication and self-confidence.
Orofacial Myologist & Orofacial Myofunctional Therapy
Why is it important to treat Orofacial Myofunctional Disorders (OMDs)?
Orofacial Myologist & Orofacial Myofunctional Therapy
How can an Orofacial Myologist and orofacial myofunctional therapy help? Orofacial Myologist are dental hygienists, dentists, or speech language pathologists who have gone through specialized training to address OMDs. We thoroughly investigate the individual's Orofacial Myofunctional Disorder, evaluate habits and other causes contributing to the OMD.
We then design a personalized treatment plan to help retrain the musculature and re-educate the neural communication of the orofacial complex. The goal is to establish new healthy patterns, which over time become the norm. Basically, orofacial myofunctional therapy addresses and corrects the compensatory muscle patterns causing the problems, retrains the orofacial complex like the tongue, lips and cheeks, to encourage the proper growth and development, and "rehabituates" or helps to integrate new healthy habits to stabilize the gains made.
Orofacial Myologist & Orofacial Myofunctional Therapy
Addressing Orofacial Myofunctional Disorders
Orofacial Myofunctional Therapy, Thankfully Word is Spreading...
Addressing Orofacial Myofunctional Disorders (OMDs) often requires a team approach. Depending on a person's needs, ENTs, Dentists, Orthodontists, Pediatricians, and Speech Language Pathologist etc. may be involved. The underlying reasons an OMD developed MUST be addressed for orofacial myofunctional therapy to be successful. If a person is unable to nose breath, you can retrain the musculature all you want, BUT the habits which have formed to compensate for the inability to breathe, will continue to affect oral resting posture and tongue placement. Your body will do what it takes to breathe! Identifying the causes of OMDs, and addressing them is a crucial part of treatment success. Its critical for success to address the underlying cause and not just try and correct dental malocclusion with orthodontics. If a person cannot obtain proper tongue resting position to guide growth and maintain space because of a significant tongue tie restriction or inability to nose breathe the odds that ortho gains will relapse go way up! The tongue and other orofacial structures need to be "retrained" once these obstacles are removed to maximize function.
Because Orofacial Myofunctional Therapy is a relatively new field, OMDs frequently go undiagnosed. Medical and dental professionals are not looking at their patients with "Myofunctional" eyes. Treatment recommendations are focused on treating the symptoms, but not necessarily all the underlying causes. Issues related to a person's OMD may be left untreated or even misdiagnosed. Maybe that child being medicated to treat ADD/ADHD or behavioral issues, is actually oxygen deprived due to an airway restriction. Expanding the airway, looking at possible nasal passage blockages, and retraining the muscles of the orofacial complex with Orofacial Myofunction Therapy, could have life-changing benefits. You can not possibly know if the OMD is having an effect, unless the OMD gets evaluated. A large majority of OMDs and related issues are getting missed. Thankfully research is becoming more accessible, and the word is getting out.
A few years ago, one of the dental hygienist that I had worked with found out I was also a Craniosacral Therapist and training to become an Orofacial Myologist. She sent me a link to a video Finding Connor Deegan .That video changed the way I viewed airway disorders and OMDs. Because at the time I was working in a pediatrician's office that specialized in complicated medical issues, we had a large population of children with ADD/ADHD, and neurodevelopmental challenges. I new I needed to continue to pursue my interest in orofacial myofunctional therapy, and wondered, "could we be missing a vital piece of the puzzle in at least some of theses awesome kiddos?" I began seriously educating myself on OMDs. I read every article, took seminars, and eventually went through Sandra R Holtzman's, Neohealth Orofacial Myology Program, knowing I wanted certification.
My Son's OMD Story
From an early age it was clear to me my son had significant malocclusion, and that at minimum orthodontia would be necessary. Looking back, I now realize many signs of an OMD were present. Along with certain visual cues, he had a difficult time latching as an infant, and was a nibbler as a child, He had a high vaulted palate, overbite and overjet, and often complained about a "plugged" nose. He was always exhausted, but a very restless sleeper. I knew airway restrictions can be a big issue for sleep apnea, but was not looking at it through an "orofacial myofunctional therapist's eyes" at that time. After he finished 2 rounds of orthodontia with a traditional expander and unfortunately a Herbst appliance that slowed maxilla growth, he underwent sinus surgery in hopes to improve breathing. We had 3 separate orthodontist evaluations, a dentist, ENT, pediatrician, and myself involved in my son's treatment plan. Though we discussed a sleep study and C-Pap, not one of us addressed the oral and breathing issues from an orofacial myofunctional view point...that the problems may be more than just a deviated septum and misaligned teeth and that expansion of both jaws rather than slowing maxillary growth was much more ideal.
We missed the factors involved in WHY his jaw and orofacial structure developed the way they did, how that could potentially affect his orofacial anatomy and airway, and that we could actually do something to treat the underlying issues! A year after sinus surgery he couldn't breathe through his nose again. His ortho improvements had also partially relapsed, even though he was pretty faithful with his retainer use. Doing Orofacial Myofunctional Therapy to retrain his muscles to optimally function, and to help him nose breathe, swallow, and hold space in his mouth with a proper resting tongue position, would have made all the difference and likely prevented relapse. He is currently in college, and will soon begin treatment to open his airway and expand his jaws. Then myofunctional therapy, so the gains we make will hold. He has gone through so much treatment already, but we all understand lifelong oxygen deprivation is linked to serious health risks, and having more energy will have an immediate impact on quality of life!
Possible Causes of Orofacial Myofunctional Disorders (can be combinations of these factors)
- Inability to breathe through nose (allergies, enlarged adenoids, anatomical/structural)
- Genetic Predisposition: Structural and Nutrient methylation challenges (more to come on vitamin deficiency related to genes & skeletal formation)
- Tongue Tie and to lesser extent Lip tie
- Oral habits (thumb/finger/blanket sucking, nail biting, lip sucking/chewing etc)
- Extended use tippy cup and pacifier
- Neurological and Developmental Disorders
*The inability to breathe through the nose is a KEY factor in the cause of OMDs. Mouth breathing changes the normal growth and development of the orofacial complex, because the tongue, lips, and jaw can not sit in their natural resting position and help guide growth and development. We are meant to nasal breathe. Not only does the nose clean and filter the air, it delivers critical nitrous oxide to the blood and body.
Orofacial Myofunctional Therapy has been shown in literature to improve oxygen levels in Obstructive Sleep Apnea (OSA) It was shown to decrease the "apnea-hypopnea" by 50% in adults and 62% in children! It seems it is time for it to be considered as an adjunct therapy in sleep apnea cases, especially in children as it is easy, fun and painless.
OMDs: Common Signs and Symptoms of to watch for: vary with age, but key signs are:
- Open bite and/or over jet
- High vaulted palate
- Tongue thrusts forward during speech or swallow. Tongue rests in low forward position, lower lip may be rolled out.
- Lips open at rest
- Forward position of the head and neck
- Mouth breathing, dry chapped lips
- Dark circles under eyes
- Lack of energy
- Excessive movement in sleep
- Teeth grinding (jaws moving to try and open airway for oxygen intake)
- TMJ pain, TMD, or popping/clicking of joint
- Lisp or difficulty articulating certain sounds
- Overdeveloped or bunched chin muscle
- Excessive facial movement when swallowing (muscles compensate for inadequate tongue movement/coordination in swallow)
OMD signs in Infants -toddler
- Poor latching and difficulty nursing
- Colic, Gerd and gagging
- Open mouth posture, chapped, red lips & Tongue visible on low lip at rest
- Torticollis (tilted head)
- Difficult transitioning to solids, picky eating & extended use of tippy cup
- difficult articulating sounds or late speech
- Failure to thrive, often tired or listless
For more information here are some outside websites and research articles:
Neohealth Orofacial Myology https://orofacialmyology.com/
Academy of Orofacial Myofunctional Therapy AOMT https://aomtinfo.org/sleep/
OMD overview IAOM pdf http://iaom.com/wp-content/uploads/2018/10/OMD-Overview-IAOM.pdf
The Breath Institute https://www.thebreatheinstitute.com/
Angela Zappone RDH, CST-T, Your Integrative Dental Hygienist
Angie's brings 30 plus years of healthcare experience, and her unique perspective from the dental, medical, craniosacral, child birth, research, and nutrition professions to each and every appointment. She has walked through OMDs and airway issues with her own family, and worked with challenging cases in each of her fields. She truly understands how the fascia in the orofacial complex interconnects with the whole body, and the importance of looking at the entire picture. She believes a team attitude is very important, and works to understand her client (or parent's) needs. She believes treating Orofacial Myofunctional Disorders can be life changing, and often takes a great team of medical, dental and speech professionals, depending on the severity and complexity of the OMDs.
Contact: 206-498-7763 or contact@come2balance.com
Orofacial Myofunctional Therapy Prices
Therapy prices vary depending on the number and severity of OMDs. Angie offers a free phone consult to briefly discuss the issues. The initial appointment is a 1.5-2 hour examination to thoroughly evaluate the orofacial complex and determine the best treatment going forward.
Initial appointment: $200
Average therapy costs vary: single OMD like tongue reeducation and training average $1000
More complex issues with multiple OMDs averages $1500-2500. Treatment ranges from 6mo-12mo