A focus on
OROFACIAL MYOLOGY
By Niki Fontaine, RDH

Orofacial Myology

Gardening hmm… A bit off topic but… I thought I could talk a bit about Growth and Development in Dental Prevention terms. As a Registered Dental Hygienist and Qualified Orofacial Myology Therapist what better to discuss than Orofacial Myology.

What is Orofacial Myology?
“Orofacial Myology is defined as the study and treatment of oral and facial muscles as they relate to speech, dentition, chewing/bolus collection, swallowing, and overall mental and physical health,” by S. R. Holzman.

Another definition is that orofacial myofunctional disorders (OMD), sometimes called “oral myofunctional disorder” and “tongue thrust,” are disorders of the face, mouth, lips or jaw. OMD’s may affect, directly and/or indirectly, breastfeeding, facial skeletal growth and development, chewing, swallowing, speech, occlusion, temporomandibular joint (TMJ) movement, oral hygiene, stability of orthodontic treatment, facial aesthetics and more.

Normal Development
All of us begin life with a tongue thrust swallow, by 6 to 8 years of age, transitioning out of tongue thrusting into correct resting tongue posture and swallowing pattern. When an issue or disorder begins, we can develop an OMD.

What causes an OMD?
An OMD includes abnormal repetitive habits such as nail biting, thumb, lip, tongue and finger sucking, pacifiers, or functional activities and postures like tongue tie, mouth open lips apart posture, teeth clenching/grinding, a forward interdental rest posture of the tongue and thrusting of the tongue in speaking and swallowing which can open the dental bite beyond normal rest position.

What happens and why be concerned?
OMD disorders lead to disruption of dental development in children and over-eruption of selected teeth in adults. In time, dental malocclusion, cosmetic problems and changes in jaw growth, development and position, as well as, impaired speech is noted in clients with OMD. For example: Chronic open mouth rest posture leads to increased vertical height of the face, retrognathic (retruded) chin, downward and backward growth of the lower face and flaccid lips. There also may be disfunction within the nasal airways, adenoids and tonsils or allergies which exacerbate the disorder.

What distinguishes dental treatment from orofacial myology treatment?
Dentist and Orthodontists are concerned with teeth together relationships, while orofacial myofunctional therapists are concerned with teeth apart postures, behaviours and muscle retraining work of therapy. The goal is therapy to create and restore normal processes of dental development in the oral environment. Treatment of OMD is called rest posture therapy and is effective, consistent and successful.

Rest posture therapy corrects the following:

Correcting lips-open mouth apart posture
Working to achieve lip competence, resting lip seal
Recapturing normal dental freeway space
Correct muscle imbalance with tongue rest and functional patterns

Who should treat OMD’s?
Speech pathologists, dentists and registered dental hygienists seek additional training in this specialty area. They are specifically trained and/or certified as an Orofacial Myologist with the credentials COM or QOM.

Is treatment effective?
Studies show an improvement of OMD’s can be 80-90% effective. Many factors contribute to success. Oral myofunctional therapy corrects muscle function problems which influence dental occlusion, facial shape, chewing, swallowing and tongue lip and jaw resting posture. Team effort, cooperation and communication is essential for long term successful therapy.