By: Rachel- Fisch Kaplan MS, CCC-SLP

What are orofacial myofunctional disorders?

Orofacial myofunctional disorders (OMDs) are patterns of movement that interfere with the normal growth, development, or function of facial structure. They are also referred to as oral myofunctional disorders or tongue thrust. OMDs can be caused or exacerbated by non-nutritive sucking behaviors (e.g., thumb sucking, teeth clenching, teeth grinding) that lead to abnormal development of dentition and the oral cavity.

OMDs that are commonly seen in children include:

  • Tongue thrust
  • Swallowing with interdental tongue placement (i.e., reverse swallow) 
  • Imprecise articulation 

What is tongue thrust?

Tongue thrust is the habitual resting or thrusting of the tongue forward/sideways against or between the teeth while swallowing, chewing, resting, or speaking. This continuous light pressure pushes the upper teeth forward and away from the upper alveolar ridge causing an open bite. 

Nearly all infants exhibit a swallowing pattern involving tongue protrusion. However, by 6 months of age, most infants integrate this reflex allowing for ingestion of solid foods. In children, tongue thrusting often results from immature oral behaviors, narrow dental arch, enlarged tonsils and adenoids, prolonged upper respiratory tract infections, spaces between the teeth, muscle weakness, malocclusion, abnormal sucking habits, and/or an open mouth posture due to genetic structural abnormalities. Resting posture of the tongue, jaw, and lips is crucial to normal development of dental/facial growth and swallowing patterns. 

There are pertinent symptomatic questions that can be considered when diagnosing tongue thrust:

  • Tongue protrusion at rest
  • Habitual mouth breathing
  • High and narrow palatal arch
  • Tongue tie (ankyloglassia)
  • Lip tie
  • Malocclusion
  • Low tone/ weak muscles of jaw, lips, tongue and cheeks

What causes tongue thrusts?

The causes of tongue thrusting pattern can be from one or more of the following:

  • Upper airway constrictions
    • Deviated nasal septum
    • Enlarged tonsils and /or adenoids
    • Chronic infections (rhinitis)
  • Prolonged bottle usage
  • Prolonged pacifier or digit sucking
  • Hypotonia/Low body tone
  • Low-lying tongue resting posture

What are the consequences of a tongue thrust pattern?

The results of the continual light pressure from the forward resting position of the tongue causes:

  • Interdental or frontal lisping/ imprecise articulation during production of: 
    • tongue tip speech sounds (/s, z, t, d, n, l/) 
    • lingual/palatal speech sounds (/sh, ch, dz/) 
  • Open mouth posture
  • Dental issues 
    • Open bite
    • Overbite
    • Over jet
    • Abnormal eruption of teeth
    • Abnormal dental arch
  • Abnormal tone of facial muscles
  • Drooling or pooling of saliva 
  • Inefficiency during the oral phase of chewing and swallowing
  • Imbalance in dental growth
  • Inadequate development of facial/cranial bones
  • Inappropriate development of muscles in head and neck

What are my treatment options at CommuniKids?

At CommuniKids, we implement a non-invasive approach to treat the muscles of the face, cheeks, lips, and tongue and their functions as they relate to breathing, resting, sucking, chewing, swallowing, and speaking. 

Myofunctional therapy is the postural training of the tongue, lips, and cheeks to restore and/or establish correct placement and function. Myofunctional therapy re-educates the tongue to rest against the palate as well as to recapture the dental freeway space. This improves chewing, breathing, sleeping, speech, and swallowing. 

A team approach is often utilized and is very effective. Our team collaborates with dentists, orthodontists, physicians, orthognathic surgeons, ENTs, osteopaths, nutritionists, dental hygienists, and sleep specialists to work with newborns to young adults. 

Our team of Qualified Orofacial Myologists and oral motor specialists evaluate and teach oral rest posture and chewing/swallowing mechanics through hands-on techniques to remediate/treat:

  • Tongue trust
  • Reverse swallowing pattern
  • Jaw clenching/grinding
  • Mouth breathing
  • Tongue ties
  • Abnormal chewing/swallowing
  • Latching on/suction for infants
  • Cessation of thumb sucking 
  • Open mouth posture 
  • Misarticulation of speech

The therapists at CommuniKids provide a multi-faceted combination of methodologies that include Myofunctional and Oral Motor therapy treatment protocols. We incorporate techniques from orofacial myology, Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT), TalkTools Oral Placement Therapy, Pamela Marshalla’s Protocol, Beckman Oral Motor Protocol, and Beckman Oro-facial Deep Tissue Release.

If you would like to learn more about orofacial myofunctional disorders or if you believe myofunctional therapy may be appropriate for your child, contact us today