Working out the Orofacial Complex: Guest Post By Brittny Murphy, RDH, COM®, QOM
Orofacial myofunctional therapy dates back to 1918 when Alfred Rogers first spoke about the effects of the musculature of the mouth. It is not a new therapy but gaining popularity rapidly. Myofunctional therapy neurologically strengthens and reeducates the muscles of the face, lips, tongue, and pharyngeal airway. It is like physical therapy, but for your mouth. We teach facial and tongue exercises, and behavior modification techniques to promote optimal breathing, oral rest posture, and chewing and swallowing patterns. I always tell my patients, your orofacial muscles are like any other muscle in your body- if you don’t use it, you lose it!
My goals are the same for every patient I work with. They include exclusive nasal breathing, lip seal, tongue resting in the roof of the mouth, and proper/optimal chewing and swallowing patterns. At rest, your tongue should be resting in the roof the mouth and your lips should always be closed. Say the letter, ‘N’. Feel where the tip of your tongue hits right behind your upper front teeth? This should be the natural resting position for your tongue. Unfortunately for a majority of my patients, this is not where their tongue rests. It may be in the floor of their mouth or between the teeth. Somewhere along the way something went wrong.
We are born obligate nasal breathers. Our tongue should act as a natural palate expander resting in the roof of our mouth. If in the correct position, our upper jaw will grow in a “U” shaped arch allowing room for our adult teeth to come in straight, versus a “V” shaped arch which would be high and narrow causing constriction and malocclusion. It is when our tongue posture drops, we generally tend to begin breathing through the mouth. Try it, suction your tongue into the roof of your mouth and open wide. Try to breathe through your mouth. It is physically impossible.
We must find the root cause of the problem. Why did somebody begin to mouth breathe? Do they have enlarged tonsils or adenoids? Do they have a deviated septum or enlarged turbinates? Do they have a tethered oral tissue such as a tongue-tie that is tethering their tongue to the floor of their mouth? In that aspect, myofunctional therapists are like detectives. However, we can’t do it alone. It is important we work as an interdisciplinary team for optimal patient outcome. For example, if I have a patient that comes to me with a high, narrow arch and a chronic mouth breathing habit I can’t just enroll them in a myofunctional therapy program and hope for the best. I would refer to provider who can give my patient the expansion they need and a referral to an ENT to assess the patency of the airways.
Check out www.ctorofacialmoylogy.com for a free airway screening!
Learn more about this subject in Dr. Solomons's recent post.