Function matters to all body parts. Function allows us to complete and achieve many activities. Functioning legs allow us to run. Functioning hands allow us to write.
The same applies to the function of the tongue and lips. Their function matters to speech production, to eating and to an even more basic necessity of life: breathing.
I recently had an orthodontist reference the exercises of orofacial myofunctional therapy as “never-ending.” The quick reference caught me off-guard and my immediate response was to explain the point of OMT is not to assign a never-ending exercise regiment for a patient’s mouth. After all, who would do those exercises forever anyway? No one. Absolutely no one. It’s not functional. Ever.
It struck me in that moment that even professionals who share in knowledge of the same body parts but practice in different disciplines don’t necessarily have a decent grasp on the goals of their professional colleagues.
The more unfortunate part here is that the orthodontist made that statement in a dismissive manner of my professional role and services when in reality, that orthodontist really needs to learn more about something that could even benefit his/her own patients.
Every professional evaluates and assesses based from their professional lens. The list for professionals who deal with the mouth is lengthy, which means sometimes there is crossover between issues that a patient might be experiencing and the professionals who can help. Recognizing when to refer to another professional to help your patient is such an important piece of treating patients. It requires some knowledge about their area of expertise or a willingness at least to learn more about their area of expertise.
So here is a quick synopsis of orofacial myofunctional therapy.
The main goals are to help patients achieve optimal resting posture of their lips and tongue.
There it is–quick, but not so simple.
Resting posture is the way we hold our tongue and lips when we are not talking or eating. It is very important for a variety of reasons, primarily for an optimal breathing pattern, which is through our nose. The entire purpose of our noses is to act as the body’s filtration system for the air we breath in. It warms and filters the air, which reduces the amount of undesirable toxins that enter our body. This filtration helps reduce illness.
Additionally, nasal breathing also allows our bodies to perform the appropriate inhalation of oxygen and exhalation of carbon dioxide–the exchange of gases for appropriate respiration. It is the most efficient way for our bodies to become oxygenated and allows the each of the other body systems to work optimally.
Meanwhile, breathing through our mouths puts our bodies at risk for many problems:illness, periodontal problems, chronic bad breath, respiratory issues, high blood pressure, sleep disordered breathing/apnea just to name a few.
For children, there are additional risks including abnormal orofacial and dental growth.
This means when a child walks around all day with their mouth hanging open, they literally might change the shape and development of the entire face and mouth. The change in shape can result in a variety of other issues requiring medical intervention such as orthodontics, craniofacial surgery, respiratory care, etc.
When assessing a patient for speech-language therapy purposes, I complete an in-depth oral-motor exam that assesses the structure, strength, coordination and mostimportantly, the function of the tongue, lips, teeth, cheeks, palate and more. The function of these parts matters. It matters for feeding. It matters for speech production. It matters for nasal breathing, and therefore overall health.
Orofacial myofunctional therapy involves exercises to help improve function.
We might be working to elevate the tongue without support from the bottom teeth/lips. Elevation is important for production of some sounds; more importantly it’s a key part of swallowing. We might be working on lip retraction/protrusion to increase strength of lips for appropriate seal and closed resting posture. We might be working on nasal/diaphragmatic breathing.
All of the work helps patients to change their lips and tongue resting postures–they achieve a different resting posture than what they had previously (closed mouth vs. open mouth, tongue in the palate vs. lying in the bottom of the mouth).
They are working toward new habituation–that means developing a new habit for their tongue and lips. Habituation is a fancy way of saying a person no longer thinks about doing it–so while during therapy they may be heavily focused on making changes, the goal is to achieve the change and reach habituation–meaning they do it the new way without much thought or effort.
Orofacial myofunctional therapy can help the outcome for patients receiving care from other professionals.
⇒It can help a patient to achieve an optimal breathing pattern.
⇒It can help a patient to achieve lasting results from orthodontia.
⇒It can help a patient to achieve typical growth and development of the jaw, dentition and face.
⇒It can help a patient to achieve clear speech articulation so they are easily understood by everyone, including strangers.
⇒It can help patients to achieve better overall health and reduce the risk for major health problems such as high blood pressure.
It can help patients achieve so much but it is often a part of the overall treatment. Patients who receive this therapy from me might also be seeing the orthodontist, an ENT, a respiratory therapist, a craniofacial specialist, etc. The key here is communication and coordination in care between professionals from the various disciplines.
Therapy involves high intensity exercises to shift habituation from the less desirable resting postures to more desirable/optimal resting postures. If exercises are “never-ending” as suggested by that orthodontist, habituation is not being achieved.
Habituation is the end-game. Once it becomes habituation, orofacial myofunctional therapy is complete.
Think of it in terms of any other activity we do without thought–let’s use drinking from a cup for example.
When a child is young (say a toddler) we have that child start drinking from an open cup. We don’t expect that to be a clean process initially. It’s messy. Water is spilled. The child’s clothes get wet. Eventually, as the child keeps “practicing” drinking from an open cup, the skill becomes more precise. During the process, the child might have to think about how they are holding the cup (upright, not tipped as they may havedone with a bottle or sippy cup). They might have to think about how tightly they need to hold the cup. They might have to think about how much to tip the cup toward their face to get a sip without spilling. Eventually though, they won’t have to think about how to do it. They can take a sip while reading a book, watching television, playing a game. They have achieved habituation with drinking. Neither the child nor the parent need to continue working on achieving this skill.
Habituation is the goal.
Speech With Sara LLC provides private speech therapy and comprehensive evaluations in the areas of speech-sound disorders, early childhood language delays, language & literacy impairments and orofacial myofunctional disorders. Have questions or want more information, please email email@example.com or call 313-815-7916.