Orofacial Myology Disorder

What is an Orofacial Myology Disorder

The prefix, “myo” stands for muscle.  Orofacial Myology is the treatment of the orofacial musculature to improve muscle tonicity and establish correct functional activities of the tongue, lips, and mandible.  The treatment is recommended so that the growth and development can take place or progress in a stable, homeostatic environment.  Of the many possible myofunctional variations, those involving the tongue and lips receive the most attention.  A tongue thrust is the most common orofacial myofunctional variation.  During rest posture, an incorrect positioning of the tongue may contribute to improper orofacial development and maintenance of the malalignment of the teeth.  Many patients exhibit an open mouth, lips apart resting posture.  This can often detract from a pleasing facial appearance.

What Causes an Orofacial Myology Disorder?

Often it is difficult to point to one particular source as the sole cause of an orofacial myofunctional disorder.  In most cases it is the result of a combination of factors.  Many authorities suggest that orofacial myofunctional disorders may result from the following:
Improper oral habits such as thumb or finger sucking, prolonged use of pacifiers, cheek/nail biting, tooth clenching/grinding
Restricted nasal airway due to enlarged tonsils/adenoids and/or allergies.
Structural or physiological abnormalities such as a short lingual frenum (tongue tie)
Hereditary predisposition to some of the above factors

Why Be Concerned?

Orofacial myology disorders may have a negative effect on the development of the dentition, particularly dental eruption patterns and/or alignment of the teeth and jaws.  Speech patterns may become more imprecise or misarticulated.  Oral habit patterns may have a negative influence on the normal functioning of the temporomandibular joint.  Correcting or improving resting tongue or lip relationships can be instrumental in aiding the development of normal patterns of dental eruption and alignment. 
Myofunctional therapy for tongue thrusting and lip incompetence may be recommended for a variety of functional or cosmetic reasons.  If the patient already has orthodontic appliances, correcting the myofunctional disorder can help stabilize the orthodontic result by creating a healthier desirable, oral environment.
Therapy programs are designed to retrain patterns of muscle function and to aid in the creation and maintenance of a healthy, adaptive orofacial environment.  This can help in the retention of the orthodontic treatment, can help enhance one’s appearance, and can help maintain optimal dental health for a lifetime of benefits.

At What Age Should Therapy Begin?

There are many diagnostic criteria that must be considered.  The age of the patient is not as important as his/her motivation to succeed.  Children as young as four years old can benefit from a diagnostic session to determine if any preventative steps may be prescribed.  Children of seven or eight years of age are often mature enough to receive complete training.  Adults of all ages are capable of success in treatment

How Prevalent are Orofacial Myology Disorders?

Research examining orofacial myofunctional disorders in various populations found a prevalence of anywhere from 38% in the general population to 81% in children exhibiting speech/articulation problems.  (Kellum, 1992, Maul, et.al, 1999).
What about thumb and/or Finger Sucking and Other Harmful Habits?
Some individuals with tongue thrust have an accompanying sucking habit.  Prolonged thumb/finger habits may have a harmful effect on the orofacial environment as well as the individual’s self-esteem.  Most Certified Orofacial Myologists are trained to help the patient conquer sucking habits quickly, efficiently, and without coercion.

Is Treatment Necessary?  Who Should Treat?

Since there are many possible variations of orofacial myofunctional disorders, the effects of these patterns need to be evaluated individually, especially when there are dental, medical, or speech concerns.  The decision to treat or not to treat should be made by a professional specially trained and/or certified as an Orofacial Myologist.  Speech pathologists, dentists, and registered dental hygienists are among the specialists who seek additional training in this specialty area.  The International Association of Orofacial Myology, (IAOM), is a professional organization that can help identify professionals in your area who are trained and/or certified to provide this specialized treatment.

Is Treatment Effective?

Many recent scientific studies have shown that treatment for orofacial myofunctional disorders can be 80-90% effective in correcting swallowing and rest posture function and that these corrections are retained years after completing therapy.  (Hahn&Hahn,1992).  Although there are many factors that contribute to the success of the therapy program, cooperation is considered the essential factor.  A team effort is essential to success and communication between the therapist and referring dental community almost always warranty a successful therapy.