Orofacial Myofunctional Disorders (Tongue Thrust)
ABOUT
Orofacial myofunctional disorders (OMD) can affect children and adults across the lifespan. OMDs encompass an array of oral motor disorders that impact the normal structural growth and functional development of the oral-facial complex. This includes the jaw, lips, tongue, and cheeks. As a result, OMDs can impact breastfeeding, dentition, chewing, swallowing, and speech.
CAUSE
There are many reasons why a person can develop orofacial myofunctional disorders. Common causes may include, but are not limited to:
- Tethered oral tissue: ankyloglossia (tongue-tie) or lip tie
- Noxious habits: Persistent finger/thumb sucking, pacifier use and bottle use
- Upper airway obstruction
- Orofacial muscular and structural differences
- Genetics
DIAGNOSIS
Similar to feeding/swallowing disorders, diagnosing an orofacial myofunctional disorder requires expertise from multiple professionals:
- Ear, nose and throat specialists
- Dentists
- Orthodontists
- Dietitians
The scope of the speech-language pathologist who has undergone special training and experience in myofunctional therapy will provide a thorough review of all systems that involve the act of breathing, speaking, chewing, and swallowing. Each of these systems will be reviewed in order to assess the degree of an orofacial myofunctional disorder.
- Medical/surgical history
- Feeding development
- Speech development
- Airway patency/respiratory breathing patterns
- Orofacial resting posture and symmetry
Tongue thrusting is the most common orofacial myofunctional disorder because it is the most evident and observable.
TREATMENT
Myofunctional therapy is neurologic re-education for the orofacial musculature to restore normal form and function so that all these structures are properly symmetrical and aligned in their intended natural resting postures. Each child or adult therapy program will look very different and is dependent on the causes and degrees of orofacial muscle imbalances in strength and range of motion. Generally, therapy goals will include the following:
- Teaching proper breathing posture and correcting the use of the orofacial musculatures
- Correcting dysfunctional oral habits
- Achieving symmetrical resting postures of the orofacial complex
- Increasing placement awareness
- Achieving proper chewing and oral preparation of food
- Teaching swallowing exercises
- Practicing specific speech sound production
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