Orofacial Myofunctional Disorders and Therapy

What is an Orofacial Myofunctional Disorder (OMD)?

According to the definition by the International Association of Orofacial Myology (IAOM), an OMD includes one or more of the following:

abnormal labial-lingual rest posture, bruxism (teeth grinding), poor nasal breathing, tongue protrusion while swallowing, poor mastication and bolus management, atypical oral placement for speech, lip incompetency and/or digit habits and sucking habits (such as nail biting). These conditions can co-occur with speech misarticulations. In these instances, the articulation disorder is not developmental or phonological in nature, but rather a result of poor oral placement and inappropriate muscle development. OMD may reflect the interplay of functional behaviors, physical/structural variables, genetic, and environmental factors. (Billings et al., 2018, p. 1;

According to D’Onofrio (2019) an OMD includes “dysfunction of the lips, jaw, tongue, and/or oropharynx that interferes with normal growth, development, or function of other oral structures, the consequence of a sequence of events or lack of intervention at critical periods that result in malocclusion and suboptimal facial development” (p. 1). Both definitions point to the fact that 1) OMDs occur across the lifespan; 2) OMDs are the nexus of function and structure; 3) the diagnosis considers the interaction of how atypical movement patterns result in structural changes; 4) and how structural anomalies impact functional skills.

Orofacial Myofunctional Disorders are often related to or can contribute to a variety of medical and dental disorders. These disorders can include but are not limited to:

  • Airway Obstruction (ex . enlarged adenoids, or deviated septum)
  • Changes associated with abnormal jaw growth and position
  • Cleft Palate
  • Down syndrome
  • Dysphagia
  • Malocclusion (improper alignment of the teeth)
  • Periodontal disorders
  • Orthodontic relapse
  • Sleep Apnea/Sleep Disordered Breathing
  • Temporomandibular Joint Disorder (TMJ)
  • Tethered Oral Tissues (buccal, lip pr tongue tie)

What is an Orofacial Myofunctional Therapy (OMT)?

Orofacial Myofunctional Therapy is an evidenced-based treatment approach that falls under the umbrella of oral motor  therapy and is not to be confused with Non-Speech Oral Motor Exercises (NSOME) as described by DR. Lof. Orofacial Myofunctional Therapy uses muscle strengthening exercises, therapeutic tools and tactile stimulation in order to target oral motor skills for swallowing, oral placement skills for speech as well as reduction of noxious oral habits and improper oral posture. The primary purpose of orofacial myofunctional therapy is to create an oral environment in which normal processes of orofacial and dental growth and development can take place, and be maintained (Hanson & Mason, 2003). According to ASHA, orofacial myofunctional  therapy  (OMT) can be effective in the treatment of OMDs, including:

  • Establish patent nasal airway
  • Improve speech sound articulatory placement
  • Eliminate non-nutritive sucking
  • Modify handling swallowing of liquids, purees, solids and saliva
  • Improve oral resting posture
  • Perform labial-lingual-pharyngeal muscle resistance exercises

Who Treats OMDs?

Only Speech-Language Pathologists  (SLPs) and Registered Dental Hygienists (RDHs)  have OMT listed in national scopes of practice through the American Speech and Hearing Association and the American Dentals Hygienist Association. These are the best professionals to provide OMT with children who are aged 4 and up (IAOM, 2020). It is important to note however that OMDs can be noticed at birth such as a tongue-tie. The way in which an OMD is treated depends on the age of the patient and cognitive status. Read more about this here: https://talktools.com/blogs/from-the-experts/orofacial-myofunctional-disorders-omd-pediatric-feeding-disorder. In addition, various disciplines treat different aspects of OMD. For example, a physical therapist may be a TMJ specialist and assist with pain management of the joint, or an occupational therapist may treat the feeding manifestations of an OMD. To learn more, click here: https://cdn.shopify.com/s/files/1/1545/7007/files/FINALLSCOPE4.pdf?452

TalkTools Certified Orofacial Myologists (COMs®)

Only the International Association of Orofacial Myology (IAOM) has a trademarked certification that has a certifying non-profit body and standardized protocol with CE requirements to maintain the certification. This is a Certified Orofacial Myologist®(COM®). Several of our instructors have achieved this prestigious certification:

 TalkTools Fellow of Orofacial Myology (FOM)

  • Lori L. Overland (link to page)

 Tools for Orofacial Myofunctional Therapy

  • Adult Straw with Lip Block

  • Bite Tube Set

  • Button Pull Kit

  • David Decides About Thumbsucking (Heitler)

  • Functional Assessment and Remediation of Tethered Oral Tissue (Merkel-Walsh & Overland)

  • Honey Bear

  • Jaw Grading Bite Blocks

  • Liper Tool

  • Original Horn Kit

  • Original Straw Kit

  • Recessed Lid Cup

  • Sensi Pre-Feeding Kit

  • Sensi Tips

  • SMILE Program (Merkel-Walsh)

  • Stop Thumb Sucking (Marshalla)

  • Swalloworks (Boshart)

  • Syringe

  • The Myofunctional Evaluation (Boshart)

  • Tongue Lateralization and Elevation Tool

References