What is an OMD?

An orofacial myofunctional disorder involves behaviors and patterns created by inappropriate muscle function and incorrect habits involving the tongue, lips, and jaws. Orofacial myofunctional disorders include one or a combination of the following:

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• Incorrect Swallowing Pattern (Tongue Thrust) – the improper placement and function of the tongue during swallowing. When swallowing, the tongue thrusts in between, forward or sideways against the teeth.

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• Incorrect Lip/Tongue Resting Posture – includes open lip posture and low or forward tongue resting posture against the teeth.

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• Oral Habits – Thumb, finger or pacifier sucking habits beyond an appropriate age. Other oral habits include fingernail biting, lip biting, lip licking, and tongue sucking.

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Why should OMDs concern me?

OMDs may negatively impact dental and facial growth patterns, particularly dental eruption patterns or alignment of the teeth and jaws. Research has shown that the consistent pressure from the resting posture of the tongue against the teeth is more influenctial in malocclusions than an incorrect swallowing pattern (tongue thrust). Constant pressure of the tongue against the teeth at rest can slow orthodontic treatment and undermine the stability of the orthodontic correction. Speech patterns may become distorted or misarticulated due to the low forward postural positioning of the tongue.

Some indicators of these OMDs include:

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• Frequent mouth breathing in the absence of allergies or nasal congestion.

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• Frequent open-lips resting posture.

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• Habitual low tongue resting posture against the upper/lower teeth.

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• Lips are often dry, chapped, cracked and sore from excessive licking.

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• Tongue protruding between or against the upper/lower front teeth when forming /s/, /z/, /t/, /d/, /n/, /l/, /sh/ and /j/.

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• During the act of swallowing, the lips squeeze and the chin has a tightened appearance.

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• Noisy chewing and swallowing (smacking and gulping).

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How are OMDs Corrected?

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Orofacial Rest Posture Therapy (also known as Orofacial Myofunctional Therapy) is designed to correct the tongue resting posture, teach a closed lips nasal breathing posture, correct eating, drinking and swallowing patterns and any speech articulation problems which may be related to the habitual open-lips resting posture. Therapy involves several stages:

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• In the beginning, an individualized program of therapeutic exercises and techniques focuses on developing and retraining the oral/facial musculature.

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• These new muscle patterns are then utilized in chewing, swallowing, and the proper resting posture of the tongue, lips, and facial muscles at the conscious level.

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• The most difficult and final part of therapy, is to firmly establish these new muscle patterns at the subconscious level.

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In some instances prior to therapy, there may be some orthodontic correction initiated to encourage the development of a more "normal" environment for correct function and rest postures. It may be necessary to have a nasal airway assessment by a medical doctor to ensure the individual can breathe comfortably through the nose.

Length of treatment depends on the specific issue(s) involved and the individual's consistency with therapeutic assignments given and the dedication to therapy.

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When Should Therapy Begin?

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The age of the individual is not as important as their maturity level and the motivation to succeed. Early intervention, such as elimination of sucking habits or assessment of other causative factors may help prevent OMDs. Children as young as five years may benefit from a comprehensive evaluation to determine if any preventative steps may be of benefit. Children of 7 or 8 years of age are often ready for the full Orofacial Rest Posture Therapy program.