OROFACIAL MYOFUNCTIONAL DISORDERS
SIGNS & SYMPTOMS
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Digestive Issues
Acid reflux, bloating/gassiness, fatigue, and food sensitivities are commonly seen in people with myofunctional disorders. When improper swallowing habits exist or when the tongue rests incorrectly in the floor of the mouth, the vagus nerve (Cranial Nerve X) does not get stimulated as much as it would with healthy function.
This nerve is a direct connection between the brain and your digestive system (and other major organs and systems). It plays a key role in our parasympathetic nervous system, which is responsible for our "rest and digest" activities. Release of enzymes, increased blood flow, and motility throughout the digestive tract are all stimulated by the vagus nerve.
The vagus nerve also plays a role in satiation following food consumption. Interferences in vagal nerve receptors have been shown to cause greatly increased food intake, and may be a part of one's struggle to lose weight.
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Mouth Breathing
What is wrong with mouth breathing?!
Mouth breathing may lead to:
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headaches
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periodontal disease
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sore throat/cold symptoms
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bad breath
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increased risk of cavities
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poor sleep->chronic fatigue->ADHD-like symptoms
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digestive issues
Mouth breathing can affect the development of the face and jaw, altering physical appearances such as:
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long/narrow face and mouth
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less defined cheekbones
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smaller lower jaw
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weak chin
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dental crowding
It also changes the position of the tongue during rest. Ideally, the tongue should rest along the roof of the mouth (the palate). Mouth breathing forces the tongue to sit low in the floor of the mouth, leading to the underdevelopment of oral musculature and possibly causing troubles with speech, chewing and swallowing.
Oxygen is the human body's number one priority for life, and the mouth is a great emergency source for air when there is a nasal blockage. However, when mouth breathing becomes a habit, many health issues may follow. It is important to address nasal blockages and consider nasal breathing a powerful tool in preventive medicine. Mouth breathing is acceptable while under physical exertion lifting heavy loads, and absolutely necessary if a nasal blockage is present, but an effort should be made to breathe through the nose day and night.
Causes of mouth breathing include:
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Allergies/food sensitivities
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Asthma
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Chronic nasal congestion
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Deviated septum
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Enlarged tonsils/adenoids
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Nasal polyps
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Respiratory infection
The nose is anatomically designed for breathing. It is within our paranasal sinuses during nasal breathing that nitric oxide (NO) is produced. NO allows for better oxygen utilization in the body and plays several important roles including decreasing blood pressure and inflammation in arteries, immune defense, memory and learning, and much more. NO can also help protect the gastric mucosal layer and decrease permeability of your GI tract. Mouth breathing can contribute to poor absorption of nutrients during the digestion process. Those who breathe through their mouths tend to have a stimulated sympathetic nervous system ("fight or flight" response) which encourages shallow breathing. Nasal breathing, on the other hand, stimulates the parasympathetic system ("rest and digest") and allows for deeper, more efficient breathing.
A myofunctional therapist can help you determine if further evaluation of airway is needed as well as assist in correcting poor breathing patterns.
For further reading...
Video from YouTube channel Aurora Kids Dentistry: https://www.youtube.com/channel/UC3aNEtadDZgkMXoYymFMQ9g
Noxious Oral Habits
Thumb sucking, tongue sucking, nail biting, hair chewing etc. can have a negative impact on the development of your face and jaw bones. When young ones grow up sucking their thumbs, the shape of the palate grows high and narrow, and a tongue thrusting habit is often formed. High, narrow dental arches mean less available space for erupting permanent teeth and smaller nasal floors, making it harder to breathe through the nose. Poor tongue resting posture (down in the floor of the mouth rather than along the palate) and mouth breathing come hand in hand, and can cause sleep breathing disorders. Working with your myofunctional therapist to break these habits at a young age, along with follow-up therapy to re-educate the affected muscles shows great promise in recovering these oral structures.
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Orthodontic Relapse
Myofunctional therapy can improve the likelihood that your teeth will stay in place after your braces are removed, and possibly decrease your total time in orthodontic treatment if you have a "tongue thrust" swallowing pattern. The tongue can act as a natural retainer for your upper teeth when it rests in the correct position.
It's best to start OMT before braces are placed, but therapy can also take place during or after orthodontic treatment.
For further reading...
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Effect of Tongue Thrust Swallowing on Position of Anterior Teeth
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Causal relationship between malocclusion and oral muscles dysfunction: a model of approach
Sleep Breathing Disorders
Snoring can essentially be the early sign of developing obstructive sleep apnea (OSA)- a serious medical condition in which your brain and body are deprived of oxygen while you sleep.
Upper airway resistance syndrome (UARS) is very similar to OSA in that the soft tissue of the throat relaxes, reducing the size of the airway. The increased effort to breathe often causes brief awakenings (often undetected by the affected individual), daytime sleepiness and cognitive impairment. Women are more likely to have UARS, which is often accompanied by symptoms of insomnia, morning headaches, chronic fatigue, anxiety or depression.
Snoring, obstructive sleep apnea (OSA) and upper airway resistance syndrome (UARS) all indicate a restricted airway. If you have been associated with any of the terms listed below, please consider a phone consult to learn how myofunctional therapy may help your individual symptoms.
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Snoring
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Sleep apnea
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Sleep breathing disorders
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Mouth breathing
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Drooling
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ADHD-like symptoms
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Tongue-tie/tethered oral tissues (TOTs)
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Teeth grinding
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Anxiety
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Forward-head posture
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Chronic ear infections
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Digestive Issues
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GERD
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Insomnia
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Bed-wetting
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Chronic pain
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Morning headaches
If the tongue tends to rest on the floor of the mouth rather than along the palate, the oral muscles are not functioning properly and this can contribute to obstructions of your airway. Myofunctional therapy can help re-pattern tongue posture and strengthen these airway specific muscles in order to reduce your snoring and/or sleep apnea symptoms. Sometimes there are physical limitations and it is always important to assure that no tongue-tie or nasal blockage is present. ENTs and sleep medicine specialists can help with diagnosing airway disorders.
For further reading...
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Sleep-Disordered Breathing in a Population-Based Cohort: Behavioral Outcomes at 4 and 7 year
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Pediatric Obstructive Sleep Apnea and the Critical Role of Oral-Facial Growth: Evidences
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Effects of Oropharyngeal Exercises on Snoring: A Randomized Trial
Myofunctional therapy may prevent
future necessity of a CPAP machine.
Tongue Tie (ankyloglossia)
The tissue connecting the tongue to the floor of the mouth is called the lingual frenum or frenulum, and when this tissue physically restricts the mobility of the tongue, it is called a "tongue tie" or "lingual tie" or medically termed "ankyloglossia." Tissues connecting your lips and cheeks to your gums (buccal/labial frenum) may also be restricted, and these are referred to as Tethered Oral Tissues (TOTs). The release of these tissues is often recommended for infants having trouble breastfeeding (after a thorough evaluation) and may also be recommended for people of all ages during therapy if necessary. Myofunctional therapy is critical before, during and after tongue release surgeries in order to attain the greatest results and decrease your chances of reattachment.
There are several names for tongue release surgeries, all of which have the same goal: increasing tongue mobility and improving oral function: "lingual frenotomy," "lingual frenectomy," "lingual frenuloplasty," and "functional frenuloplasty," are becoming more common for adults, as more research is showing the relation of tongue-tie and other chronic health concerns.
Some restricted lingual frenums are very easy to see in the mirror, but sometimes the tie is deep under the tongue and takes a trained eye to detect. This is referred to as a "posterior tongue-tie" which can affect an infant's ability to latch and can play a role in developing TMD, sleep apnea, ADHD and several other health concerns for people of all ages.
Infants should always be checked for tongue tie and other TOTs if they have difficulty breastfeeding or have GERD symptoms. A successful latch between mother and infant is challenging if not impossible when a tongue-tie is present. Poor latch causes infants to swallow great amounts of air which can cause excess bloating, vomiting, spit-up and other GERD-like symptoms, in addition to very painful circumstances for the mother. Certified lactation consultants are highly recommended for difficulties with breastfeeding, as successful breastfeeding has countless benefits for the growth and development of your child.
For further reading...
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Tongue-Tie - MayoClinic
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Short Lingual Frenum and Obstructive Sleep Apnea in Children
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Evaluation of a tongue - RDH Magazine
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Lingual, labial frenums: Early detection can prevent health effects associated with tongue-tie - RDH Magazine
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Dr Lawrence A Kotlow - has a wealth of great information!
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How Adult Tongue-Tie Release Saved My Life! - Dr Steven Lin
Tongue Thrust
A "tongue thrust" swallowing pattern is considered a myofunctional disorder, and can cause problems with dental development, speech, facial muscle tone, and even breathing.
It is a behavioral pattern in which the tongue protrudes through the teeth during swallowing, speech, and rest. This bad habit often begins with frequent thumb-sucking or use of a pacifier as an infant. The brain is conditioned to thrust the tongue forward even after the sucking habit is no longer present.
Tongue thrust often coincides with poor resting tongue posture (low in the mouth rather than along the palate) and can result in an open bite and pushing the teeth and facial bones forward.
With healthy function, the tongue should be placed on the roof of the mouth rather than between the teeth during a normal, healthy swallow.
For further reading...
TMD
(Temporomandibular Joint Dysfunction)
TMD symptoms are seen in people of all ages, and it has been estimated that 30% of adults suffer from jaw pain. The tongue plays a major role in jaw stabilization, and if it isn't functioning properly or if it rests in the wrong position, there is a very high chance this can be contributing to your symptoms. History of teeth grinding or visual signs reported by your dentist such as "occlusal wear" or "abfractions" are often treated with nighttime appliances. Tooth grinding (bruxism) can be a sign of a restricted airway during sleep. If you struggle with clenching/grinding, it might be time to evaluate your tongue and it's relation to your jaw joints. Myofunctional therapy may relieve your headaches and jaw pain if the root of these issues is related to your tongue and it's association with jaw movements.
For further reading...