While orofacial myofunctional disorders (OMDs) may be identified throughout the lifespan, orofacial myofunctional therapy is not applicable to infants or babies, due to the need for active involvement in the therapy process. However, recognizing these issues early and making the appropriate referrals to qualified specialists are preventative for compound problems that may occur later in life. This includes issues such as mouth breathing, tethered oral tissues, and orofacial muscle tone issues. The referral and/or treatment of patients may be provided by an interdisciplinary healthcare team that includes dentists/orthodontist (DDS), physical therapist (PT), occupational therapist (OT), craniosacral therapist (CST), otheopathic (DO), speech language pathologist (SLP), oral surgeons, ENTs, sleep medicine specialists, and body work professionals, and lactation consultants.

Ideally an IBCLC or an SLP/OT who is both a Board Certified Orofacial Myologist® and a feeding specialist will work with newborns and infants who present with OMDs early in life, to help mitigate oral motor and feeding challenges that are addressed with oral motor and feeding therapies.

Clinical RDHs who are also Board Certified Orofacial Myologists® can be a critical part of the care team through early oral health screenings, evaluations for TOTs as well as working with release providers for active wound management post-frenectomy.

This is a large age range, that can present with a myriad of issues including mouth breathing, sleep disturbances, temporomandibular joint disorder, orthodontic problems, tethered oral tissues, poor oral rest posture, difficulty with chewing, challenges with the oral preparatory and transit phases of swallowing, tongue thrusting, reduced speech clarity, feeding disorders (picky eating), voice disturbances (hoarseness and resonance issues) and prolonged noxious habits. The older the child, the more they may have developed physical compensations (i.e. atypical head and neck posture, atypical oral placements for speech).  Over time, if left untreated, symptoms of breathing, sleeping, swallowing, and speech deficits may impact the activities of daily living. 

It is important to note that orofacial myofunctional therapy is an integral part of orthodontics and studies have shown that it may shorten orthodontic treatment time and prevent orthodontic relapse. Those patients experiencing negative craniofacial growth, TMJ pain and dysfunction, obstructive sleep apnea (OSA), or upper airway resistance syndrome (UARS) may also benefit from orofacial myofunctional therapy as part of an interdisciplinary plan of care.  An RDH,Board Certified Orofacial Myologist, physical therapist, ENT, sleep specialist and/or dentist specializing in TMJD are often needed in these specific cases.

The referral and/or treatment of patients >4 years of age may be provided by an interdisciplinary healthcare team that includes but is not limited to a Board Certified Orofacial Myologist, dentist/orthodontist (DDS/DMD), registered dental hygienist (RDH), physical therapist (PT), occupational therapist (OT), craniosacral therapist (CST), osteopath/ chiropractor (DO/DC), speech-language pathologist (SLP), oral surgeon, ENT, sleep medicine specialist, and bodywork professionals.

For more information, please visit the American Dental Association (www.ada.org), The American Academy of Pediatric Dentistry (www.aapd.org), The American Dental Hygiene Association (www.adha.org), The American Speech-Language Hearing Association (www.asha.org) or The Oral Motor Institute (www.oralmotorinstitute.org).

Orofacial myofunctional disorders (OMDs) in this age group may include issues with nasal breathing, chewing, the oral preparatory phase of swallowing, speech sound development and oral rest posture. The toddler age range, from 2-3 years old, requires commitment & compliance from both the caregivers and the child. 

This age range benefits with oral motor, feeding and oral placement therapy techniques to remediate the OMD. Young children with OMDs may need the expertise of the pediatric dysphagia specialist (SLP/OT) to select the right feeding utensils, food textures and placement of the food into the mouth to optimize feeding safety and maximize progress in therapy.

For toddlers aged 2-3 years old who have myofunctional disorders without feeding issues, the focus shifts to supporting proper nasal breathing, promoting an ideal oral rest posture, and addressing related concerns such as breathing patterns, airway growth, sleep quality, and the risk of malocclusion. A proper oral rest posture, with lips closed, nasal breathing, the tongue resting on the palate, and teeth slightly apart, helps maintain balance in the oral and facial muscles, reducing the likelihood of malocclusion as the child’s teeth and jaws develop. Therapy may include simple exercises to strengthen orofacial muscles and improve breathing patterns, which can positively impact sleep quality. Caregivers are essential in reinforcing these habits and exercises consistently, fostering optimal orofacial and airway development while promoting better long-term health outcomes for their child.

Some preschoolers may start to develop skills to engage in OMT exercises as they age and improve their ability to follow volitional directions and self-monitor, which usually occurs by the age of 3.5-4.0 years. At this point children need to have some sense of self-monitoring, age-appropriate motor planning skills and the ability to imitate OMT techniques.

At this age, if a child has not already been weaned from sucking habits, such as thumb sucking or pacifier use, then it should be addressed by using habit elimination programs. Therapists use a non-invasive, positive reinforcement program to help eliminate these habits without the use of punitive oral appliances. This age group is also ideal for early myofunctional appliances that may assist in guiding facial growth, supporting the development of the orofacial complex.

Children and adults with special needs also fall into this category.  A Certified Orofacial Myologist® (Board Certified Orofacial Myologist) may not be dually trained in specific feeding, swallowing and speech techniques which are more passive in nature and designed for individuals who cannot follow volitional directions.

The referral and/or treatment of these patients may be provided by an interdisciplinary healthcare team that includes but is not limited to a Board Certified Orofacial Myologist (ages 3-4 and up), dentist/orthodontist (DDS/DMD), registered dental hygienist (RDH), physical therapist (PT), occupational therapist (OT), craniosacral therapist (CST), osteopath/ chiropractor (DO/DC), speech-language pathologist (SLP), oral surgeon, ENT, sleep medicine specialist, and bodywork professionals.