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Orofacial Myofunctional disorders can be described in terms of "how the muscles of the face mouth and throat work" and "How the tissues & muscles of the face mouth and throat look". They may occur in conjunction with anatomical anomalies and oral habits, chronic medical condition, dental or orthodontic problem, or diagnosed disability. An OFMD be associated with digestive, respiratory or aesthetic issues. Recent research describes a relationship between OFMD and potential for Sleep Disordered Breathing or Obstructive Sleep Apnoea. When diagnosing an OFMD, we look at:
Orofacial Myofunctional Assessment includes a thorough orofacial examination at rest and during function, (swallowing, chewing, speaking, breathing) and oral habits. Speech assessment is an integral part and can only be done by a skilled Speech Pathologist who is trained in differential diagnosis of speech disorders. Speech problems may co-exist and have a direct relationship to an OFMD but may also be independent of OFMD.
Orofacial Myofunctional assessment and diagnosis includes identification of:
The goals of OFM interventions are to assist in the creation, restoration and maintenance of a normal orofacial muscle environment for orofacial muscle rest postures and functions, including chewing, swallowing, breathing, resonance and speaking. Therapy is aimed at neuromuscular retraining until new habits become an automatic part of daily life. Progress and results are seen as early as 3 months of therapy however, with diligent home practice, much faster results are seen. Some evidence shows that this process can take up to 2 years, that means “chipping away, a little everyday”, at home practice over long periods to allow new habits to develop and consolidate. Regular reviews may be required to ensure good habits are establishing and old habits are on the way out.
Ideally Orofacial Myofunctional Disorders are identified and corrected in the first 6 years of life especially during early breast and/or bottle-feeding, where it can have its most dramatic affect. Any underlying medical issues which lead to mouth breathing need to be corrected in conjunction with Orofacial Myofunctional therapy to ensure the most ideal result. The ages 0-6 is a critical developmental period for the bones of the face and jaws. The longer poor habits are left, the higher likelihood that detrimental muscle habits associated with e.g. tongue fronting and mouth breathing will have a negative affect on growth of the upper jaw, and the likelihood of dental and orthodontic problems increases dramatically.
First and foremost, it is important that all underlying medical issues contributing to mouth breathing or open mouth posture and tongue-fronting are addressed: e.g. URTI, allergy, nasal obstruction (deviated septum) either before or during the initial stages of the treatment program. Involvement of a Respiratory or Sleep Specialist, ENT and/or ALLERIST may be required. Failure to address these issues will contribute to perpetuation of orofacial muscle dysfunction and poor success in OFM treatment.
Further reading www.medicinenet.com/upper_respiratory_infection/article.htm
Early correction of OFMDs can interrupt the development of dysfunctional habits, which take longer to correct if treated later and once dysfunctional habits have become established. Early intervention supports development of ideal orofacial muscle habits that will support ideal growth of the skull face and jaws. Oral habits e.g. thumb sucking are well known to distort the shape and growth of the upper jaw. The general rule of thumb is correct the oral habit by age 2 and at the VERY LATEST by age 4.
If the problem is not corrected before the age of 6, it is not too late to change habits and Orofacial Myofunctional programs can be successful at any age, but it will take longer and is more likely that other dental and/or orthodontic interventions are required e.g. plates or expanders to help correct the narrow upper jaw associated with tongue fronting and mouth breathing.
Your treatment program will be individually designed, depending on results of your assessment. Treatments are usually half hour weekly sessions that can run from 4-14 weeks. Your progress in treatment is dependant on many factors, including other concurrent detail or orthodontic treatments, co-existing conditions, which may need to be resolved concurrently or prior to commencement of your program e.g. allergies and mouth breathing habits that need to be managed. Diagnosed conditions which impact muscle strength and control will lead to slower changes and programs are modified according, to the pace that can be happily managed by you and your child.
Your success in therapy is heavily dependant on the effort you put in, so the other demands in your life, and timing of therapy are important factors in determining the ‘start-point’ for a program and will influence your success.
A formal progress review will be required following treatment.
Your team of medical and dental professionals will be able to let you know when your treatment goals are successfully reached. You may know yourself, when e.g. new habits for swallowing chewing and breathing have become a natural part of life, without you having to pay attention to them. Before and after photos and videos will show the difference.
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Orofacial Myofunctional Practice is the study of patterns of muscle use and rest postures, of the face and the mouth
...the demands in your life and timing of therapy are important factors in determining the ‘start-point’ for a program and will influence your success...
Early detection and treatment is ideal but therapy can occur at any age