When changing habits practice makes perfect

Speech Pathology can improve your pronunciation, irrespective of the cause

A recipe for success in therapy: Fun

A recipe for success in therapy: Family Involvement

Acccurate diagnosis is key

A thorough assessment is critical for a clear diagnosis

Computer Apps can help with practice

Orofacial Myofunctional Practice can enhance facial aesthetics

Orofacial Myofunctional Practice can help you change oral habits

Speech Pathology can help you to overcome your communication challenges

Orofacial Myofunctional Practice modifies swallowing, chewing and breathing habits

More About Orofacial Myofunctional Practice

More facts about Orofacial Myofunctional Practice (OFM)

If you want to find out more about these questions, click on the question or scroll down the page:

What is an Orofacial Myofunctional (OFMD) Disorder?

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  Anatomy: e.g. large tonsils&/or adenoids, tongue-tie, narrow or obstructed nasal airway, narrow or small jaw/s, .....
  • Orofacial Rest Postures: e.g. lips, jaws, tongue, soft palate, cheeks...
  • Orofacial Functions: e.g. chewing, swallowing, speech, resonance, phonation and breathing
  • Oral Habits: e.g. thumb, finger, dummy and tongue sucking habits, extended bottle use, lip licking, lip biting
  • Chronic Medical conditions like URTI, allergy, glue ear, asthma,  syndrome, sleep apnoea,....
  • Neurological, craniofacial, congenital or genetic, conditions that predispose someone to bony, tissue or muscle abnormalities of the face, mouth or jaws e.g. Downe’s Syndrome, Cleft Palate, low or high muscle tone that occurs in conjunction with Cerebral Palsy, Ehlers Danlos that leads to joint laxity..

    

Orofacial Myofunctional Assessment

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:

  • normal orofacial myofunctional patterns
  • dysfunctional orofacial myofunctional patterns
  • the cause of orofacial myofunctional dysfunctions
  • co-existing problems which may contribute to or perpetuate dysfunction

What happens at an assessment?

  • A detailed interview dealing with early developmental, feeding medical, dental, behavioural and learning history is conducted
  • Orofacial examination looks at the morphology of the face and mouth at rest. Measurements of facial anatomy and photos are taken
  • Orofacial Function assessment looks at how the muscles move during: facial expression, prescriptive tongue, lip, jaw and soft palate movements, chewing, swallowing and speaking. Videos of function are taken at the assessment and again at treatment reviews
  • Results of the assessment underpin recommendations for therapy

What are the aims of Orofacial Myofunctional therapy?

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.

What are treatment targets?

Correction of:

  • orofacial rest postures
  • orofacial functions
  • oral habits

How and when is an OFMD treated?

Early intervention is best

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.

What can I expect during treatment?

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.

How do I know when treatment has been successful?

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.

How do I make an appointment?

You can contact Well Spoken by clicking here.

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...

Orofacial Myofunctional Practice Overview What is Orofacial Myofunctional Practice? Make an appointment Contact

Early detection and treatment is ideal but therapy can occur at any age