With no regulatory body or standardized path of entry it can be difficult to navigate entry into the field of myofunctional therapy. Many times, prospective professionals find themselves with more questions than they can find available answers to. But with a profession that is rapidly growing in public awareness and demand it is ever more important to provide transparent answers to the burning frequently asked questions that dental hygienists have about myofunctional therapy.
What is myofunctional therapy, and how does it differ from traditional dental hygiene practices?
Myofunctional therapy is an alternative modality that focuses on eliminating dysfunction in the orofacial musculature. Termed in the early 20th century by B.E. Lisher with regards to the research and published works of prominent orthodontist Alfred Rogers, myofunctional therapy was developed on the premise that the resting soft tissue pressures of the lips, cheeks, and tongue have a direct impact on craniofacial development. While it was developed by dental professionals myofunctional therapy is not like clinical dentistry or dental hygiene.
Myofunctional therapists are similar to personal trainers. They job consists of assessing and evaluating asymmetry, overdevelopment, underdevelopment, and compensatory muscle function in the orofacial and some of the oropharyngeal structures. Once dysfunction is determined a personalized treatment plan is developed and administered over a series of visits wherein the client is given exercises or activities that target and remediate the dysfunction. It requires a different skill set, although vastly different mindset, than that of traditional clinical dental hygiene.
How does myofunctional therapy contribute to a comprehensive approach to oral health and overall well-being for patients?
Myofunctional therapy has a wealth of benefits for systemic health and overall wellness. It blends well as an additional service to help patients in the dental office with parafunctional habits (bruxism, cheek biting, tongue sucking, lip biting, etc…), tongue thrust, temporomandibular joint disorder, orofacial pain, limited opening, mouth breathing, and sleep breathing disorders. Many of the aforementioned are manifestations of oral myofunctional disorders. Traditional dental treatments are more effective in the management or elimination of those when myofunctional therapy is collaboratively performed.
Can registered dental hygienists practice myofunctional therapy independently, or does it require supervision by a dentist or specialist?
Myofunctional therapy is supported by the American Dental Hygiene Association with several practice recommendations written that provide guidance for how it fits in within the skillset and knowledge of registered dental hygienists. This is a wonderful success for our professional organization, however, the ADHA is not a regulatory organization or body. When seeking advice on myofunctional therapy’s role in the dental hygiene scope of practice it is important to revert back to your individual state practice act. As of the publication of this blog post, there are NO United States dental practice acts that have orofacial myology, myofunctional therapy, or orofacial myofunctional therapy stated within as a part of the dental hygiene scope of duties.
What does that mean for dental hygienists that desire practicing safely and within scope? It means you regard it as you would any additional practical skillset you could acquire. Let’s take for example, yoga certification. Becoming a yoga instructor may be beneficial for dental patients and could be useful while practicing clinical dental hygiene, but no one would ever consider inquiring if yoga is within the dental hygiene scope or regulated by the dental board. Similarly to yoga, myo does not have a regulatory body and is not to be practiced simultaneously with clinical dental hygiene.
How long does it typically take to complete myofunctional therapy training, and what are the educational pathways available?
Myofunctional therapy is a specialty that requires separate continuing education after licensure. The path to entry looks vastly different and many hygienists make the rookie mistake of taking multiple introductory courses. Upon initial search or inquiry about courses it’s easy to discover that course lengths vary between 8 to 14 weeks. During that time frame you are introduced to various concepts, exercise, and skills over weekly or bi-weekly scheduled meetings or self-study modules.
This is a broken model of instruction that I hope innovation and dedication to excellence in execution will eventually break. Often dental clinicians are very tactile learners, who would not be the practitioners they are without the clinical experiences they had in college. Those days of implementing the didactic education achieved in the classroom helped to create the mastery that built confidence prior to taking board exams and entering the professional workforce. With Covid, the increase of distance learning and myofunctional therapy introductory course rose and provided an excellent opportunity to enhance the field. However, it disabled the clinician that needed clinical support for implementation of myofunctional skills from achieving that proficiency and confidence. Ideally a blend of extended instructor time, access to course resources, and on site mentorship created the perfect environment for a worthy return on investment. (Learn more about Myo Pathway)
What are the key skills or techniques I will learn during myofunctional therapy training that I can apply in my dental hygiene practice?
Myofunctional therapy education consists of many elements of dental hygiene education. There are reviews of dental head and neck anatomy, dental embryology, oral systemic health, and oral pathology. In clinical dental hygiene those skills are used daily during intraoral and extraoral assessments. Having the additional education in oral dysfunction during the myo training and introductory course can be a useful way to amplify clinical skills for improved patient education and guidance.
Are there opportunities outside of clinical dental hygiene besides doing myofunctional therapy?
Taking a myofunctional therapy introductory course does not limit opportunities to strictly performing the therapy. Many take the educational aspects of the training and leverage those skills to become consultants, advisors/advocates, administrative team members, or treatment coordinators. As a consultant they help dental practices or independent therapists establish, grow, and scale their business. As advisors/advocates they help individuals and families navigate the complexities of managing airway centered disorders. Many provide guidance for those seeking an airway team or deciding on how to best prioritize treatment needs within their budget. As administrative team members they help to manage dental practices that perform tongue ties, airway centered orthodontic treatment, and myofunctional therapy. As treatment coordinators they manage case presentation and acceptance with dental patients within the practice. There are also many opportunities to work in sales for oral appliance, dental sleep medicine, and laser companies.
Are there ongoing professional development or continuing education requirements for myofunctional therapists?
Similarly to dental hygiene continuing education is a necessary part of myofunctional therapy. Though not required for licensure, there are some certification organizations that require a specified number of continuing education credits to maintain standing. Nevertheless, the field is ever evolving with new research and developments and with the importance of interdisciplinary collaboration there is always much to learn. Many advanced practice courses and conferences are available for continuing education.
Is there a demand for myofunctional therapy?
The National Health Institute did a survey that revealed 1 in 3 Americans are actively seeking more alternative and natural treatments. This data combined with an increase in awareness of the benefits of myofunctional therapy for sleep apnea, TMJ issues, orthodontic treatment or speech difficulties has grown the industry by 30% in the last 2 years. KPMG, a leading global consulting and research firm, estimates that myofunctional therapy will be a $2.5 billion industry by 2027. The answer to this question based on research and my own experience with practice growth, is a resounding yes.
What are the job prospects and career opportunities like for registered dental hygienists trained in myofunctional therapy?
Myofunctional therapy is not for the weak. There are not job boards with postings in search of myofunctional therapists. The opportunities for jobs are not readily available, they are created by the therapists that have a desire to implement within an office. Some present the idea to an office they are currently working within as an adjunctive service that can be profitable for the practice, whereas others present it as a collaborative referral relationship.
Is myofunctional therapy covered by dental insurance, and how does billing and reimbursement work in this field?
This question is two fold. Elements of this question also want to address the compensation or salary prospects as a myofunctional therapist. So let’s begin first with insurance. Medical insurance can be difficult to achieve reimbursement from for myofunctional therapy, particularly for registered dental hygienists. While there is no ability for a dental hygienists to directly bill medical insurances, there are some insurance companies with out of network coverage for myofunctional therapy that can be reimbursed through patient claims using a superbill. The rate of coverage is typically low and the process frustrating. It is an uphill battle that is difficult to navigate and often winds up unproductive. An important consideration when choosing an introductory course, for those who are interested in medical billing, is to choose one with that instruction.
Compensation for myofunctional therapy is often higher than that of dental hygiene, however, there are many factors that play a role in determination of compensation. The list of roles and responsibilities for those working in a dental practice impact wages. Likewise, the business expenses of independent practice ownership also impacts earning potential. Compensation is sometimes an hourly wage or percentage of production with fees for myofunctional therapy services varying based on location between $1,500-6,000 for full programs.
*BONUS*
What resources or support networks are available for registered dental hygienists interested in pursuing a career in myofunctional therapy?
Professional organizations and social groups exist to help prospective and practicing myofunctional therapists navigate entering the field and advance once within. The International Association of Airway Hygienists is the only professional association dedicated to dental hygienists practicing airway. Membership consists of monthly educational lectures, networking opportunities, and directory listings. The International Association of Orofacial Myology is the oldest professional association for allied health professionals practicing myo. Membership consists of certification opportunities, directory listings, and professional discounts. On Facebook the OMT for the RDH group and The Intentional Hygienist group are both a great source of education and networking with other myofunctional therapists.
Airway Matters 