5 Things You Need To Know Before Starting Myofunctional Therapy And Everything I Wish I Knew

Ready to take your breathing and health in a new positive direction? Myofunctional therapy may very well provide you with relief from the negative manifestations of sleep disordered breathing and airway centered disorders.

As a parent of four children who did myofunctional therapy as an adjunctive natural treatment method for ADHD, sleep disorders, dental crowding, frequent congestion, and poor eating habits, AND as a practicing therapist, I have clear knowledge of the process. This is everything I wish I knew and everything you need to know before you begin myofunctional therapy.

It is a commitment

Myofunctional therapy is like having a personal trainer for all the muscles below the eyes and above the shoulders. They work to strengthen and coordinate those orofacial and oropharyngeal muscles for proper oral resting posture. This is accomplished through learning various exercises and activities on a regular basis until new neuromuscular patterning has occurred and habituation is established.

Whether the therapy is for you or for a child, remain conscious of the fact that therapy is designed to retrain the habits you have established from at or shortly after birth. Years of poor habits must be relearned and adjusted. You will be required to go home and practice your exercises daily. Eventually, exercises evolve into daily life integration and you must actively monitor your orofacial muscle movements and coordination while you perform daily tasks.

Myofunctional therapy involves much more than the time you have to spend actively working with the therapist weekly or bi-weekly, it requires daily commitment.

It is varied

No two therapists will work the same type of program. The field of myofunctional therapy is continually growing and evolving. Often times therapists share case successes, failures, and struggles to learn from each other. The programs that are taught are not yet regulated to be exactly the same. Which is to the benefit of the patients. It requires a therapist to seek out further education and courses, as well as expose them to a basic fact: people are different.

What would work best for you in a myofunctional therapy program is not what would work best for another person. You may present with specific problems or concerns that require certain exercises and the elimination of others. It is imperative that you speak and consult with a few myofunctional therapists to determine who would work best for your concerns.

It is collaborative

While myofunctional therapy is a great natural treatment for a myriad of eating, breathing, and sleeping issues, it hardly ever is the only treatment used. A team of medical and dental professionals often will work together to accomplish your health goals. Often your myofunctional therapist will have various methodologies they use to increase efficiency or enable goals to be accomplished within their program. Expect to need more than just myofunctional therapy and plan accordingly.

It changes your appearance

Strengthening and coordinating proper orofacial muscle movement will improve your facial appearance. The cheeks become less flaccid, the palate becomes wider, the lips strengthen, the teeth shift, and the posture improves. You may notice more physical changes in your pain levels, daily energy, health, and sleep in addition to your appearance. Photographs are usually taken at the beginning of treatment to be compared to the final visit.

Changes are slow and usually difficult to see as you progress through the program. You see yourself daily and gradual results are hard to observe. Do not be surprised to see a new you in the treatment photographs.

It can not be short-cutted

The internet is an amazing and destructive thing. We are offered ample opportunities to seek out information and fulfill needs rapidly. Because myofunctional therapy is a collaborative effort, it often is not done when other traditional medical and dental treatments are draining the budget. The internet has filled the void for everything you need to be done and can not afford.

When it comes to health, there are no shortcuts. Youtube videos are available that have a few or even a series of myofunctional therapy exercises. Many people assume that it can be done through videos alone. The problem with that theory is it disregards coordination and habituation. What specific exercises will address your concerns? What order do the exercises follow to establish new patterning? How do you tackle roadblocks for exercises you are unable to perform? Can you determine whether you are performing exercises with the isolation of the muscles involved in that process?

There are many questions that someone without training would be unable to answer. There are some questions that even some therapists with training are unable to answer. The only way to guarantee results and optimal care is to work with a therapist. Alternatives exist when the budget has little to no wiggle room.

 

I personally struggled initially trying to treat my four children on a budget.  Heed my advice and learn from my mistakes. The path to this natural treatment method is paved with dedication, variation, collaboration, change, and no shortcuts.

The Parent Guide to Child Dental Visits: From Cleanings to Check-Up- Know More Than Your Dentist and Ease Anxiety

Visiting the right pediatric dentist got my children’s health in order. We had information and a plan to end sleepless nights, behavioral issues, rounds of antibiotics and medications.

We are in an incredible time in healthcare. Science and clinical evidence are finally connecting some sleep, breathing, behavioral, and developmental health issues oral development. How do you get the proper screening your child deserves?

Airway Focused Practices

Understanding the importance of proper oral development for an optimally wide airway is essential. The tongue is the blueprint for the optimal development of the oral cavity. In proper resting posture the tongue sits up against the roof of the mouth and it guides the growth of the maxilla and development of the face.

While there are many dentists throughout the United States, there are few that are airway focused and trained in the etiology of narrow oral cavities. This knowledge is critical in getting your child care that encompasses their overall wellness and goes well beyond the presence of cavities or not.

Know What To Look For

An airway focused pediatric or general dentist will ask a more detailed medical history than expected. They need to understand any known birth, breastfeeding, developmental, sleep, oral habit, and dental history. As they progress through this complete medical history they get a picture of any further screening needed for treatment or referral.

Induction, birth traumas, and difficulty latching for breastfeeding can be indications for tethered oral tissues, mouth-breathing, and poor oral development. Developmental delays and behavioral problems can be indicators for certain dental appliances and possible sleep study referral. Oral habits, grinding, snoring, mouth breathing at night are indicators of possible sleep study referral, cavities, and a potential need for early orthodontic intervention.

Have a thorough knowledge of your child’s full medical history prior to going to your appointment. Observe mouth posture, sleep, and eating habits. The more you can fill in the blanks, the more accurate your dental provider can be with their suggested treatment and referrals.

When You Have Suspicions

If you suspect that your child may be tongue-tied, have cavities, or an airway centered disorder, do not give them too much information. When parents come in nervous for their children, that anxiety is not only felt by the child, it feeds into their mood. Most pediatric offices are full of staff trained to show, tell and do. Relax and be honest with your child, without giving too much information.

The show, tell, do technique is taught in dental schools that requires all steps in the dental visit are shown to the child and verbally told before they are done. Dental hygienists are typically very engaging with young anxious children and can ease fears by explaining the cleaning. The “scary” instruments, dental chair, x-ray machine, and dentist are all discussed in a special lighthearted way using age-appropriate wording and analogies where necessary. In most cases, it is confusing to the child to have their parent explain something one way and the dental staff explains it differently.

This includes any treatment that is determined by the doctor. Should your child have cavities, need a tongue tie release, or is referred to be seen by a specialist, do not discuss the treatment needs in front of the child. Allow the child to play in a waiting room or common area while you discuss any concerns you have and get all your questions answered. The best way to translate a need for treatment usually involves phrasing such as:

“Your teeth are sick and we will return for medicine”

“This doctor thinks you’re special and would like to see your tongue and/or teeth again for a special visit.”

“You were chosen to see another special doctor”

Identifying The Right Dentist

When it comes to rectifying prior negative experiences, the right dentist is important. Not all pediatric offices are created equal. You can call the office and request an after-hours appointment with the dentist to consult with them about your prior experiences and how you want future visits to go. While you may not get a long meeting with the doctor, you will get to speak with them and get a “feel” for the office.

Also, call the office and find out if they are airway focused and if they commonly see patients that have similar issues as your child. The front desk should be familiar with how the doctor treatment plans common cases. They may be able to give you a heads up about what you can expect for treatment recommendations.

When it doesn’t feel right, let them know you appreciate their time and carry on. You will never regret traveling to get your child the best care.

My kids were ignored, heed my warning: Don’t let doctors ignore yours

It took 10 years and a pediatric dentist for me to realize that I was a terrible mother. I fell into the trap of taking the pediatrician at her word. She said they would grow out of these problems, she advised medication for years before I regretfully succumbed, and she said it was all normal.

I’ll admit I started out motherhood at a deficit. I was just shy of 19 years old when I had him and 21 when I had her.

I tried desperately to breastfeed him as an infant, but his birth was fast and my recovery complicated, so we settled for bottle feeding. He was the perfect baby for the first 6 months. Most of the day was eating and sleeping with occasional quiet playtime. The moment we crossed over 6 months was a turn for his health. We battled stomach viruses that seemed to come one after the other, and sleeping became an issue so we co-slept. Which meant he slept while I dealt with blows from kicking and rolling all night.

He turned 2 and one month later he was a big brother. I resented her for coming into our lives and disrupting the time and attention I had for him. Looking back, I know I had postpartum because resent was a mild way of putting it.

With her, I didn’t want to go through the health struggles he has, so we were successful at breastfeeding. Almost without much effort from me. The only vice she had was thumb sucking. Though, admittedly, I was initially thankful for that, as he dropped his pacifier often and I knew I wouldn’t have to deal with her dropping her thumb on the floor of a retail store and wanting to place it back in.

By the time she hit 6 months, she was a loved and well-accepted member of our trio. However, we ceased being a trio by the time she was 3. I met my husband and we made 3 a full family of five.

fam

Insert chaos. He became a kindergartner, she stopped being potty trained and the baby girl S was an around the clock breast-feeder. The baby seemed to never be satiated, was particularly fussy, and had very poor sleep habits.

From kindergarten, teachers told me that they suspected he had issues. He was particularly “energetic” and difficult to “focus.” The pediatrician thought the teachers were too eager to label him with ADHD. At those appointments, I also mentioned that she, at age 3 then, would not sleep through the night, routinely wet the bed, and has numerous accidents during the day. The pediatrician wrote that off too as regression due to baby S.

Acceptable. I could and would wait it out. Only many of those problems never went away. Breastfeeding never got better and ended before I was ready due to a lack of supply. Sleep and fussiness was a consistent problem. He continued to struggle with attention as he moved up in grades.

By the time he was in 5th grade, we expanded from a group of 5 to 6 and we finally succumbed to the inevitable neurology evaluation.kids

All the while, his stomach issues persisted, she continued to amplify her sleep issues with daily bed-wetting, night terrors, and sleepwalking. Baby S, surprisingly thrived as a big sister with no signs of regression but suffered from repeated ear and throat infections. Baby L, struggled with breastfeeding and after two bouts of mastitis, we called it quits. My home was full of love but swimming in health issues. All of which were deemed “normal” and to be outgrown.

His ADHD was officially diagnosed, and after two years of resisting medication, we gave in. The girls maintained sleep issues and cycles of antibiotics for routine infections. I was the mom that would respond with a generic, “good,” when asked how the kids were.

But they weren’t good, I knew it. Motherhood is many things, but devoid of intuition it is not. I wanted help and often Googled in search of it, but nothing helped. How could I stop medicating my kids, buying night diapers for her at 10 years old, and suffering in silence?

The dentist. All I needed was a great dentist. I began working for one and in the interview, she went over airway dentistry in great length and insisted that if I wanted the job I needed to be knowledgeable and an advocate of it. I understood mildly at that moment what it meant, but it wasn’t until my kids were in the chair not long after that I fully comprehended Airway Centered Disorder (ACD).

Every single one of them had issues all directly related to their breathing. His ADHD and digestion problems, her sleep issues and persistent thumb sucking, and S & L’s ear and throat infections and nursing problems. It was always present in their facial features, oral development, and sleep habits. Just never diagnosed.

The restless sleep with tossing and turning at night. The open mouths with a tongue that would rest in between the lips. The dark circles under the eyes and chubby cheeks. The crowded teeth and thumbsucking. The hyperactivity and inability to focus. All of it tells a story of a child with an ACD.

All of it missed by the pediatrician who routinely saw my family for various issues. Yet, all I ever received, in hindsight, was palliative care that kept symptoms down for a little while or no care because they would outgrow the sleep problems.

If the medical field was aware of what so many in the dental field are coming to understand, my children would not have been ignored. S & L would have received tongue tie releases during infancy. He and she would have had a sleep study as toddlers and received treatment for their apnea.

I dove deep into myofunctional therapy, dental appliances, alternative therapies, the impact of diet, and ACD. Parent to parent, after over $10K in continuing education, I know now where I went wrong and I do NOT want you to repeat my mistakes.

4 Steps to Getting Help for Airway Centered Disorder

My Post

1. Monitor everything

How often is your child sick with a routine cold, allergies, or even asthma? How do they sleep at night? Do they mouth breathe? Do you see their tongue frequently when they talk? Are they very picky eaters, have a strong gag reflex, chew loud or messy, eat very fast, or very slow? Do they maintain dark circles under their eyes or baby like chubby cheeks?

To a certain extent, some of these things are okay when seen infrequently. Having an ear or throat infection once or twice a year with the change of seasons is not something to worry over. But having chronic infections is a concern. Note exactly what you experience with your child because it will be important when you are in front of a medical or dental professional.

2. Insist on screenings

While not right, you may experience push-back from your pediatrician or possibly dentist. Not everyone is trained in ACD and it’s impact on the growing child. Inform your pediatrician that you would like a referral to a sleep physician. Ear, Nose, and Throat doctor (ENT) referrals are usually best after a sleep study because it calls the notoriously underpaid ENT to action. Sleep apnea can be fatal in adults and is detrimental to child development, growth, and health. Your child with swollen tonsils or adenoids that prevent nasal breathing can be easily dismissed by an ENT. You should be armed with a sleep study or at least the knowledge that your child does not need further intervention in the medical field.

A diagnosis of no sleep apnea is great, but if you see other signs that your child has an ACD consult with a myofunctional therapist. We treat mouth breathing by establishing proper oral resting habits through exercises and activities.

3. Do your research

Knowledge is power. You cannot change the past and all the things you did not know, but you can impact the future. Establish a strong foundation of research on the impact of ACD on health and development.

Foundation for Airway Health, American Academy of Physiological Medicine and Dentistry, and this Airway Matters blog are all excellent resources to start your journey.

I did a Breathe for Health webinar that breaks down myofunctional therapy and how it can positively impact the effects of ACD. In 45 minutes you come to understand the signs and symptoms and the 3 step process of treatment.

4. Establish your team

Treating an ACD is hardly ever just a one-stop solution. A team can consist of a dentist and a bodyworker. A dentist and an ENT. A sleep physician and myofunctional therapist. A lactation consultant and an ENT. A speech therapist and dentist. There are a number of options and sometimes more than two providers are essential for successful treatment. Know how to proceed once you determine that there is a problem.

Stand your ground

As a parent, there are many different things people will tell you about your child. Your instincts trump it all. You know when something is not right, or feels off. Don’t be passive with their health and accept palliative care, like I did. Take a stand for them and positively impact their health for their lifetime.

Resources

Find journal articles, professional research, peer-reviewed studies and clinical evidence all compiled in one source that support the existence and clinical treatment of ACD here.

If you are a mother of small children or babies, you can intervene early to minimize or eliminate treatment in the future. Read our e-guide Avoid Braces Naturally.

My Post (51)

 

Tongue to Toes: The Whole Body Connection

The human body is an amazing and intricate work of natural art that we will probably study for centuries to come before we ever establish a complete understanding of it. From what we do know from current research and physiologic understanding, it is all very connected.

Every organ, bone, muscle, and tissue is connected in some way to each other. Consider, now, how that connection can impact your body in a negative way.

My Post (58)

Many are familiar with muscles and their connection to the body and movement. Yet, little is ever mentioned of its structural companion, fascia. Fascia is a thin band of connective tissue that envelopes our muscles.

muscle-anatomy

It’s a protective sheath that groups together muscles of similar function and helps to distribute nerves and blood vessels.

While there are 4 layers of fascia that cover certain portions of the body, our outermost layer covers the entire body. Think of it as akin to the skin in encompassing connectivity. If you were to pinch your skin on your arm you may feel the pull or tension of that stretched skin in another area of the arm.

A tongue tie works similarly in fasical pull, as our deep front line fascia connects our tongue in one continuous band of fascia down to our toes.

fascia

It is only in the given imagery above that you can see how a tongue tie (which is restrictive or tight connective tissue band connecting the floor of the mouth to the base of the tongue) can affect breathing, posture, pelvic floor stability, and toe walking. Often a “harmless” tongue tie can be just the clinical tip of the iceberg, masking within the body various linked medical and dental problems.

My Post (60).jpg

Some people do claim to have miraculous feelings of relief or immediate postural improvement. While not unusual, most people do have to wait or accompany a tongue tie release with manual bodywork to assist in fascial strain release. Those pulls by fascia that is holding you together may just be holding you back from real relief.

Don’t let your tongue affect your body negatively. Have your tongue functionally assessed by a myofunctional therapist. Or, learn more about the tongue’s impact on the body, coupled with resources to guide you on your journey from tied to free with our Ultimate Guide for the Tongue Tied.

[Want a closer look at this surgically extracted deep front line with detailed explanation. Get a better view on YouTube.]

The Ultimate Guide for the Tongue Tied

Without fail there are only two responses I get when I notify someone that they have a tongue tie:

  1. No one has ever told me that before
  2. My (or his/her) speech is fine

Given the general lack of information out regarding tongue ties and the linked health concerns, those answers are understandable. However, it is beyond time to break the myths and provide more centralized information that is easy to digest.

A tongue tie may very well be the biggest little thing you never knew you had as it impacts and affects many other parts of the body and is involved in an essential bodily function.

Facts

TMS tongue tie infographic

What if you don’t release

While a tongue tie can very well impact speech, I honestly list speech towards the bottom of reasons to treat a tongue tie. The tongue in it’s proper resting posture should be up against the roof of the mouth for proper breathing, development, and function. A restrictive lingual frenum (string of tissue connecting the floor of the mouth to the base of the tongue) will make proper posture difficult if not impossible. Without release and therapy to obtain proper tongue posture you are risking the possible consequences below.

TMS tongue tie consequence

THE RESOURCES

Frenectomy Tips Before They Snip

A three page guide with the four major steps you should take prior to releasing or considering releasing a tongue tie. Including why pre and post exercising is essential for optimal healing outcomes.

7 Questions You Must Ask Before Choosing A Release Provider

This resource has our list of every essential question you should have answered prior to deciding whether or not this provider is right for you. Not all release professionals are equal in tools, experience, and technique. To make an informed decision you should ask as many questions as possible. Remember, while not a major hospital stay surgery, a tongue tie release is still a surgery.

Tongue Tie Release Checklist and Questionnaire

Accompany resource to our 7 Questions, is this checklist and questionnaire. Use the questionnaire to document what your desires are when it comes to your release experience and healing. Also document the answers to the 7 questions you ask each provider you interview so you can compare responses and make the best decision.

Frequently asked questions

Our YouTube video series, Sixty Second Saturday, answered common questions in less than 60 seconds, like: Frenectomy vs. Frenuloplasty: what’s the difference and Frenectomy healing time: how long.

F.R.E.E. Your Tongue

A self-guided course of myofunctional therapy for those who are unable to work one-on-one with a myofunctional therapist prior to getting released.

 

The Real Reason Why You Need Braces

Braces have never been and never will be unavoidable. They are not some genetic guarantee you receive upon birth. They are merely the result of oral habits developed from birth; particularly those dealing with the tongue.

After years of braces and the last straw in lost retainers, there’s a reason why your teeth shifted. I hope you’re sitting… because the culprit is not your lost retainer it’s your tongue!

The tongue is now and will continue to reign as the MVP in oral and facial development. Never to be dethroned by any orthodontist or supplier of braces.

It’s a lot to take in. Similarly to discovering that you lived with Santa and the Tooth Fairy you’re whole childhood (i.e. they weren’t real). How is it that the tongue is so powerful that it has this profound impact on the size of the mouth, the shape of the face and the structure of your teeth?

What kind of barn is your mouth?

Imagine a simple drawing of a house without a roof. It has a simple 3-line open rectangle shape. Two lines that meet at a point would complete the roof and create a pointed top, thus creating an almost pentagonal shape. Now imagine a simple drawing of a barn with a nice rounding that completes the roof. Ideally, we want our palates to develop into a barn shape with the nice arched round roof. Our dental arches should form with a U shape.

ushapedarch

The tongue is the foundation for that development. The tongue should naturally sit up along the palate when we are optimally nasal breathing. The constant pressure of the tongue on the arch facilitates growth around the tongue into that perfect U shape.

Our tongue in that sense is the blueprint for palatal development and should fit in the palate without overlapping the teeth.

When the tongue is low in the mouth, we lose the foundation, and like the open rectangle house, without that round support the palate forms a narrow and almost pointed “roof” shape. It would create an A shape, narrow arch with a high palatal vault. This narrows the available space for the teeth and causes dental crowding and often malocclusion. Ashapedarch

The mandible (lower arch) follows the growth of the maxilla (upper arch). So the growth, or lack thereof, in the palate will be matched, in most cases, by the mandible. Those with underbites, or a wider mandible that contains the maxilla (either in part or fully), often have a tongue that is lying low. The pressure from the tongue on the mandible, along with prolonged spacing between the teeth, cause the mandible to extend and restricts the growth of the maxilla further.

Crowding is not new

A narrow arch does not develop overnight. A high palate (roof of the mouth) and tight primary dentition (baby teeth) can predict the formation of a narrow arch and crowding of permanent teeth.

Typically a pediatric dentist may inform you that your child will need braces in the future. However, an orthodontist that is not trained in early intervention orthodontics will most likely not treat this until the child has developed around 12 permanent teeth. Treatment usually involves a palate expander that forcibly pushes the palate open, ideally, to the width it should have grown.

Retention is maintained by a retainer. When teeth “shift back” to some form of malocclusion it is often because the tongue has not maintained that palatal width with the pressure we discussed earlier. Our teeth are in constant motion and with a lack of stability from the tongue, they will gravitate to their position of origin. Granted, if expansion was done, the teeth do not shift back to origination. But they will move out of the alignment established with braces.

TMJ pain that’s hard to swallow

A low tongue posture is often accompanied by a “reverse swallow.” This improper swallow occurs when the tongue thrusts forward either against the teeth or between them to swallow. Every thrust forward causes the mandible to shift backward and compress the temporomandibular joint (TMJ) in an unnatural way. Multiple cases of this pressure will compound and affects the longevity and stability of the TMJ. Thus feelings of pain, clicking, and popping occur and cause frustration.

retruded mand

The reverse swallow also creates a long narrow face with a mandible that is recessed or retruded. In profile, this would appear as a lower lip that is not aligned with the upper lip. Even in people whose teeth appear straight, this form of a malocclusion does require braces as well. Over time the way the teeth occlude, or bite together, would cause undue harm to the jaw and discomfort during chewing.

What to do

Establishing proper tongue posture with good habits, early intervention, or myofunctional therapy leads to proper oral development in young children. However, it is never too late to attain proper tongue posture to improve wellness. A wide palate means a wide nasal floor with open passages and greater airway space. Ultimately reducing and/or eliminating the potential for sleep apnea, chronic infections, anxiety, asthma and more.

Contact me to find out how myofunctional therapy can help you with your braces or read our introduction to airway post to discover the many paths to airway health.

Why did my doctor recommend myofunctional therapy?

I guess you thought you were in for a simple visit. A routine visit with a simple diagnosis or the always preferred, confirmation of health. Thankfully, you have an excellent doctor who cares about your whole body and sent you on a wellness path!

There are several reasons why you may have been referred to myofunctional therapy, and several types of providers who do refer.

Who may have sent you and why

Speech Language Pathologist (speech therapist) – refer for speech problems that are not improving due to a tongue tie or tongue thrust. Common referrals include lisps and difficulty with S, L, T, D and N sounds. (*myofunctional therapists that are NOT speech therapists do not treat the speech problem, they treat the tongue posture and speech improves in conjunction with continued treatment with the speech therapist)

Otolaryngologists (ear, nose, and throat doctors)– refer in conjunction with a dentist in their airway team. Typically for those with high narrow dental arches, chronically inflamed tonsils or adenoids, and/or a deviated septum.

Dentists or Orthodontists – refer for tongue thrust, open bite, malocclusion, thumb sucking, high palate (roof of the mouth), narrow arches, mouth breathing, and most commonly in conjunction with braces or oral appliance.

Sleep Physicians – refer for mild sleep apnea and CPAP (continuous positive airway pressure) compliance.

If you do myofunctional therapy…

There is far more to gain from myo then what you may have been referred for. Often times problems you had no idea were associated, can be caused by an orofacial myofunctional disorder (OMD).

The body is one large connected unit with many functioning parts. When there is dysfunction in a muscle, often it leads to the body creating a compensatory use of another muscle to perform the task. For example, when you have a reverse swallow it can cause overdevelopment of your mentalis muscle and alter facial appearance.

OMDs can contribute to numerous problems as can be seen below in the infographic. Myofunctional therapy may be the answer you never knew you needed to problems your healthcare provider referred you for, in addition to other underlying issues.

25 Health Benefits of Myofunctional Therapy-01

Still unsure where to go on this airway health journey? Read start with this beginner’s guide.

Contact us to get started with myofunctional therapy today!