What is Orofacial Myology?

This year I had the opportunity to travel to Sydney (for a country girl at heart, this was daunting enough) to attend The Australian Academy of Orofacial Myology 4 day course. If the chaos of Sydney wasn’t enough, little did I know my Speech Pathology mind was going to explode to full capacity. I have always had a keen interest in swallowing and feeding disorders, particularly with the paediatric population. It is impossible to sum up this course thoroughly enough in a “news flash”, but here are the main messages from a practicing Speech Pathologist and Orofacial Myologist that I would like you to take away from this summary…

  • Does your child snore?
  • Does your child breathe through their mouth?
  • Does your child have an open mouth posture (minimal lip seal at rest)?
  • Does your child’s tongue sit at the bottom of their mouth at rest?
  • Does your child wake up unrefreshed and moody?

If you answered “yes” to any of the four questions above this is a big indication that your child might be experiencing an Orofacial Myofunctional Disorder. None of the above are “typical” indications for healthy development of our orofacial muscles, nor are they indicators of efficient and correct breathing mechanisms.

Many of these issues are “brushed off” and not seen as a serious concern. However, as human beings it is never normal to breathe through our mouth or snore. If these issues are not investigated and managed, you are ultimately not breathing correctly or efficiently and you are depriving your body of much needed clean and filtered oxygen. Orofacial Myology places a major focus on clear airways, correct swallow pattern and thus, correct development of the orofacial musculature.

Why is it that we put so much energy into developing our major muscle groups in the body through gross motor activity, but our tongue and face are neglected and not exercised?

We start to exercise our orofacial musculature from the moment we are born through sucking, oromotor sensory play, breathing, swallowing, babbling, chewing, biting, smiling, using utensils and speech production. If any of these processes are compromised we could be compromising many other aspects of your child’s health.

As Speech Pathologists, we should be screening many things prior to commencing any type of therapy intervention with children. Children should have the following screened at initial appointments:

  1. Airways – Do they breathe through their mouth or nose, do they have allergies, do they have enlarged tonsils or adenoids, do they have a nasal obstruction?
  2. Frenums – Does your child have a tongue or lip tie affecting the elevation of their tongue? Is there a tongue restriction present that is impacting on them during mealtimes/feeding or speech production?
  3. Habits – Does your child have any orofacial habits that are impacting on their development. E.g. thumb sucking, finger sucking, dummy sucking, prolonged bottle feeding, prolonged breast feeding, lip wedging, nose picking, nail biting, shirt chewing, excessive dribbling, grinding teeth, jaw clenching, prolonged sippy cup use or excessive food pouch use.

A Speech Pathologist should be checking all of these aspects before commencing therapy. Orofacial Myofunctional Disorders are classified as “patterns involving orofacial musculature that interfere with normal growth, development, function of structure or calls attention to itself (ASHA, 1993)”.

An Orofacial Myofunctional disorder can present with the following symptoms :

  • Tongue thrust and dentition complications
  • Increased asthma (from mouth breathing and unfiltered air intake)
  • Increased allergies (from mouth breathing and unfiltered air intake)
  • Speech and Articulation difficulties (particularly with palatal sounds. I am finding many difficulties correcting a lateral lisp without Orofacial myofunctional therapy)
  • Feeding difficulties/ messy eaters
  • Sleep apnoea and decreased quality of sleep
  • Behavioural problems (often presenting like a child with Attention Deficient Hyperactivity Disorder (ADHD) due to poor sleep patterns)
  • Dental complications (e.g. open bites, overjet, overbite, decay)
  • Dry chapped lips
  • Increased drooling
  • High narrow palate, decreased nasal cavity space
  • Meal time fatigue
  • Jaw soreness
  • Poor posture
  • Obvious facial asymmetry
  • Venous pooling under eyes (dark circles)
  • Long narrow face and jaw
  • Snoring
  • Orthodontic referrals for later on in life
  • Anxiety and Depression (often from poor sleep quality or ongoing sleep apnoea).

I urge you to seek advice and an assessment if you have concerns with your child’s orofacial myofunctional development. Your tongue is one of the most important muscles in your body but it is often forgotten about and can have such detrimental affect on your health long term. Our bodies are a long line of connective tissue – starting from your tongue and orofacial musculature. Learn to breathe easy!

Emily Green Speech Pathologist and Orofacial Myologist