Orofacial myofunctional therapy is a non-invasive therapy that uses targeted exercises to retrain the muscles of the face, mouth, and tongue for better function and balance. It supports healthy nasal breathing, speech, chewing, and swallowing, while also promoting good oral rest posture when the muscles are not engaged in movement. This gentle approach can boost overall health, encourage proper growth in children, and even contribute to better sleep.

Orofacial Myofunctional Therapy can address the following issues:

• Mouth breathing

• Snoring

• Obstructive sleep apnea

• Tongue thrust

• Orthodontic relapse

• TMJ discomfort

• Clenching/grinding

• Forward head posture

• Dental misalignment and tooth decay

• Chewing and swallowing difficulties

• Reduced facial muscle tone

• Neck and shoulder tension

• Headaches

• Other related issues

By targeting these underlying issues, therapy can improve overall health, comfort, and quality of life.

Mouth breathing can be problematic because it bypasses the nose's natural ability to filter, warm, and humidify the air we breathe. Over time, this can lead to dry mouth, a higher risk of tooth decay and gum disease, enlarged tonsils, changes in tongue and jaw posture, and poor sleep quality. In children, chronic mouth breathing can also affect how the face and jaws grow, sometimes leading to crowded teeth, an underdeveloped airway, and poor sleep quality-all of which can impact focus, behavior, and overall health.

Our nasal passages filter out debris, such as allergens, germs, and particles, while warming and humidifying the air we breathe. They also produce nitric oxide, a vital gas that enhances oxygen delivery throughout the body. Because nasal breathing is naturally slower and more regulated, it can help:

• Lower stress and anxiety

• Reduce blood pressure

• Support heart health

• Boost energy and focus

Also, your tongue should be up in the roof of the mouth, which is only possible while you are breathing through your nose!

Nitric oxide is a natural gas produced in the body that plays a vital role in overall health. It helps blood vessels relax and widen, which improves blood flow and oxygen delivery. When you breathe through your nose, your body naturally produces more nitric oxide, which can support heart health, boost your immune system, and even improve how your body uses oxygen during sleep and exercise. Mouth breathing doesn't provide these same benefits, which is why good nasal breathing habits are so important for your overall well-being.

Proper oral rest posture refers to how your mouth naturally rests when you're relaxed or sleeping. Ideally your tongue should be gently suctioned against the roof of your mouth within the dental arch, your lips should be softly closed, and you should be breathing through your nose. The teeth should be slightly apart, creating enough space in the oral cavity space to comfortably house the tongue. This space, known as the "freeway space", helps maintain healthy jaw alignment and proper muscle function.

When your tongue naturally rests against the palate, it encourages healthy nasal breathing and activates the tongue muscles that help you eat, speak, and breathe efficiently. This resting position also stimulates the vagus nerve, which supports the body's 'rest and digest' response. Proper tongue posture during growth helps guide healthy jaw development and width, creating enough space for the tongue and teeth and supporting the development of a well-formed upper airway.

A myofunctional therapist can evaluate tongue and lip ties and determine how severe they may be. Tongue restrictions are not always obvious, for example, while a visible tie in an infant may cause feeding difficulties, some ties are hidden further back (such as a posterior or a submucosal tie), and can still interfere with proper tongue function. Unless a tie is very severe, it's impact on function and development cannot be fully understood with just a quick visual check. A thorough functional assessment is needed to determine if your tongue's range of motion is limited by tissue restriction. Providers who are not trained in assessing tethered oral tissues may miss these subtle but significant impacts.

Sleep-disordered breathing includes various conditions that interfere with smooth airflow while we sleep. Common contributing factors include soft tissue blockages, such as enlarged tonsils and/or adenoids; poor muscle tone in the throat area; improper tongue posture; skeletal concerns, such as a narrow upper jaw or a recessed lower jaw; and excess fat around the neck.

The SDB spectrum includes:

-Snoring: a partial blockage of airflow through the mouth or nose

-Upper Airway Resistance Syndrome (UARS): involves increased resistance to airflow with symptoms like frequent awakenings and daytime fatigue

-Obstructive Sleep Apnea (OSA): repeated episodes of partial or complete airway blockage during sleep, causing pauses in breathing, interrupted sleep, daytime fatigue, and other health related issues

Myofunctional therapy can help improve sleep-disordered breathing by training the tongue and orofacial muscles to support a clear, open airway. Better tongue posture and nasal breathing can reduce snoring, improve airflow, and promote deeper, more restful sleep.

*UARS and OSA are both diagnosed through a sleep study, also known as polysomnography.

Myofunctional therapy can make CPAP treatment more effective and comfortable by:

• Strengthening the tongue and airway muscles

• Encouraging nasal breathing

• Improving overall airway stability

By addressing the underlying muscle dysfunction that contributes to airway collapse, therapy can help:

• Reduce CPAP pressure needs

• Make wearing the mask feel easier

• Support long-term success with treatment

**Research shows that myofunctional therapy alone can reduce apnea-hypopnia index (AHI) in OSA patients by approximately 50% in adults and 62% in children.

Source: Camacho et al., "Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systemic Review and Meta-analysis," Sleep, 2015.*

Myofunctional therapy works hand-in-hand with orthodontic treatment by addressing the root muscle and habit patterns that can undermine tooth and jaw alignment.

While braces or aligners move the teeth into place, myofunctional therapy helps retrain the tongue, lips, and facial muscles to support proper oral posture, swallowing, and breathing. When the muscles work correctly, the tongue acts as a natural palate expander and stabilizer, and the lips and cheeks help hold the teeth in position-reducing the risk of relapse once braces come off. By improving muscle function, myofunctional therapy can help orthodontic treatment work more efficiently and last longer. This means a healthier bite, better facial development, and a lower chance of teeth shifting back out of alignment.

When muscle dysfunction is not corrected, orthodontic treatment may be less effective or only temporary because the soft tissues can push against the teeth and bone-which is why many people need to wear retainers for life. By addressing these issues early, you can help protect your orthodontic investment and support long-term stability.

When the upper airway space is blocked or partially blocked by the tongue, the body naturally tries to open the airway by activating muscles that pull the tongue forward. This can create tension in the jaw and face, leading to clenching, grinding (bruxism), and shifting of the lower jaw to keep the airway clear. Over time, this constant muscle activity can stress the TMJ (jaw joint) and surrounding tissues, resulting in pain, tension headaches, and even migraines. It can also damage the teeth, causing wear, fractures, and other trauma.

Myofunctional therapy helps address these issues by retraining tongue posture and muscle function, promoting healthier breathing patterns, and reducing strain on the jaw and teeth.

Myofunctional therapy addresses the muscle imbalances and poor oral habits that often contribute to tension and strain in the jaw joint. By retraining the tongue, lips, and facial muscles to work in harmony, therapy supports healthier jaw alignment, reduces clenching and grinding, and eases tightness in the surrounding areas-which can make everyday movement more comfortable and reduce related headaches and muscle pain.

While myofunctional therapy is not a cure-all for TMJ issues, it can be a valuable piece of the puzzle when combined with splint therapy, stress management, physical therapy, and airway support.

Myofunctional therapy can help improve poor posture by addressing the oral habits and muscle patterns that often contribute to it. Proper tongue posture and nasal breathing support better head and neck alignment, which can reduce forward head posture and overall strain on the shoulders and spine.

Many of the traits linked to ADHD and other attention or behavioral challenges closely mirror the signs of poor sleep quality. For example, poor tongue posture, mouth breathing, or sleep disordered breathing can lead to fragmented sleep and lower oxygen levels at night, which may contribute to trouble focusing, hyperactivity, or behavioral challenges during the day. That is why I strongly recommend assessing sleep and myofunctional health whenever these concerns are present or being considered. I firmly believe that to thrive, we must sleep well and breathe well. It's important to explore and address potential root causes first-especially before starting other interventions like medications.

Yes, recurring ear infections can be related to poor tongue posture and an underdeveloped jaw. When the tongue rests low in the mouth instead of up against the palate, it may not activate certain muscles that help keep the Eustachian tubes open and draining properly. A narrow or underdeveloped upper jaw can add to this problem by limiting space for proper tongue posture. Together, these factors can contribute to fluid buildup and more frequent ear infections, especially in children.

Many doctors and dentists focus on treating symptoms like cavities, misaligned teeth, or sleep issues- but they may not be trained to look for the underlying muscle patterns, oral habits, or tongue posture that contribute to these problems. Airway, sleep, and myofunctional health are only beginning to be included in dental, dental hygiene, and speech language pathology training programs. It often takes years for new research to be validated, integrated into standard education, and then fully adopted in everyday practice. As a result, many providers may not yet be aware of, properly informed about, or trained to use the screening tools needed to detect, prevent, and treat orofacial myofunctional disorders. Myofunctional therapy is a specialized area that is often overlooked in routine exams, which is why a functional assessment can be so valuable.

Orofacial myofunctional issues are becoming increasingly common because many modern factors can interfere with healthy oral and airway development. Soft, processed foods mean our jaws and facial muscles do not get the same exercise they once did. Bottles, pacifiers, and sippy cups can encourage poor muscle patterns in young children. Higher rates of tongue and lip ties, environmental allergens, and a lack of awareness or early screening also play a role. Together, these factors can lead to mouth breathing, poor tongue posture, and other habits that affect how we breathe, sleep, and grow.