Disorders
Tongue Tie
In the past, a tongue tie was thought to be something that only affected babies and breast-feeding. As we are learning more, we are finding that the problems associated with tongue tie can affect both adults and children of all ages.
A tongue tie is also known as a tethered oral tissue (TOT) or a restricted lingual frenum. The frenum is the band of tissue under the tongue that connects the tongue to the floor of the mouth. While we all have one, in some people it is too tight or too short. This can restrict the movement of
the tongue as well as prevent it from resting in the correct place against the roof of the mouth.
When the tongue fills up the roof of the mouth it provides a support structure for the upper jaw. If it is in the correct place your teeth will grow in straighter and your face will develop properly. A tongue tie prevents this by keeping your tongue “tied” to the bottom of your mouth.
A myriad of issues can happen for people who are tongue-tied. They often breathe through their mouth which causes them to experience a variety of myofunctional problems and symptoms. Studies show that children who are tongue-tied are more likely develop sleep apnea or airway issues. Also, people who are tongue-tied may have an increased incidence of headaches, clenching and grinding, jaw and facial pain, as well as dental and orthodontic issues.
As we are learning more about this, releasing a tongue tie is becoming an integral part of achieving optimal oral and dental health. In myofunctional therapy we can help with this process by working with the patient doing pre-op exercises, help with wound care, as well as retraining and strengthening the muscles post release.
With the proper tongue tie release and assistance with myofunctional therapy, the treatment is easy, and the results are permanent and life changing. Even if you choose not to do the tongue tie release surgery, myofunctional therapy may help, especially in mid and posterior tongue-ties
Sleep Disordered Breathing
There are several sleep related abnormalities included in the term sleep disordered breathing. Most of these can be helped with myofunctional therapy. These include clenching and grinding (bruxism), snoring and obstructive sleep apnea (OSA).
Bruxism (clenching and grinding)
Bruxism is the medical term for clenching or grinding teeth during sleep or while awake. Bruxism can cause chronic jaw pain and/or headaches as well as abnormal wear to your teeth. Most people are unaware that they are clenching and grinding until it is pointed out. During the day, it is something that you get in the habit of doing when you think, when you’re worried, or when you’re distracted. At night, you may be clenching and grinding while you sleep.
The function of our jaw during the day and at night are complementary. If you are clenching and grinding during the day you most likely are clenching and grinding at night while you sleep. Establishing healthy position, posture and habits during your daily routine can lead to less clenching and grinding at night. Myofunctional therapy can help you get control of your oral habits so that you can stop.
Retraining your muscles can lead to anatomical changes that can improve the conditions that lead to sleep bruxism such as your anatomy and the configuration of your teeth and jaws. For example, sleep clenching and grinding is commonly associated with sleep apnea caused by a narrow airway. Myofunctional therapy can help expand your airway to alleviate breathing problems and contribute to healthy sleep - without clenching and grinding.
The benefits of myofunctional therapy for clenching and grinding have been documented in a clinical study. In this study, people saw a reduction in episodes of clenching and grinding from 24 per hour to 9 per hour. Muscle tension reduced as well. Perhaps most importantly, people saw their pain reduced dramatically, from around 8 on a 10 point scale to less than 2.
Snoring
Snoring is the vibration when air flows pasted relaxed tissues in your throat that causes a horse or harsh sound. Almost everyone snores now and then but for some people it can be a chronic problem and sometimes it may also indicate a serious health condition. Snoring may contribute to sleep apnea’s because the constant vibration of the muscles in the mouth and throat become larger and may cause changes in width, thickness and size.
The first three goals of myofunctional therapy are nasal breathing, proper lip seal and tongue posture, all three of these goals will help reduce or eliminate snoring.
Sleep Apnea
According to the mayo clinic sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts. If you snore loudly and feel tired even after a full night’s sleep, you might have sleep apnea. The most common type of sleep apnea is obstructive sleep apnea which occurs when the throat muscles relax. According to the national sleep foundation, sleep apnea affects more than 18 million Americans and most are completely unaware that they have it. When left untreated sleep apnea can lead to high blood pressure, memory problems, impotence, type two diabetes, obesity, anxiety and even stroke or congestive heart failure.
Myofunctional therapy can help with obstructive sleep apnea by working with the muscles of the oropharyngeal complex. In 2015, a meta-analysis of CPAP compared to my functional therapy concluded: “current literature demonstrates that myofunctional therapy decreases apnea – hypopnea index by approximately 50% in adults and 62% in children. Lowest oxygen saturations, snoring, and sleepiness outcomes improve in adults. Muscle weakness contributes to sleep apnea. Strengthening those muscles through myofunctional therapy helps improve breathing, sleeping, snoring, etc…”
Myofunctional therapy may help with sleep apnea, however, depending on the severity, CPAP or other devices may still be needed.
Temporomandibular joint (TMJ) disorder
Disorders of the temporomandibular joint (TMJ) may result in a popping or grinding noise when you open and close your mouth or chew, intermittent pain and clicking in your jaws, discomfort when your mouth is wide open, tenderness in your neck or shoulders, lockjaw, frequent headaches and/or chronic ear aches. Myofunctional therapy helps to retrain your jaw muscles which, is an essential goal of TMJ treatment. When we train the jaw muscles to function properly it fosters healthy habits that intern lead to less clenching and grinding, less pain and less damage to teeth and joints.
Headaches, Migraines and Neck Pain
When muscles of the head, neck and jaw overwork it can cause headaches, neck pain and even migraines. When the muscles become painful the pain makes you feel tense and uptight which worsens the muscle spasm in turn increasing the pain. When you have jaw instability or are chewing on one side of the mouth this can cause headaches. A forward head posture puts excessive weight on the head neck and shoulders which may also cause a headache. These causes may be alleviated through myofunctional therapy.
Proper Facial Growth
Development of the muscles, bones, and teeth is a complex process in which function influences growth that creates form, which intern influences function. In an optimal system the natural demands you put on your jaw will cause the jaw to develop into a system that is capable of performing all the demands in a healthy way. However, if your muscles aren’t functioning optimally they can influence the development of your teeth, jaws, and other structures that may lead to problems such as crooked teeth, obstructed airway, jaw clenching, painful muscles, and/or other problems.
Having an open mouth posture is a sign of mouth breathing. This can be a sign of an inability to breathe through the nose. When the mouth is continually open, the facial muscles develop and then adapt and function improperly around this abnormal posture.
And open mouth posture can lead to flattened features, narrow and vaulted palate, elevated nostrils, a long narrow shape to the face, a short upper lip, a gummy smile, a small lower jaw and sleepy and droopy eyes. It is important to realize a child with an open mouth will grow into an adult with these features. In a child, these symptoms can be avoided through myofunctional therapy with great success. The younger the child starts therapy the better. In an adult, myofunctional therapy can still be very successful although the features cannot change as drastically as in children. However, a clear difference can be seen once normal rest position and function are achieved.
Allergies and Asthma
Sinus inflammation, congestion and postnasal drip are often associated with allergies. However, they could be a result of a narrow airway. This is true especially in cases where the patient experiences year-long “allergies”. A large number of patients who breathe through their mouth also display the signs and symptoms of allergies. The airway is directly linked to both asthma and asthma like symptoms. Most people treat their asthma with medication or palliative treatments. However, asthma may be treated with a combination of myofunctional therapy and dental appliances. Widening of the dental arches along with nasal breathing has brought relief to many people who are suffering asthma like symptoms.
Mouth breathing can make allergies worse as the nose is a highly effective filtration system, filtering, warming, and humidifying the air we breathe. When the patient breathes through their nose many of the particles and pollutants are filtered by a number of structures and systems before they have a chance to reach the airway. Bacteria and viruses are also removed meaning we are less exposed to them which is easier on our immune system.
Nasal breathing also creates the production and supply of nasal nitric oxide. This cellular signaling molecule is connected to several important bodily processes, including the reduction of inflammation.
Myofunctional therapy focuses on proper lip seal and tongue posture so that the patient is breathing through their nose on a regular basis thus reducing allergies and asthma attacks
Chewing, Swallowing and Digestion
Orofacial muscles - the muscles of the mouth, jaw, neck and face are involved in the most basic and important activities of our day-to-day lives including chewing and swallowing. Proper functioning of these processes requires a number of different elements to work in harmony. Many young children do not develop the correct motor function patterns when it comes to chewing and swallowing. These habits continue onto adulthood unless corrected.
Many children are messy eaters, chewing on one side of their jaw, with her mouth open, ending up with food around their mouth. Chewing issues can affect the way their face and jaw develops and should be addressed early on. Improper or
incomplete chewing affects both swallowing and digestion of food.
Correct swallowing depends on a proper relationship between muscles of the face, mouth, and throat. Muscles and nerves in the tongue, cheeks and throat must work together in harmony. When a person swallows incorrectly as a child the pressure may push teeth out of place (tongue thrust), prevent teeth from erupting, and may cause an anterior open bite.
Both chewing and swallowing are important for proper digestion. Aerophagia is the swallowing of air. When you swallow improperly, air is swallowed, leading to digestive issues such as frequent stomach aches and acid reflux. Myofunctional therapy teachers correct chewing and swallowing mechanics. This includes learning how to slow down, to bilaterally chew and swallow without compensation from any additional muscles. The correct tongue posture can improve digestive problems by stimulating the vegas nerve located at the “spot”. The vegas nerve is responsible for the regulation of breathing and digestion. Learning how to breathe properly may also help decrease or eliminate digestive issues due to the balance of sympathetic and parasympathetic nervous system response. Mouth breathing may cause digestive issues because the body is in a chronic fight or flight mode, which causes a more sympathetic nervous system response, instead of the rest and digest response of the parasympathetic nervous system.