Myofunctional Therapy

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In addition to speech therapy, we offer myofunctional programs to address open mouth rest posture, tongue “thrusting” during chewing and/or during swallowing, immature chewing patterns, and uncoordinated food manipulation. Orofacial myology includes the evaluation and treatment of abnormal structure and/or functioning of the tongue, lips, and jaw in relation to oral rest postures, swallowing/chewing, and speech.

Orofacial Myofunctional Therapy focuses on remediation of thumb sucking/finger sucking and other oral habits such as nail biting, open mouth resting posture, tongue thrusting and other difficulties that affect appropriate growth and development of the orofacial structures.

Related factors can include allergies, enlarged tonsils or adenoids, excessive or extended thumb/finger sucking habits, excessive or extended pacifier or sippy cup use, and structure abnormalities such as tongue tie or lip tie.  These factors should be addressed to ensure proper orofacial development.


What is an OMD?

Orofacial Myofunctional Disorders (OMDs) are disorders of the muscles and functions of the face and mouth. OMDs may affect, directly and/or indirectly, breastfeeding, facial skeletal growth and development, chewing, swallowing, speech, occlusion, temporomandibular joint movement, oral hygiene, stability of orthodontic treatment, and more.

Most OMDs originate with insufficient habitual nasal breathing or with oral breathing. The subsequent adaptation of the muscles and the orofacial functions to a disordered breathing pattern creates many OMDs.




Sucking is a normal part of early oral development, You may have even seen ultrasound pictures of your child sucking in the womb. As babies grow into toddlers, optimal oral experiences should enable that sucking habit to lapse. By the age of 5, when the permanent dentition starts to come in, that little digit or digits need to be out the mouth. At our Thumbsucking Clinic, we provide a thorough assessment and review of your child’s habit and how it is impacting their growth and development. With this knowledge, we are able to customize a positive and motivating program to help your child STOP their oral sucking habit for good! Our non-nutritive sucking elimination program can be used with children 5 years and over.


Tongue Tie:

We specialize in the before and after care for lip and tongue ties. When the tongue is anchored to the floor of the mouth, it is difficult to maintain the ideal tongue “resting posture” with lips closed at the tongue pressed up against the roof of the mouth. This can lead to a high, narrow palate that can affect facial development and the stabilization necessary for speech clarity.

Tongue tie can also affect the processes of eating and swallowing. When the tongue is restricted, any of the following may result:  messy eating, dental caries/tooth decay due to not being able to clean food from teeth, fatigue from chewing, inefficient chewing, bites that are too big, difficulty accumulating the bolus on the tongue in order to swallow, a tongue thrust swallowing pattern, malocclusion, difficulty licking ice cream cones, difficulty swallowing pills, and drooling due to poor management of saliva.  Digestive problems may also develop due to poorly chewed foods (Boshart, 2015).

Symptoms of Tongue Tie in Children

  • Sleep Apnea
  • Snoring
  • Teeth gapping
  • Teeth movement/turning/crowding even after braces
  • Not being able to clean teeth properly with tongue
  • Speech-Articulation Issues
  • Slow movement of tongue while speaking
  • Resonance issues
  • Food and texture aversions
  • Holding food in mouth instead of chewing
  • Affected smile
  • Jaw or TMJ issues
  • Facial tension
  • Throat/Neck pain while talking, eating, or chewing
  • Migraines

The tongue is meant to “rest” at the roof of the mouth.


Tongue “Thrust” Swallow:

Correct swallowing depends on a proper relationship between muscles of the face, mouth and throat. The act of swallowing is one function that depends on the body’s vital balance. To swallow properly, muscles and nerves in the tongue, cheeks and throat must work together in harmony. When a person swallows normally, the tip of the tongue presses firmly against the roof of the mouth or hard palate, located slightly behind the front teeth. The tongue acts in concert with all the other muscles involved in swallowing. The hard palate, meanwhile, absorbs the force created by the tongue.

In a “tongue thrust” swallow, the tongue moves forward and pushes against the teeth. If a child is using this type of swallow, they may not efficiently clear the mouth of food drink, or saliva. The tongue thrust swallow is also associated with open-bites and over bites. Tongue thrust swallows may also affect speech production. Lisps are the most common problem associated with tongue thrusts, but s, z,sh, ch, and j may be affected.

Our tongue thrust program can help “retrain” your child’s swallow for optimal oral development.

How do I know if my child has a tongue thrust swallow?

  1. Can you see your child’s tongue move forward between her gums and teeth when she swallows?
  2. Is there food left in your child’s mouth after she swallows one time? Try this with a cracker
  3. Does your child tense their lips when they swallow?
  4. Does your child tend to place too much food in their mouth?
  5. Does your child want sauces on most of their food?
  6. Does your child breathe through their mouth?
  7. Does your child have a persistent oral habit such a sucking their thumb, using a pacifier, or chewing on their clothing or objects?
  • This information is from Diane Bahr MS CCC-SLP


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How do I know if my child has an Orofacial Myofunctional Disorder?

  1. Does your child have an open mouth at rest or do they breathe thorough their mouth?
  2. Does your child have rest their tongue against their teeth or between their teeth?
  3. Have your child’s teeth moved after orthodontic treatment?
  4. Does your child’s jaw or neck hurt often?
  5. Do you have an incorrect swallowing pattern? (e.g., tongue thrusting in between, forward or sideways against the teeth, chewing with your mouth open)
  6. Does your child have frequent headaches?
  7. Does your child drool or have bloating or stomach distress after eating?
  8. Is your child a stomach or side sleeper?
  9. Does your child have oral habits such as thumb, finger or pacifier sucking habits
  10. Does your child have a lisp at times when saying the “s” sound?

If you answer “YES” to 4 or more questions, a Myofunctional Therapist may be able to help!

Learn more about the International Association of Orofacial Myology at:


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