Myo (Myofunctional) Therapy  

Therapy for the muscles of the mouth, face & throat. 

Myofunctional Therapy is a specialized form of therapy aimed at improving the function and coordination of the muscles in the face, mouth, and throat. It involves therapeutic exercises and techniques designed to help patients improve their breathing, chewing, swallowing, and speaking by focusing on retraining the muscles to work and function more effectively leading to improved oral health, speech clarity and reduced symptoms associated with conditions like sleep apnea, or TMD. Myofunctional Therapy before and after orthodontics assists in the progress and long term success of treatment.

Common Symptoms

Poor sleep, speech clarity, upper body tension, headaches, inability to focus, grinding teeth, painful infant nursing

  • Do you:

    • Have difficulty getting certain words out or speaking fast?

    • Have a history of speech therapy?

    • Have difficulty swallowing or unable to swallow pills?

    • Mouth breathe or have your mouth open during the day?

    • Wake up tired and not refreshed? Restless at night?

    • Sleep with your mouth open?

    • Snore?

    • Have neck or shoulder pain or tension?

    • Have a strong gag reflex?

  • Does your child/Is your child:

    • Have frustrations with communication?

    • Difficult to understand by parents or outsiders?

    • Have trouble with certain sounds? History of speech therapy?

    • Have a strong gag reflex? Gag or choke with certain food textures?

    • Mouth open / mouth breathing during the day

    • Hyperactive/ inattentive?

    • Restless sleeping (moves a lot or wakes often)

    • Sleep with mouth open?

    • Wet the bed or had prolonged bed wetting?

  • Has your infant experienced:

    • A shallow latch at breast or bottle?

    • Poor or slow weight gain?

    • Snoring, noisy breathing, or open mouth breathing?

    • Clicking or smacking noises when nursing?

    • Frustration at breast or bottle?

    • Spit up often?

    • Slide or pop on and off the nipple?

Four Goals of Myo Therapy

  1. Proper Breathing

  2. Correct Tongue Posture

  3. Lip Seal 

  4. Correct swallowing

  • We will provide any other areas of support that is needed as each patients’ specific needs & goals may be different. We strive to tailor our therapy programs to provide therapy that is consistent with the latest and most current research & techniques. 

Steps in Myo Therapy

A quick pre-screening assessment will help to identify if a full assessment is needed.

Infants only need an Assessment, Release and a Follow-up appointment.

  • A 60-90 minute oral exam with photos, videos, and measurements to assess:

    • Medical, Dental & developmental history

    • Verify the significance of symptoms from the pre-screening questionnaire and discuss how they affect function.

    • Facial & jaw structure

    • Airway and nasal clearance

    • Tongue Space and Tongue Range of Motion

    • Tongue & Lip Tone

    • Muscle imbalances and the presence of any compensations

    • Oral habits

    • Presence of oral restrictions (Tongue or Lip Ties)

    • Swallowing & chewing

    • The need for any intraoral appliance in conjunction with myofunctional therapy

    • The need for referral to other health professionals

  • Appointments are typically 30-40 minutes 1–2 weeks apart. Initial therapy sessions focus on functional respiration & developing a nasal breathing habit while creating awareness of the correct oral rest posture, tongue functions, muscle toning and increasing mobility & coordination of the tongue and decreasing any muscle compensations.

    Evaluation for oral restrictions and preparation therapy for a tongue &/or lip tie release if indicated.

  • The need for a lip or tongue tie release (functional frenuloplasy) is based upon the severity of the restriction, your level of function and your symptoms.

    Surgical modification could also be any procedure recommended and performed by a collaborative health care professional such as an ENT.

  • Continues to retrain tongue posture, increase strength and awareness to improve muscle coordination, decrease habits and compensations and rehabilitate the muscles to restore proper function.

    This phase also includes the necessary post op therapy needed following a tongue or lip tie release.

    Each session is 30-40 minutes 1-3 weeks apart depending on individual needs, progress, function, goals, and compliance.

  • Focuses on awareness, habit elimination and new formation to maintain a balanced muscle environment and ensure that neuromuscular re-patterning has occurred.

    Each session is 30-40 minutes 2-4 weeks apart

    At the end of your therapy program 3,6,12- month check in sessions may be recommended as part of maintenance. Suggestions for continued awareness will be discussed and specific exercises, adjuncts or tools may be recommended.

Myo Therapy can play a vital role in your health & well-being.

  • Your tongue’s position affects your airway. Proper tongue position helps to maintain an open airway & reduces the risk of breathing problems & sleep disorders such as upper airway resistance syndrome, obstructive sleep apnea and snoring.

  • Your tongue’s posture can impact the development of your facial features. Proper tongue posture can contribute to a more balanced & aesthetic facial structure.

  • Having the lips closed & nasal breathing protects the mouth from changes in pH balance associated with mouth breathing which increases risk of cavities, oral microbiome imbalances, gingivitis, and gum disease.

  • Proper tongue position helps hold the framework of the arches and stabilize teeth. Myofunctional therapy done before and during orthodontic treatment can help by eliminating any orofacial muscle dysfunction or noxious oral habits that may adversely affect the progress, outcome, and long-term success of treatment.

  • The tongue’s placement and movements are important to clear and precise speech. Improving tongue & lip tone leads to improved function which can aid in speech improvements.

  • The tongue initiates the swallowing process, guiding food to the digestive system ensuring efficient digestion and nutrient absorption. An improper swallow can cause digestion issues (swallowing air, bloating, constipation, etc.)

  • The tongue plays a significant role in upper body tension through its connections to the muscles & fascia in the head, neck & shoulders. When the tongue is tense or improperly positioned it can create tension leading to stiffness, discomfort or pain in the upper body.

    Also, limited tongue mobility from a tongue tie can lead to compensatory tension in the muscles of the upper body because your body tries to accommodate for the restricted tongue motion.

Tongue-Tied

  • A tongue tie, medically known as ankyloglossia, is when the band of tissue that connects the underside of the tongue to the floor of the mouth is too tight or short, restricting the movement of the tongue. In children this condition can affect speech, feeding & swallowing, facial development, breathing, sleep and overall health. Adults with a tongue-tie are also more likely to suffer from poor sleep quality, digestive and swallowing problems, TMJ pain, posture issues, speech impediments, headaches, and upper body tension.

  • Many children are born with a tongue or lip tie.

    As an infant, most of the symptoms are tied to breastfeeding:  messy eating, clicking, inability to latch, fussy, gassy, colicky, nursing often, spitting up, falling asleep at the breast frequently, and failure to thrive. 

    When left untreated, a tongue or lip tie can affect breastfeeding, causing a painful or uncomfortable latch for the mother and cause inadequate nutrition for baby. It can also lead to speech issues for children and alter future eating habits.

  • A tongue tie release, or frenuloplasty, is a surgical procedure that can help alleviate issues.  

  • Adequate preparation before the procedure helps build strength, coordination, awareness, and behavior modifications as you work with your therapist to address proper tongue posture and breathing habits.

    Attaining good muscle tone and control prior to the procedure will help achieve a successful release.

    Myofunctional Therapy helps you to heal correctly. Learning post – procedure exercises, stretches and wound management aids in the healing process.

    Myofunctional Therapy following the release is necessary to rehabilitate the oral structures and to restore and improve correct oral function.

    Towards the end of your program the focus is on retaining your newly formed habits and proper function to ensure that neuromuscular re-patterning has occurred and can be maintained.

  • A release changes the structure and allows for proper movement. Muscles must learn how to use the new movement and change old habits. This takes time, awareness, and repetition to accomplish.

Real Release Results

Daesha
Lip & Tongue Release

”…after I had the procedure done, it was amazing to see most of the symptoms went away…”

Shelly
15 minutes
after Tongue Release

“…I already feel release in my neck, in the front, in the back, bottom half of my head and through my shoulder blades…”

Shelly
One month
after Tongue Release

“…not only did this help with my sleep pattern but took away a lot of the anxiety…”

“Since Sean's release and myo treatment, he has been sleeping better, able to focus more, and anxiety has greatly diminished. He has become a more relaxed person, and homework is not a battleground anymore! This procedure has changed our lives!! Thank you Ivory Family Dentistry”

  • Jean Q. (Sean's mother)

THE HEAD-TO-TOE CONNECTION 

Our entire body is covered in fascia which connects our body from our head to our toes.  When there is a restriction or tethered oral tissues (tots) a domino effect is created on our body and it will learn to compensate in any way it can to survive and function.  

As we age our body’s adaptations and compensations can begin to give way resulting in increased symptoms, pain, and dysfunction.  

Your Team

Dr. Wilen and our Myo Team are knowledgeable, specialized and able to coordinate collaborative care with additional providers when needed.

Great Questions

  • The duration of myofunctional therapy and the exercises assigned can vary depending on each patient’s needs, compliance, and progress throughout the program. The therapy is individually tailored to address the specific myofunctional disorders, dysfunction and/or tethered oral tissues found in each patient and their specific therapy goals.

    Most patients can progress through their active therapy in 4-6 months. Those patients that do not need as comprehensive of therapy will finish sooner than those that do.

    Most patients need 8-12 therapy sessions which are scheduled 1-4 weeks apart depending on which phase of therapy they are currently in.

    The speed & success of therapy is dependent on the severity of the myofunctional disorders, patient needs & goals as well as on the patient’s compliance and commitment to the program

  • Typically, 3-5 exercises will be assigned at each appointment to be completed daily at home two times per day. There may be a combination of passive, active, breathing, and/or postural exercises.

    Some exercises may require a tool or adjunct to assist in performing the exercise or provide resistance.

    Your therapist will provide you with a kit that you will need to bring along to each appointment.

  • Myofunctional therapy has no age limit and can be started as early as 4 years old, however, the patient must be motivated and mentally mature enough to be dedicated to the program. For young children parental guidance is important to ensure exercises are being completed correctly and consistently every day.

  • Not all tongue ties need to be released unless it is causing symptoms and affecting oral function.

    Specific exercises targeted to prepare the tongue for a release may be given at your first few sessions. In other cases, patients may begin their myo program and work through 1-4 sessions with a focus on improving function and eliminating myofunctional disorders and decreasing compensations before determining if a release is needed.

  • A frenuloplasty is a surgical procedure intended to release tethered oral tissues that can interfere with tongue mobility and/or the correct tongue position which contributes to many symptoms as well as functional limitations and muscular compensations. Studies have shown that a functional frenuloplasty is more successful when done in conjunction with myofunctional therapy.

    The procedure involves a recovery & healing process.

    Your myofunctional therapist will give you a specific set of instructions, exercises and stretches to complete several times per day following your release during the recovery and healing process.

  • It is a simple and straight-forward outpatient procedure completed in the dental office with local anesthetic. You will be completely numb. First a topical anesthetic gel is applied around the frenum and tissue underneath the tongue and then an injection of local anesthetic, like you would have for a dental filling, is given. The anesthetic ensures that you are comfortable throughout the procedure.

    During the procedure an incision is made in the frenulum with a laser so that the Doctor can access the underlying connective tissue and fascia to release the tension and modify the frenum attachment.

    A CO2 laser is used which helps with control, precision, reduces bleeding and helps to minimize post operative discomfort.

  • After the surgery, you may experience some discomfort and swelling, but these symptoms typically subside within a few days.

    Initially, you may be advised to follow a soft diet to avoid irritating the surgical site.

    It is essential to follow your post op instructions closely to promote proper healing and ensure the best possible outcome.

  • No, antibiotics are not needed following your release. We do recommend rinsing with salt water or an alcohol-free mouthwash several times per day to keep the site clean.

  • This varies as every person has a different pain tolerance.

    Swelling & discomfort are not unusual for the first few days following the procedure and they will subside with time.

    The swelling and discomfort can be managed with over-the-counter pain relievers, oral gels and ice or cold compress.

  • Immediately following the procedure, it may be difficult and /or uncomfortable to talk due to the swelling. This will improve gradually as the surgical site heals and the tongue mobility improves and swelling decreases.

  • Sutures typically dissolve in 5-7 days

  • For patients under 4yrs old there is no sutures placed. A primary release performed in early childhood is related to tongue and/or lip ties which can impact oral function, feeding (for infants), speech development, oral health, and overall well-being. Often times when the child is older a secondary and more functional release may be necessary.

  • Everybody is different and their bodies will respond differently. We advise taking the remainder of the day off following your procedure to rest. It is also important that you follow the recommendations given to you to aid in optimum healing and pain management. Most patients can return to work/school after 1 day.

  • Myofunctional therapy is often used in conjunction with intraoral appliance therapy and/or before, during, or after orthodontic treatment. Myofunctional therapy done before and during orthodontic treatment can help by eliminating any orofacial muscle dysfunction or noxious oral habits that may adversely affect the progress, outcome, and long-term success of treatment. There are some orthodontic appliances, however, that myofunctional therapy cannot be done in conjunction with due to physical limitations.

  • We prefer to see you in person for your initial assessment and consultation appointment. If you are traveling a distance, we may schedule your first appointment for up to 90 minutes to allow extra time in case we are able to begin therapy the same day. We do have the option and ability to do subsequent therapy sessions virtually.