Orofacial Myofunctional Disorders (OMDs)

What is an Orofacial Myofunctional Disorder?

An orofacial myofunctional disorder (OMD) is a condition that involves abnormal functioning of the muscles and structures in the mouth and face. This disorder affects functions such as breathing, chewing, swallowing, and speaking.

Common aspects of OMDs include:

1. Tongue Thrust: When the tongue pushes against or between the teeth during swallowing, speaking, or at rest, which can affect dental alignment and cause issues like an open bite.
2. Mouth Breathing: Breathing predominantly through the mouth instead of the nose, which can impact facial development, oral health, and may lead to other health issues.
3. Incorrect Oral Rest Posture: Incorrect resting positions of the tongue, lips, and jaw can affect facial development and dental alignment.
4. Chewing and Swallowing Difficulties: Problems in chewing or swallowing food properly.

OMDs can be caused by various factors such as genetics, improper oral habits during childhood, structural issues, neurological conditions, or even environmental factors. Treatment often involves therapy from a speech-language pathologist or orofacial myofunctional therapist. This therapy focuses on exercises and techniques to retrain the muscles and correct dysfunctional habits, aiming to improve speech, swallowing, breathing, and overall oral function. In some cases, dental, orthodontic, or ENT interventions may also be part of the treatment plan.

What Causes an OMD?

Orofacial myofunctional disorders (OMDs) can stem from various factors, including:

These causes can sometimes overlap or interact, contributing to the development or exacerbation of an orofacial myofunctional disorder. The specific cause or combination of causes can vary from person to person, and identifying the root cause often informs the approach to treatment and therapy.

What Signs Should You Look For?

Several signs and symptoms might indicate the presence of an orofacial myofunctional disorder (OMD).

Here are some common signs:

1. Speech Difficulties: Problems with articulation, speech sounds, or certain speech patterns might indicate an OMD.
2. Open Bite or Dental Issues: An open bite, where the front teeth don’t meet when the mouth is closed, could be indicative of an OMD caused by tongue thrusting.
3. Mouth Breathing: Breathing predominantly through the mouth rather than the nose can be a sign of OMDs, potentially indicating issues with oral muscle function or airway problems.
4. Tongue Resting Position: Observing where the tongue rests in the mouth when relaxed can provide clues; if the tongue habitually rests between or presses against the teeth, it might suggest an OMD.
5. Chewing and Swallowing: Difficulty chewing food or swallowing issues could be linked to OMDs, particularly when associated with improper tongue placement or muscle coordination.
   •        Chewing and Swallowing Patterns: Incorrect chewing or swallowing patterns during childhood can persist and contribute to OMDs. These patterns might involve improper tongue placement or muscle coordination.
   •        Oral Sensory Issues: Some children may have sensory issues related to textures or temperatures of foods, leading to avoidance or altered feeding behaviors. These issues might indirectly influence oral muscle development.
6. Facial Muscle Tension or Pain: Some individuals with OMDs might experience tension or pain in facial muscles due to improper muscle function.
7. Thumb-Sucking or Prolonged Pacifier Use: These habits, especially if prolonged, can contribute to the development of OMDs.
8. Orthodontic Relapse: After orthodontic treatment, if there’s a regression in the alignment of teeth, it might suggest underlying OMDs.
9. Snoring or Sleep Apnea: While not always directly linked, OMDs can sometimes contribute to sleep-related breathing issues like snoring or sleep apnea.

Diagnosing an OMD often involves an assessment by a speech-language pathologist, an orofacial myofunctional therapist, or a healthcare professional experienced in recognizing and treating these disorders. They will evaluate the individual’s oral muscle function, habits, and behaviors to determine if an OMD is present and formulate a suitable treatment plan.

Glossary

Tongue Thrust: A swallowing pattern where the tongue pushes forward against or between the teeth during swallowing, speaking, or even at rest. In a typical swallow, the tongue presses against the roof of the mouth (palate) while swallowing to help propel food or liquid backward into the throat. 

Obstructive Sleep Apnea: A sleep disorder characterized by repeated interruptions in breathing during sleep. These interruptions, called apneas, occur when the muscles at the back of the throat temporarily collapse or become relaxed, leading to a partial or complete blockage of the upper airway. This blockage results in reduced or halted airflow, and the individual may briefly awaken to resume normal breathing.

Cerebral Palsy: This condition, resulting from brain damage or abnormal brain development, affects muscle control and coordination. It can lead to OMDs such as difficulties with chewing, swallowing, and speech.

Stroke: A stroke, which occurs due to interruption of blood flow to the brain, can cause muscle weakness or paralysis affecting the face, mouth, or throat muscles. This weakness can contribute to OMDs.

Parkinson’s Disease: Parkinson’s affects motor control and can cause stiffness, tremors, and difficulty with movement. These symptoms can impact oral muscle function, speech, and swallowing.

Multiple Sclerosis (MS): MS is a condition affecting the central nervous system, causing a range of neurological symptoms. Muscle weakness, coordination issues, and fatigue can affect oral motor function and contribute to OMDs.

Amyotrophic Lateral Sclerosis (ALS): ALS is a progressive neurodegenerative disease affecting motor neurons, leading to muscle weakness and eventual paralysis. OMDs can develop due to weakening of the muscles involved in speech and swallowing.

Traumatic Brain Injury (TBI): Injuries to the brain can impact motor function and muscle coordination, potentially leading to OMDs depending on the areas affected by the injury.

Neurodevelopmental Disorders: Conditions like autism spectrum disorders, ADHD (Attention-Deficit/Hyperactivity Disorder), or specific learning disorders can sometimes involve challenges with oral motor function and OMDs.

Down Syndrome: Individuals with Down syndrome often exhibit low muscle tone (hypotonia) and altered oral muscle function, which can contribute to OMDs such as tongue thrust or difficulties with speech and swallowing.

Cerebral Palsy: This condition, caused by brain damage or abnormal brain development, can result in impaired muscle control, affecting the muscles involved in speech, chewing, and swallowing.

Muscular Dystrophy: Various types of muscular dystrophy, which involve progressive muscle weakness and degeneration, can impact the muscles used for chewing, swallowing, and other oral functions, potentially leading to OMDs.

Prader-Willi Syndrome: This genetic disorder is characterized by weak muscle tone, feeding difficulties in infancy, and problems with oral motor skills, which might contribute to OMDs.

Angelman Syndrome: Individuals with Angelman syndrome may experience difficulties with chewing, swallowing, and tongue movements due to neurological and developmental issues associated with the disorder.

Rett Syndrome: Although primarily a neurological disorder, Rett syndrome can also affect oral motor function, leading to difficulties with swallowing, chewing, and speech.

By Meghan Rich, MA, CCC-SLP