Under normal physiological circumstances there is a strict balance between the functions of the intra- and extra-oral muscles, such as Mm. Orbicularis oris, Mm. Masseter, Mm. Buccinator and the intrinsic and extrinsic muscles of the tongue. The masticatory muscles, the tongue, the lips, the opening and closing muscles of the mandible; they all have their own functional forces onto the dentition. If some muscles do not function appropriately, this will mostly have direct consequences for the anatomical form of the dentition and the jaws. As a side effect we often see a disturbed articulation such as a lisp (sigmatism).
If there is just a deviate articulation, under normal circumstances regular speech therapy could solve the problem. But if we have a functional problem in such a way that the jaws, the teeth, the masticatory muscles and sometimes the TMJ are involved in the problem, classical speech therapy cannot reach a long lasting result. Since the cause of the problem, the muscular imbalance is not treated.
Goal for a speech pathologist, specialized in OMFT
Oromyofunctional therapy aims to bring all intra- and extra-oral muscles in harmony by training the involved muscles and to get rid of the wrong habits. So the therapy deals with the cause of functional problems and not only with the effect or result of muscular disharmony. After having created a oral muscular harmony, other therapies, such as articulation training, orthodontics or a surgical correction of the jaws will have a stable result.
Indications for OMFT
Generally speaking we can say that bad oral habits can cause many dental, orthodontic and speech disturbances. If you can recognize and treat these bad habits, you can prevent a lot of trouble for your patient, in terms of relapse of the deviate form and treatment time for orthodontics.
A non-physiological function of the tongue can have great consequences for the way a person grinds his food, shapes it to a ball and swallows it. The deviate swallow mostly goes together with a tongue thrust forwards and/or lateral. The consequence is almost always a change of the position of the teeth and/or the molars as well as a different shape of the jaws. There, where the tongue acts like an interference between the teeth, the upper and lower teeth cannot reach each other and we will see an anterior open bite together with a lisp. When the sounds are created laterally we often see a lateral open bite. Such open bites can possibly be closed by orthodontic treatment and the teeth can be perfectly aligned. But very often (in 26 – 38 % of the cases) after some time we see a relapse of the anterior or lateral open bite, because the cause of the open bite, in the case the deviate swallow and/or the abnormal rest position of the tongue, is not changed.
The nose has the function to moist, warm and clean the air that is inhaled. This good function is neglected when there is mouth breathing. The consequence can be: multiple infections in the throat, of the tonsils or ever recurring inflammations of the middle ear. With mouth breathing we often see that, because of the lack of pressure of the lips against the teeth, the front teeth will move forward. We also very often see a narrow gothic palate because the lateral pressure of the tongue against the lateral processus is missing.
Thumb sucking and long lasting pacifier abuse
It is well known that intensive thumb- or fingersucking gives a change of the position of the teeth and/or the jaws.
All these wrong habits cause a disturbance of the balance between the intra- and extra-oral muscles (lips. masticatory muscles, tongue and its muscles). So the shape of the jaws (and the position of teeth and molars) will adapt to the deviate forces created due to the improper muscle-balance. In other words: the (in this case wrong) function of the muscles results in a (in this case wrong) shape of the jaws and/or a wrong position of the teeth. If we want to change the created form, we have to start changing the function of the involved muscles. That is what we call oromyofunctional therapy.