What is Myofunctional Therapy?
Myofunctional Therapy is a type of treatment that looks at the way the tongue and oral muscles move and function. Many people experience low muscle tone and swallowing issues that can lead to health problems.
Myofunctional therapy is based on a series of exercises that help patients learn to change bad habits. This improves tongue placement, breathing, speaking, chewing and swallowing, which can have a huge impact on their overall health and well-being. Patients experience a variety of myofunctional issues. It can sometimes be overwhelming when you start learning about myofunctional therapy.
Below you will find some answers and information that patients inquire about when they start to research symptoms or contact me.
There is a prevalent perception out there that myofunctional therapy is only suitable for young children. This is probably because most people know that kids’ faces and skeletal structures are still developing and dramatically changing. That translates to it being much easier for their bones to physically remodel when exposed to an external stimulus such as orthodontic treatment or myofunctional therapy.
However, in my practice so many of my adult patients have had life-changing results from myofunctional therapy. In fact, most of my patients tend to be adults who want to make positive changes and have healthier lives.
While it may seem that our bone structure is fixed once we reach adulthood, we actually know bone is constantly remodeling. That’s why a broken bone will heal and why adults can benefit from orthodontic expansion of their palate. With the right stimulus, change is possible, especially over a longer period of time.
It’s important to note that myofunctional therapy and switching from mouth breathing to nasal breathing can have a noticeable effect on our oral and facial muscles. In fact, any changes to the structure of the jaws and face that may happen as a result of therapy are driven by changes to the functionality and coordination of the relevant muscles. And as I always tell my patients, myofunctional therapy is like physical therapy, just for the muscles of the face and mouth. If it’s possible to benefit from physical therapy at any age, it’s also possible to benefit from myofunctional therapy.
Myofunctional therapy can change the way we look but I’m much more focused on the underlying health concerns that go hand-in-hand with oral myofunctional disorders.
For example, a narrow face indicates a narrow airway, and that’s tied into sleep-related breathing problems. And a mouth breathing habit is a dysfunctional breathing pattern that can also lead to sleep disordered breathing. A low postured tongue or a tongue thrust swallowing pattern are also dysfunctional — that’s just not how the human body is meant to function.
Being in these dysfunctional states can lead to so many different problems with health, including sleep apnea and other types of sleep disordered breathing, jaw pain and tension, headaches, gastrointestinal disturbances, and more.
Once the underlying issues are addressed and functionality is restored, then we’re on track to make a substantial difference to health and quality of life. When I say it’s never too late for myofunctional therapy, what I really mean is that it’s never too late to get healthier. Of course, addressing and treating oral myofunctional disorders early is the best possible approach. After all, prevention is always better than cure, and putting your body in a highly functional state early sets the stage for a healthy life. But whatever your age, it’s absolutely worth taking care of your health as much as you can.
More recently though, Los Angeles-based Dr. Soroush Zhagi has developed an even more effective technique for the tongue-tie release. His new approach has proven to provide patients with amazing results. Dr. Zaghi’s Breathe Institute website summarizes the functional frenuloplasty best:
“We have a multidisciplinary protocol of functional frenuloplasty that integrates myofunctional therapy (and sometimes craniosacral therapy) both before, during, and after surgery. Our technique is based on precision: releasing the appropriate extent of tissues for maximal relief; not too much, and not too little.
“Scalpel and/or scissors causes no thermal tissue damage as compared to laser and allows for the placement of sutures to promote healing by primary intention. We find that leaving the wound open to heal by secondary intention (without sutures) predisposes to excessive scarring.”
I have had many patients over the last few years who have experienced excellent results from the functional frenuloplasty. Their results are lasting and have minimal, if any, reattachment. The number of doctors and dentists performing the functional frenuloplasty is growing month by month. This is great for my patients because I’ve got a growing referral network to refer them to for a tongue-tie release.
Whether it is a functional frenuloplasty or a frenectomy, the most important thing to know about tongue-tie releases is that the skill and experience of the person doing the procedure are still by far the most important factors in getting a good result.
A frenotomy/frenulotomy is a minor incision into the connective tissue at the bottom of the tongue to free the tongue from the floor of the mouth. This is usually done for babies. The full frenectomy procedure is also known as a frenulectomy or frenuloplasty or functional frenuloplasty. This involves removing or altering the connective tissue under the tongue.
Frenectomy procedures are low risk, generally using local anesthetic. The procedure is done with a laser, a scalpel, or scissors. With a laser, a diamond shape wound appears under the tongue and doesn’t require sutures. With a scalpel or scissors, sutures will be placed to help the wound heal. Wound healing usually takes one to two weeks, although it may take longer. Pain is usually not a major factor and can be managed with mild painkillers most of the time.
Posterior tongue-ties aren’t obvious at first glance. The back part of the tongue is restricted rather than the front portion of the tongue and the restriction is totally different.
Posterior tongue-ties can be difficult to diagnose because the other muscles of the face and mouth compensate for the restriction. One clue I look at is the floor of the mouth lifting up to allow the tongue to move to the palate. Often people with this tie can stick their tongue out a long way or get the front or the whole tongue to rest on the top of the mouth.
However, when these muscles compensate, we see pain and tension all throughout the neck, face, jaw, shoulders, and more. This can lead to clenching, grinding, TMJ problems, postural problems, as well as sleep apnea or other sleep disordered breathing conditions. Babies with a posterior tongue-tie may also have difficulty breastfeeding.
Like most myofunctional therapists, I’ve built up a substantial referral network over the years. This allows me to recommend the right doctor, dentist, orthodontist, or bodyworker for my patients with TMJ-related issues depending on their unique requirements.
- Jaw and facial pain, tension, and stiffness
- Pain and tension that radiates into the neck, shoulders, and upper body
- Hearing difficulties
- Tinnitus (ringing in the ears)
- Clicking or grating sounds when opening the mouth, yawning, or chewing
- Clenching and grinding of teeth
- Difficulty opening the mouth wide or yawning
- Difficulty chewing
- Locking open of the jaw
Temporomandibular disorders or TMD refers to any pain, discomfort, dysfunction, or tension related to the jaw. Often, it is also called TMJ syndrome.
It can be a challenge to determine the cause of these temporomandibular disorders because there are many factors that can contribute. These factors include, but aren’t limited to:
- Epigenetic changes
- Age-related degeneration
- Autoimmune conditions such as arthritis and rheumatoid arthritis
- Nutritional and dietary issues
- Chronic stress
- Postural and structural issues
- Teeth clenching and grinding
- Improper chewing or swallowing patterns
- Incorrect tongue resting posture and mouth breathing
- Persistently sleeping on one side
- Anything that affects the functionality or structure of the temporomandibular joint can lead to TMJ dysfunction, pain, tension, and a wide range of other symptoms.
We know that healthcare costs can add up, but NW Myofunctional Therapy cannot directly bill insurance. We are considered an out-of-network provider.
Working with an out-of-network provider makes the treatment plan costs more transparent for both the provider and the patient, and allows us to work for you rather than insurance companies. Costs are laid out up front and there are no hidden fees, co-pays, or premiums. The NW Myo team prefers to work directly for the patients that hire us, rather than for insurance companies that dictate the time spent with patients and determining what is worth spending time on.
We aim to fully educate and empower you during our time together, which isn’t always possible following insurance guidelines. We also offer direct access which prevents excess appointments, getting referrals, and waiting for openings.
Time and effort are valuable, so we want to make the most of our time together rather than following codes for care.
We do offer a superbill halfway through treatment and at the end of treatment to submit to your insurance for potential reimbursement. There is no guarantee that any/all invoices will be reimbursed. We do understand that cost can be a barrier and we have a variety of treatment plans and options to fit most budgets.
We can accept FSA and HSA health accounts as a form of payment and provide the appropriate receipts.