1. Myofunctional Therapy
Annette Hulse, DO

2. Osteopathic Principles
Function and structure are reciprocally inter-related

3. Nose & nasopharynx: breathing

4. Mouth & oropharynx: eating

5. Laryngopharynx: Speaking + coordinating

6. Functions of the Face Mouth & Pharynx
Suck/Swallow
Breathe
Chew/Swallow
Speech

7. Infant (Visceral) Swallow
Jaws apart
Tongue between gum pads
Mandible stabilized by facial muscles (CN VII) & tongue
Vigorous lip/cheek contractions
Swallow guided/controlled lips and tongue

8. Mature Swallow Teeth together
Mandible stabilized by muscles of mastication (CN V)
Tongue tip up on palate
NO lip contractions
Usually by months

9. How Do We Treat the Function?

10. Buteyko Breathing

11. Breathing
Wind instruments (e.g. Didgeridoo)
Singing (esp. choral)

12. Tongue

13. Myofunctional Exercises
Tongue exercises include:
Move tongue along the superior and lateral surfaces of teeth
Position the tongue tip up on hard palate (“the spot”)
Suck up entire tongue against palate (“caves”)
Force tongue onto floor of mouth

14. Facial Muscles

15. Myofunctional Exercises
Facial exercises
Lip (contraction and relaxation of the orbicularis oris)
Buccinators (suction and expand)
Jaw muscles (lateral jaw movements)

16. Myofunctional Exercises
Stomatognathic functions (swallowing and chewing exercises)
swallowing with teeth together & tongue positioned in palate
alternating chewing sides

17. When Should You Refer?

18. Tongue Tie

19. Mouth Breathing

20. Sleep Apnea

21. Systematic Review in 2015
Myofunctional therapy decreases AHI by ~50% in adults and 62% in children
Camacho M, Certal V, Abdullatif J, et al. Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis. Sleep. 2015;38(5): doi: /sleep.4652.

22. Thumb/Finger Sucking

23. Thumb/Finger Sucking

24. Thumb/Finger Sucking

26. Abnormal Tongue Postures

27. How Do You Find a Myofunctional Therapist?

28. Aomtinfo.org

29. Online Resources