speech / OMD

What are Myofunctional disorders?

Orofacial myofunctional disorders involve a variety of postural and functional disorders including sucking habits and inappropriate oral postures or functions of the muscles of the tongue, lips, jaw, and face. A common disorder familiar to the public is “tongue thrust”, where the tongue rests against or between the front or side teeth during swallowing rather than lifting up into the palate (roof of the mouth). Tongue thrusting frequently occurs with a low, forward resting posture of the tongue, with a lips apart posture. Just as the controlled continuous forces of orthodontic appliances (braces) can move teeth, abnormal postures and functions in the oral cavity can contribute to the development of dental malocclusions such as incorrectly positioned teeth, an improper bite relationship or other problems related to oral or facial muscle dysfunction or a malformation of the bones of the dental arches.

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Signs and symptoms of Oral Myofunctional Disorders

Although a “tongue thrust” swallow is normal in infancy, it usually decreases and disappears as a child grows. If the tongue thrust continues, you may look, speak, and swallow differently than others of the same age. You may become self-conscious about your appearance. Signs of Oral Myofunctional Disorders include:

  • Tongue Thrust Swallow
  • Open bite (Lateral, Anterior or Posterior)
  • Thumb, Finger, Pacifier sucking

What affect do Oral Myofunctional Disorders have on speech?

Some people produce sounds incorrectly as a result of OMD. OMD most often causes sounds like /s/, /z/,  “sh”, “zh”, “ch” and “j” to sound differently. For example, the child may say “thumb” instead of “some” if they produce an /s/ like a “th”. Also, the sounds /t/. ;d;. ;nl, and /l/ may be produced incorrectly because of weak tongue tip muscles. Sometimes speech may not be affected at all

How are Oral Myofunctional Disorders diagnosed

OMD is often diagnosed by a team of professionals. In addition to the child and his or her family or caregivers, the team may include:

  • a dentist
  • an orthodontist
  • a physician
  • a speech-language pathologist (S-LP)

Both dentists and orthodontists may be involved when constant, continued tongue pressure against the teeth interferes with normal tooth eruption and alignment of the teeth and jaws. Physicians rule out the presence of a blocked airway (e.g., from enlarged tonsils or adenoids or from allergies) that may cause forward tongue posture. S-LPs assess and the treat the effects of OMD on speech, rest postures, and swallowing.

How can we help!

A speech-language pathologist (S-LP) with experience and training in the treatment of OMD will evaluate and treat the following:

  • open-mouth posture
  • speech sound errors
  • swallowing disorders

S-LPs develop a treatment plan to help you change your oral posture and articulation, when indicated. If tongue movement during swallowing is a problem, the S-LP will address this as well.

Treatment techniques to help both speech and swallowing problems caused by OMD may include the following:

  • increasing awareness of mouth and facial muscles
  • increasing awareness of mouth and tongue postures
  • improving muscle strength and coordination
  • improving speech sound productions
  • improving swallowing patterns

If airways are blocked due to enlarged tonsils and adenoids or allergies, speech treatment may be postponed until medical treatment for these conditions is completed. If unwanted oral habits (e.g., thumb/finger sucking, lip biting) exist, speech treatment may first focus on eliminating these behaviours first.