This informational report is intended to provide information about the field of orofacial myology and treatment issues of interest to dental professionals, orofacial myologists, speech language-pathologists and other health professionals.

Informacion sobre miología orofacial y actualización de algunos diagnósticos y temas de tratamiento de posible interés.

Dr. Mason’s response: When I was a university professor in speech pathology, I taught the clinical perspective that the wider the maxillary posterior dental arch the flatter and lower the palatal vault, while the narrower the upper dental arch, the higher the hard palatal vault. Also, the narrower the posterior maxillary dental arch, the more often a posterior dental crossbite will be found.

Question When my 2 yr old had her adenoids and 2nd set of tubes done last July it was discovered that she has a "bifid uvula consistent with a submucous cleft palate." Her speech regressed extensively after the surgery but I was told to "wait and see".

This informational memo is intended to inform you of current clinical practice guidelines regarding the factors involved in the decision to perform a tonsillectomy in children along with, in some instances, an accompanying adenoidectomy. The Foundation of the American Academy of Otolaryngology – Head and Neck Surgery, issued the guidelines shown below, which were published on January 3, 2011, on the website Medscape Medical News. Medscape is a leading online destination and is part of WebMD that healthcare professionals can go to for timely and trusted medical information that provides support for them at the point-of-care.

The procedure used by some orofacial myologists of lightly taping the lips to help stabilize a lips together rest posture is discussed. Since airway needs change during sleep, this technique could result in harm to patients, and should be discouraged. A minimum prerequisite for use of lip taping, even during the daytime, is clearance from a physician that the patient’s airway is clear and can tolerate this procedure without fear of creating medical problems.

The purpose of this report is to share background information about the complex nature of abnormalities associated with Down syndrome, and to offer clinical guidelines that may help orofacial myologists determine whether or not to treat individuals with Down syndrome.

The modern oral and maxillofacial surgeon has the capability of surgically placing the jaws in virtually any new position. Individual who suffer functionally or cosmetically fro m skeletal dysplasia (abnormality of development) can benefit from surgery on the upper or lower jaw or both.

The term lip incompetence is a poor descriptive term that should be changed. The chances of this label being changed, however, appear to be slim to none. At present, lip incompetence remains a universally-used term in dentistry and medicine to describe individuals who can close their lips together but are unable to achieve a relaxed, consistent, lips-together rest posture. The lips remain open, with some upper front teeth (maxillary incisors) showing. Why this is described as incompetence is a mystery.

This article addresses many myths that have persisted over the years in dentistry and orofacial myology regarding the nature of orofacial myofunctional disorders (OMD’s). Myths include 1) the concept that the term “tongue thrusting” includes the rest posture; 2) that there is an excessive amount of pressure exerted against the anterior teeth in swallows, that swallowing pressures add up, and the frequency of swallowing has an impact on the dentition; 3) the idea that the tongue is the strongest muscle in the body; 4) the view that a muscle will be the winner in any tug of war between muscle and bone; 5) the claim that a tongue thrust can cause an open bite malocclusion; 6) the claim that a tongue thrust can cause a Class II malocclusion; 7) the claim that the tongue molds the palatal vault; 8) the notion that a low tongue tip posture at rest presents a problem; and 9) the claim that OMD’s represent a muscle imbalance that can be brought into balance with therapy. Each of these false claims or “myths” is discussed and corrected, with the positive acknowledgement that clinicians are abandoning the incorrect notion of muscle balance and imbalance as had been claimed previously.

The purpose of this editorial is to alert otolaryngologists to Orofacial Myofunctional Disorders (OMDs) and their primary causes of airway interferences including allergies. An understanding of the variety of OMDs should facilitate improved communications between otolaryngologists and orofacial myologists.

Opinions about a possible role for orofacial myologists in providing services for sleep apnea and other sleep-related conditions. As most orofacial myologists know, professionals from a variety of fields have begun to solicit the services of orofacial myologists in the treatment of sleep apnea.

BACKGROUND: If you have some free time and want to have some fun, try Googling chewing pattern. You will find a variety of opinions, study methods, and conclusions that will affirm almost any idea you may have about chewing. If you feel that children chew in a different manner from adults, or not, both conclusions can be easily found. It will become quickly obvious to you that the physiology of mastication has been a topic of considerable dispute.

X-Ray films of the head and neck (roentgencephalograms) have been used for over fifty years in clinical practice in medicine, dentistry, and to some extent in spech pathology. Cephalometrics x-ray films provide a means of evaluating the interrelationship of cranial, facial, and pharyngeal structures either on s longitudinal or serial basis.

This document responds to questions from an orofacial myologist about how to collect data in orofacial myology for clinical research with orofacial myofunctional disorders (OMDs).

How to handle patients after the braces come off. In this article Robert N. Pickron, DDS talks about his 43 years of experience and his personal treatment of a multitude of patients, and how they taught him more than a few lessons. In addition, his role as owner/manager of a multi-doctor practice with more than 3,000 finishes per year gives him a lot of insight on what is working and what is not.

Like most other specialty areas, orthodontics has a rich special literature containing disagreement and debate on a number of topics. One are of controversy since the inception of orthodontics in the late 1800s is the relationship between tongue functions and the development of malocclusion.

Colleagues: The American Association for Dental Research has recently (March 3, 2010) revised its policy statement regarding temporomandibular disorders. A new standard of care for TMDs has been approved. This policy statement regarding TMDs has implications for orofacial myologists who may wish to participate in treatment protocols for TMDs. The policy statement is provided here, followed by information, guidelines and recommendations

The goal of this study was to verify the prevalence of nutritive (breast-feeding and bottle-feeding) and non-nutritive (pacifier) sucking habits, the methods used to eliminate them, and success of these methods.

Clinicians aspiring to a career in the area of orofacial myology have a desire and need to assimilate dental terminology and concepts pertinent to the discipline. Many dental/orthodontic concepts and terms are not easily located in the dental literature. Our purpose here is to provide useful selected dental information for myofunctional clinicians that can aid in communicating evaluation findings to dental personnel. The selected topics will be presented in a question and answer format.

Some selected questionable clinical practices in orofacial myology will be discussed. These include: intervention in sleep-related problems; nasal irrigation (lavage); the evaluation and treatment of temporomandibular disorders (TMJ/TMD); and facial rejuvenation.

Dentists can play an important role in speech screening by identifying potential speech problems in children, determining the child's ability to outgrow the problem, and initiating referrals to speech pathologists. Speech screening involves less that five minutes and can be done in the dental office.

Most professional groups have a particular vernacular that permits effective and rapid communication among members. In clinical report writing, it is easy to forget that when information is transmitted outside of the group to parents or other professionals, the private vernacular and abbreviations acceptable among group members are not always understood or appreciated by those outside of the group. With a goal of clarifying terminology in the clinical reports of speech-language pathologists and orofacial myologists, some examples of potentially confusing terms often used will be discussed.

The buccal corridor is the area of darkappearance space, both horizontally and vertically, that can be found between the inside of the lip commissure (the outer/lateral margin of the lips), and the outside (buccal area) of the posterior dental arches.

Non-nutritive sucking habits may adversely affect the orofacial complex. This systematic literature review aimed to find scientific evidence on the effect of pacifier sucking on orofacial structures.

PROBLEMS OF OVERGROWTH OF A JAW: It is well known among orthodontists that where there is a growth process involving overgrowth of a jaw, the rule is that growth should be allowed to proceed and then treat the situation after growth has ceased. The reason for this is that growth cannot be effectively stopped or otherwise modified to the extent that jaw growth can be overpowered; that is, “Mother Nature” is smarter than any of us in dentistry.

While much appropriate attention has been directed toward the evaluation and treatment of tongue-tie, the labial frenum can also become problematic and may need to be released. Although there are normally several labial-gingival frenulae around the upper and lower labial and buccal vestibules, the midline maxillary and mandibular frenums are the ones that can become problematic.



Afzelius-Alm A, Larsson E, Löfgren CG, Bishara SE.(2004). Factors that influence the proclination or retroclination of the lower incisors in children with prolonged thumb- sucking habits. Swed Dent J. 28(1):37-45.

Ballard, JL, et al (2002), Ankyloglossia: Assessment, Incidence, and Effect of Frenuloplasty on the breastfeeding dyad. Pediatrics 110;e63

Dimberg L, Bondemark L, Söderfeldt B, Lennartsson B. (2010). Prevalence of malocclusion traits and sucking habits among 3-year-old children. Swed Dent J. 34(1):35-42

Fernando, C. (1998). Tongue Tie from confusion to clarity.  Sidney, Australia: Tandem Publications

Green, H, & Green, S. (1999), The Interrelationship of Wind Instrument Technique, Orthodontic Treatment, and Orofacial Myology. IJOM 25: 18-29

Green, S.(2009) Concomitant trichotillomania cessation and thumb-sucking elimination: of course, they're related...aren't they? IJOM Nov;35:55-73.

Hahn, V. & Hahn H. (1992), Efficacy of Oromyofunctional therapy. IJOM, 18, 22-23

Hanson, M.L. & Mason, R.M. (2003). Orofacial Myology: International Perspectives. Springfield, IL: Charles C. Thomas.

Hazelbaker, Alison ATLFF

Larsson E. (2001). Sucking, chewing, and feeding habits and the development of crossbite: a longitudinal study of girls from birth to 3 years of age. Angle Orthod. Apr;71(2):116-9.

Mason, R.M. (2011). Myths that persist about orofacial myology, IJOM, Vol 37:26-36. Mills, C.S (2012),History of the IAOM, IJOM, Nov.,Vol.37:5-25

Mukai S, Mukai C, Asaoka K. (1993) Congenital Ankyloglossia with deviation of the epiglottis and larynx. Ann Otolaryngol;102: 620-4

Niedenthal, Paula M., Augustinova, Maria, Rychlowska, Droit-Volet, Magdalena Sylvie, Zinner, Leah, Knafo ,Ariel & Brauer, Markus (2012): Negative Relations Between Pacifier Use and Emotional Competence, Basic and Applied SocialPsychology, 34:5, 387-39

Proffit, W.R., Fields, Jr,H.W. & Sarver, D.M.(2012), Contemporary Orthodontics, 5th Edition, St. Louis, MO, C.V.Mosby

Sexton S, Natale R. (2009). Risks and benefits of pacifiers, Am Fam Physician. Apr 15;79(8):681-5.

Tillmann, B.N. (2007). Atlas of Human Anatomy. Mud Puddle Books, Inc., New York, NY. Van Norman, R.A. (1999).  Helping the Thumb-Sucking Child.  Avery Publishing Group, Garden City Park, NY.

Van Norman, R. (1997). Digit sucking: a review of the literature, clinical observations and treatment recommendations. International Journal of Orofacial Myology. 23(1). 14-34

Warren JJ, Bishara SE, Steinbock KL, et al (2001). Effects of oral habits' duration on dental characteristics in the primary dentition. J Am Dent Assoc. Dec;132(12):1685-93; quiz 1726.

Weiss, TM, Atanasov, S &  Calhoun, KH, (2005), The association of tongue scalloping with obstructive sleep apnea and related sleep pathology, Otolaryngol Head Neck Surg. Dec;133(6):966-71, Department of Otolaryngology, Southern Illinois University, USA.