Orofacial Myology Newsletter - Mar 2026

Airway, Articulation, and Alignment: The Cross-Disciplinary Crisis No One is Talking About

Dental and speech professionals are facing a shared challenge that rarely gets named: airway, articulation, and alignment are deeply interconnected, yet our clinical systems treat them as separate issues. The result is a growing population of patients with undesirable oral‑motor patterns, orthodontic relapse, and undiagnosed airway dysfunction.

Airway is the foundation. When nasal breathing is compromised, the tongue drops, the palate narrows, and compensatory patterns emerge. These changes affect craniofacial growth, occlusion, and speech clarity—long before they show up as clinical problems.

Articulation becomes the early warning sign. SLPs often see the first red flags: low tongue posture, jaw instability, and difficulty achieving precise placement. These aren't just speech issues—they're functional indicators of a system under strain.

Alignment cannot hold without functional stability. Orthodontic relapses are frequently rooted in muscle patterns, not mechanics. Alignment simply cannot remain stable without correcting tongue posture, swallowing, and oral rest habits.

The real issue is the cross‑disciplinary disconnect. Each profession sees only part of the picture, and patients bounce between providers without a unified plan.

A Call to Action: Breaking the Silence

This crisis persists because our training programs remain siloed, and interdisciplinary collaboration is still the exception rather than the norm. But the opportunity is enormous. By embracing airway‑centered, function‑driven, collaborative care, we can achieve the following:

• • • Improve long‑term orthodontic stability
    • Enhance articulation outcomes
    • Reduce chronic oral habits
    • Support healthier craniofacial development
    • Identify airway issues earlier
    • Provide truly comprehensive care

The crisis is real—but so is the solution. It begins with awareness, continues with collaboration, and succeeds when we commit to treating the whole system, not just the visible symptoms.

Women, Airway, and OSA; What Orofacial Myologists Should Know

By Karen Wuertz, DDS QOM‑D

Obstructive Sleep Apnea (OSA) has historically been viewed as a condition that primarily affects men. Emerging research now confirms that symptoms and anatomical characteristics differ greatly between men and women. This helps explain why women are frequently under‑identified and underdiagnosed.

Women’s symptoms often overlap with stress, mental health concerns, or hormonal changes, leading to misdiagnosis. Men typically present with “classic” OSA symptoms, making them more likely to receive prompt evaluation.

Men vs Women in Obstructive Sleep Apnea

A Myofunctional Therapy Perspective.

Men – Classic OSA Phenotype

• • • Loud habitual snoring
    • Witnessed apneas
    • Excessive daytime sleepiness
    • Higher AHI severity
    • Greater airway collapsibility
    • Larger neck circumference

Women – Often Atypical OSA

• • • Fatigue rather than sleepiness
    • Insomnia symptoms
    • Mood disturbance/anxiety
    • Morning headaches
    • REM‑dominant OSA
    • Often underdiagnosed

Clinical Insights: Women frequently present with insomnia, fatigue, and REM-dominant OSA rather than classic sleepiness – important for dental and myofunctional screening.

For orofacial myologists, these differences highlight the importance of airway screening during evaluation. Common signs below may also contribute to compromised airway function and increased risk for sleep-disordered breathing. Identifying these patterns can support early referral and interdisciplinary care with sleep physicians, dentists, and other healthcare providers.

Screening Clues for Myologists

• • • Low tongue posture or scalloping
    • Narrow maxillary arch / high palatal vault
    • Mouth breathing / lip incompetence
    • Forward head posture
    • Fatigue, insomnia, morning headaches
    • History of snoring or bruxism

The consequence of underdiagnosed OSA in women can be signi‑cant. If left untreated, it increases the risk of hypertension, diabetes, cardiovascular disease, cognitive impairment and a reduced quality of life.

Improved awareness and recognition of these di­fferences is a crucial step towards women receiving a timely diagnosis and appropriate treatment.

A New Myo Grad’s Experience...

By Alivia Bauman, M.A., CCC‑SLP, QOM Candidate

Prior to completing the Orofacial Myology Course in November of 2025, colleagues and I discussed and debated, “What is missing?” from our treatment. Although we frequently saw success with our patients that came for a variety of disorders, all of us had at least one client, often several, who was not progressing. We had tried traditional approaches, and noted our clients seemed to have underlying deficits we could not pinpoint. Upon completion of the course, I have felt much more equipped to handle these cases, including patients with lisps, chronic mouth breathing, oral habits, and more. My coworkers and I began to network with local dentists to help spread awareness that this type of therapy is available, and how it can _ll the missing “gap”. After many phone calls, emails and in-person meetings, most of the responses were the same. They frequently saw these patients in their practice and were pleased to find this therapy was available. One dentist even discussed they had begun taking courses in the realm of orofacial myology, and their next step was finding

an orofacial myologist to refer to! Each dentist was relieved that we offered another option for habit elimination. They often commented they did not like to use habit appliances, and were unsure what to tell parents to help them with oral habits. Nearly all of the dentists responded that this therapy applied to their patients, addressed underlying causes, and answered the question, “What is missing?”

Tongue-Controlled Technology: Could Orofacial Myologists Play a Part?

By Zohara Nguyen, CCC‑SLP, CPSP, QOM

Imagine a future where your tongue tip, not your finger tip, is in control of your interaction with the digital world: it can make video calls, write essays, paint digital images, check the weather and even doom scroll. It seems likea concept for a sci-fi tv show, but the future of handsfree human-computer interaction is happening now. For years handsfree technology has been opening up a more inclusive world for people with a range of physical disabilities or challenges to interact with the digital world by using voice-command, head and eye tracking and chin or lip-controlled joysticks.

Tongue-Controlled Technology is the Future

Recent innovation of assistive technologies has integrated utilizing tongue-controlled interfaces that connect to smart phones or computers. These tongue-operated technologies, intraoral  joysticks or mouth-based touchpads, leverage the tongue’s dexterity and its general lack of fatigue (compared to eye tracking technology). Tongue-controlled interfaces are also desirable to users who want to use their handsfree personal devices discreetly without a hefty, conspicuous apparatus. As handsfree assistive technology is becoming more sophisticated, less cumbersome, easier to operate and much smaller. Users who have mobility issues due to significant spinal injury or limited/no use of their hands can gain increased independence and active participation in society using tongue-controlled technology. This is especially true when it connects to their phone or computer. The application of this technology can even be employed when the hands are temporarily occupied, such as when playing a musical instrument or when performing surgery and the user needs to interact with a screen.

An example of one such handsfree, tongue-controlled technology is the MouthPad^ (by Augmental), a customized, 3-D printed intraoral pressure-sensitive touchpad. It is encased in dental resin and worn as a palatal appliance that resembles a retainer. Precise tongue movements (across horizontal, vertical and lateral planes) control the cursor on this bluetooth connected device. To make a selection (or “click”), the user simply applies lingual pressure on the pad. To perform a “right-click”, it is activated with a sipping action. Users can do all the things that people usually do with a mouse pad or touchscreen for all their personal devices – it’s just operated by their tongue!

Orofacial Myologists as Tongue-Controlled Technology Consultants

Because the user is required to perform precise lingual and oral skills, tongue-controlled technology presents opportunities for Orofacial Myologists as consultants in this exciting and innovative space. Since Orofacial Myologists are intimately familiar with the mouth and understand the mechanics of lingual movements, they are well-equiped to offer a unique professional perspective. Their role could be integral to identify and address usability issues with the technology as a result of poor lingual-mandibular differentiation limited lingual range of motion, poor lingual control and shaping, reduced suctioning ability, and any structural barriers including ankyloglossia. Myo therapy would address the user’s oral control and coordination to improve their usability of the intraoral technology. Tongue-controlled technology is quickly becoming the future and will probably be widely used before we even expect – Orofacial Myologists better be ready when that time comes!

How is Your Rhythm?

by Becky Ellsworth, RDH, BS, QOM

Feeling tired? Run down? Anxious? Stressed out? If you are like a lot of people, this might sound familiar. Many things can be attributed to all of these conditions, but have you ever considered that your nose might be responsible... Or should I say the lack of your nose functions? In this busy world in which we live, one very simple thing could make a world of difference -nasal breathing 100% of the time.

Most people believe we breathe evenly out of both nostrils throughout the day, but that is not true. This process, controlled by the autonomic nervous system, is known as the nasal cycle. At any given time, one nostril is more open than the other, allowing for greater airflow. This occurs because of increased blood flow causing the inferior nasal turbinate on that side to swell. This shift continues to switch about every four hours which helps maintain ideal nasal function.

Though largely unnoticed (only about 80% of people are aware of this shift), research is finding a deep connection between the respiratory system, the brain and the nervous system! Current research suggests that the dominant nostril may be associated with activity in the opposite brain hemisphere. When the right nostril is dominant there is increased activity in the left hemisphere, which correlates to language skills, logical thinking and analytical thinking. When the left nostril is dominant, there is increased activity in the right hemisphere which correlates to creativity, spatial awareness and emotional processing.

The importance of nasal cycles is also of interest in displaying shifts in the autonomic nervous system. Right nasal dominance relates to activation of the sympathetic nervous system, which activates our “fight or flight” response. This relates to one’s alertness, increased heart rate and readiness for action. Left nasal dominance relates to the activation of the parasympathetic nervous system which correlates to relaxation, digestion and restorative processes. When the system is functioning properly, this helps maintain the body’s internal balance of action and rest. These findings indicate that the nasal cycle is a powerful reminder that our bodies operate on finely tuned rhythms—even when we’re not consciously aware of them. When this rhythm is disrupted, the delicate coordination between the brain, nervous system, and respiration can be affected.

So how does understanding this natural rhythm influence our work as Orofacial Myologists? When chronic nasal obstruction or mouth breathing interferes with the nasal cycle, the consequences can extend beyond breathing alone. Disruptions may contribute to delayed speech development, behavioral concerns, and other functional challenges. By paying attention to how they breathe, we gain insight into why our clients may feel tired, run down, anxious, or stressed out.