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Services We Provide

Wide-eyed girl sticking out her tongue

Orofacial Myofunctional Therapy

Orofacial myofunctional therapy is essentially physical therapy for the mouth, face, and airway.  The focus is on using exercises to strengthen the lip, tongue, and facial muscles, and restore functional breathing to help improve chewing, swallowing, speech, posture, and systemic functions.  In children, this treatment contributes to optimal growth and development of the head, jaw, and airway. 

I aim to build awareness and strength of the oral and facial muscles in order to meet these important goals:  1) Getting the tongue resting in its proper position, 2) Keeping the lips closed when the mouth is not in use, 3) Optimizing healthy chewing, and 4) Utilizing a proper initial-phase swallowing pattern.  When these tasks are accomplished habitually, troublesome symptoms are alleviated, and issues related to speech, jaw/TMJ problems, sleep apnea, orthodontics, digestion, etc. are more easily managed.

The ultimate treatment focus is on the airway because, above all, we need to breathe effectively in order to survive and thrive.  The tongue plays a major role in the airway, however it’s just one piece of the larger puzzle.  Some of the other factors considered in my assessment and treatment approach include:

  • Tonsils and adenoids
  • Mouth breathing vs. nasal breathing
  • Tongue and lip-ties
  • Orthodontic treatment
  • Diet/nutrition and digestion
  • Chewing and swallowing technique
  • Speech and articulation
  • Jaw pain and dysfunction
  • Head, neck, and facial pain
  • Facial structure
  • Posture
  • Oral habits
  • Sleep quantity and quality
  • Sleep disordered breathing

Nasal Breathing Re-Education

“How often should you breathe through your mouth?  As often as you eat through your nose!”  Though I can’t recall who said it, the first time I heard this, it made me chuckle.  Then it made me think.  While it sounded like a silly thing to say, it was also a bit sobering. 

I would guess that you’ve never eaten through your nose, but have you ever breathed through your mouth?  I know I have.  The caveat here is that while it is actually perfectly natural to breathe through your mouth at certain times, such as when lifting a heavy load, exercising intensely, or even temporarily when your nose is congested, breathing through the mouth most of the time can cause health problems.

Close-up of fingers pointing to nose
Mouth breathing starts when we can’t get enough air through the nose, so the mouth takes over.  Basically, there are times when we are forced to breathe through the mouth out of sheer necessity but this can become a detrimental life-long habit if not corrected.
 
Common Causes of Mouth Breathing:
  • Allergies
  • Asthma
  • Enlarged tonsils and/or adenoids
  • Chronic rhinitis or nasal congestion
  • Deviated septum
  • Nasal polyps
  • Respiratory infection
  • Stress
  • Food sensitivities
  • Diets heavy in inflammatory foods
  • Tongue positioning low in the mouth
  • Mirror neuron/learned behavior
  • Habit

Such factors make it physically difficult or even impossible for a person to regularly nasal breathe.  If nasal breathing is not possible, the body’s only choice is to revert to its innate back-up plan of mouth breathing.  

In order to change the habit of mouth breathing, the cause(s) need to be identified and addressed.  Additionally, it must be recognized that a body accustomed to mouth breathing simply doesn’t know how to breathe normally, as muscles of the face, mouth, and body have compensated and learned to work incorrectly over time.

Orofacial myofunctional therapy helps to retrain the mouth and facial muscles, which is necessary for effectively managing mouth breathing.  In conjunction with Buteyko Method breathing exercises, treatment at Mouth Matters Therapy further aims to gently restore functional nasal breathing,  improve respiratory muscle function, and optimize oxygen uptake.  Normalizing breathing in this way ensures the correct balance of respiratory chemistry.  Subsequently, when patients are effectively retrained to nasal breathe, dramatic changes to their health and quality of life can occur.

Some Benefits of Nasal Breathing:
  • Stimulates nasal nitric oxide production (helps fight infection, improve blood flow, increase lung volume)
  • Optimizes oxygen absorption
  • Maintains body temperature
  • Improves brain function
  • Reduces hypertension and stress
  • Improves sleep quality

How Does Mouth Breathing Affect The Body?

Mouth breathing, or an open-mouth posture, leads to a number of detrimental effects on the mouth and body:

Just as a tongue that is positioned in the bottom of the mouth contributes to mouth breathing, mouth breathing likewise changes where the tongue rests in the mouth and how it functions.

Your tongue should naturally rest in the top of your mouth.  However, when your mouth is open, the tongue rests in the bottom.  This leads to underdeveloped oral musculature and can cause problems with breathing, speech, chewing, and swallowing.  Additionally, when the tongue rests low in the mouth, it must push forward against the teeth in order to swallow, creating what is commonly referred to as a tongue thrust.

Believe it or not, breathing through your mouth can actually change your face’s shape and appearance.  This is due to alterations in the positioning and functioning of the tongue, mouth, and facial muscles.  

Symptoms of untreated mouth breathing include long, narrow faces and mouths, less defined cheekbones, small lower jaws, recessed chins, gummy smiles, and crooked or crowded teeth.  Such impacts on appearance are especially relevant for children because they are still growing. 

Mouth breathing can also affect the positioning of teeth, subsequently affecting their bite.  Lips typically provide external support for the teeth.  However, when the mouth is perpetually open, this external support is decreased because the lips become weakened.  The tongue simultaneously pushes forward, as aforementioned, progressively moving the teeth over time.

As you might imagine, this can cause problems with orthodontic treatment.  Specifically, time spent in braces will be longer, and there is a far greater likelihood that the results won’t be permanent.

Nasal breathing is linked with “diaphragmatic” or slow, deep breathing, which triggers our bodies’ rest and digest parasympathetic nervous system functioning (i.e., our relaxation response).  

On the other hand, mouth breathing involves “chest breathing,” which is a more rapid and shallow breathing pattern associated with our bodies’ fight or flight sympathetic nervous system functioning (i.e., our stress response).  When our bodies are chronically functioning in this fight or flight response pattern, it leads to systemic inflammation, which ultimately takes a toll on our physical, mental, and emotional health by contributing to illness and disease.

Quite basically, regularly using the mouth for breathing contributes to an imbalance of oxygen and carbon dioxide, as well as changes in hormones, blood sugar levels, etc. within our bodies.  Mouth breathing thereby disrupts many aspects of our bodies’ natural functioning.  Symptoms can include, but are not limited to:

  • Headaches
  • Dry mouth
  • Bad breath
  • Gingivitis and gum disease
  • Cavities
  • Sore throat
  • Cold symptoms such as mucous production and blocked nasal passages
  • Poor sleep and chronic fatigue
  • Anxiety and depression
  • ADD and ADHD symptoms
  • Impaired academic performance
  • Digestive disturbances such as gas, upset stomach, acid reflux, etc.
  • Heart problems
  • High blood pressure
  • Poor growth and development

Breathing through the mouth also alters body mechanics, leading to postural changes and spinal issues.  When the mouth is open and the tongue is positioned low and forward, the head tends to also rest forward, causing the shoulders and upper back to slump, and making it more difficult to sit or stand up straight.  In this way, mouth breathing further contributes to muscle imbalances from the neck down, leading to postural and mechanical issues throughout the body.

Credit, in part:  Sarah Hornsby, Founder of Faceology

Female practitioner assessing seated male patient's head and neck

Physical Therapy Interventions

“The thigh bone’s connected to the hip bone. The hip bone’s connected to the backbone…”  Most of us appreciate the fact that our bones are interconnected to comprise our skeletons.  However, it seems we often take for granted that the rest of our tissues are interconnected, as well.

The tongue is a muscular organ in the mouth.  But how amazing is it that the tongue is actually connected via fascia to multiple other points throughout the body, all the way down to the toes?  Fascia is a thin casing of connective tissue that surrounds, protects, and holds every organ, blood vessel, bone, nerve fiber, and muscle in place within our bodies.

Deep Front Line Fascia

Photo credit: Tom Myers,

Photo credit: Tom Myers, “Anatomy Trains”

While the mouth and tongue are reasonably considered as usual suspects in TMJ and swallowing disorders, they all too often are not considered as pertinent factors in issues that appear elsewhere in the body, and vice versa.  Yet orofacial myofunctional disorders frequently go hand in hand with such issues as those related to posture and alignment, gait and other biomechanics, and even pelvic floor function.  

Through the incorporation of traditional physical therapy interventions with orofacial myofunctional treatment, we can essentially address issues from multiple angles to optimally impact the whole body’s function.

Interdisciplinary Treatment

Although I wish it was possible, I know all too well that no one person can be an expert at everything.  That’s why I rely on a team approach to patient care.

Building strong relationships with trusted colleagues within various specialties allows me to focus on what I do best, and enables me to help my patients get the thorough care they need and deserve.

Four hands piecing together four puzzle pieces

Some of the professionals I collaborate with include therapists (e.g., physical, speech, occupational, vision, massage, etc.), orthodontists, dentists, chiropractors, ENTs, allergists, dieticians, sleep specialists, pediatricians, family physicians, functional medicine practitioners, counselors, and more.

With consent, I am happy to maintain open communication as appropriate with any practitioners involved in my patients’ care to ensure the best possible outcomes.

Close-up of teeth biting fingernails

Oral Habit Elimination

Habits such as finger or thumb-sucking are often used as forms of self-regulation for young children, while such things as nail biting or lip sucking are common outlets of anxiety for adults.

Although they might be effective in these ways, such habits unfortunately also contribute to altered mouth and facial muscle use, malalignment of teeth, and they force the tongue to be in a low-resting position in the mouth.  This ultimately adversely affects breathing and orofacial development, as well as such things as swallowing, speaking, and posture.  

With proper training, it is possible to eliminate these habits, develop more effective self-regulation skills, and improve the development and function of mouth and facial muscles for long-term health.  Oral habit elimination is an important first step of an effective overall orofacial myofunctional therapy program.

Supportive Services

  • At-Home Sleep Studies for children and adults
  • Mediator Release Testing (MRT)
  • Nutrigenomics Testing
  • Supplement and Nutrition support
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Services We Provide

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Cognitive Behavioral Health

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Cosmetic Concerns

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Dental/Oral Health

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Digestion/Eating Issues

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Ear/Nose/Throat Health

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Exercise/Activity Restrictions

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Musculoskeletal Issues

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Oral Habit Elimination

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Respiratory Health

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Sleep-related Issues