The IAOM defines OMDs as “behaviors & patterns created by inappropriate muscle function & incorrect habits involving the tongue, lips, jaw & face. Of the many possible myofunctional variations, those involving the tongue & lips receive the most attention. A tongue thrust is the most common orofacial myofunctional variation. During the act of swallowing, (deglutition), and/or during rest posture, an incorrect positioning of the tongue may contribute to improper orofacial development and maintenance of the misalignment of the teeth.”

• Thumb sucking/ finger sucking/ tongue sucking
• Tongue ties (ankyloglossia)
• Open mouth rest posture
• Weakness in lip muscles
• Forward rest posture of the tongue
• Breathing & upper airway difficulties (such as enlarged tonsils and adenoids or allergies)
• Difficulty with chewing & picky eating (trouble chewing, gathering & swallowing food)
• Malocclusions
• Speech sound disorders
• Orthodontic relapse

• Yes! Both can occur simultaneously, although it should be noted that not everyone with an articulation disorder will also have an orofacial myofunctional disorder.
• When there is an underlying OMD with a speech disorder, progress in speech therapy may be affected.
• When the tongue rests low in the oral cavity, producing the following sounds can become compromised: /t,d,n,l,s/
• Having low tone in the middle portion of the tongue creates a flaring in the lateral portions of the tongue, which can contribute to a lateral lips (or a “slushy” sound)
• Without therapy, it may be difficult to achieve the precision and mobility needed to have good articulation in conversations

• The American Dental Association (ADA) & the American Academy of Pediatrics (AAP) both state that after 6 years of age, chronic thumb/finger sucking should be addressed
• Complications that can occur as a result of thumb sucking include:
  • Possibly creating a dental malocclusion
  • The pressure of the thumb against the roof of the mouth can create a high/narrow palate
  • A forward tongue rest posture due to sucking habits that push the tongue down
  • Abnormal tongue patterns such as pushing out instead of up/back
  • May alter facial growth, which can alter respiratory & airway patterns

• Dentists: are concerned about preventing behaviors that can lead to concerns about the teeth. If an OMD can be identified and eliminated early, the teeth & jaws can grow in a normal process
• Orthodontists: work on how teeth fit together (in occlusion), while OMD’s occur when teeth are apart. If tongue and lips are in an abnormal posture, their function can lead to malocclusions & if not corrected, can contribute to orthodontic relapse following orthodontics
• Oral Surgeons: similar to orthodontists, oral surgeons may have concerns about OMD’s such as tongue ties. Following any surgical procedure in the mouth, the oral environment needs to remain stabilized and any postural and/or functional problems should be corrected
• Pediatricians: become concerned if a sucking habit persists past 6 years of age, as it affects the shape of the dental arches & the hard palate can be negatively affected
• Speech-Language Pathologists: become concerned if a child has an OMD in conjunction with a speech sound disorder. Transitioning and progressing speech sound production from sounds in isolation to sounds in connected speech may be compromised

• Normal oral rest posture includes lips together and a correct posture of the tongue. This is crucial to facilitate normal growth and development of the oro-facial structure. Normal growth/development can be affected by the following:
  • Thumb sucking/finger sucking/tongue sucking-these are habits that force the tongue to remain low and protrude forward during sucking
  • Open mouth rest posture-lips may stay open due to upper respiratory problems like enlarged tonsils, adenoids, or chronic allergies that disrupt normal nasal breathing
  • Tongue tie-will restrict elevation of the tongue, difficulties with range of motion and will often affect feeding, eating & production of clear speech sounds, & may impact occlusion

If your child is experiencing open mouth posture, prolonged thumb sucking habits, difficulty with chewing/picky eating, please reach out to Monarch Pediatric Speech Therapy for an evaluation.