Orofacial Myofunctional Disorders (OMD) are disorders of the muscles and functions of the face and mouth. They may affect breastfeeding, facial growth and development, chewing, swallowing speech, occlusion, TMJ movement, oral hygiene, orthodontic treatment, facial esthetics, and more. Some dental problems related to an OMD include: mouth breathing, thumb sucking, tongue tie, reverse swallow pattern, low tongue posture, tongue thrust, malocclusion, open mouth posture or sleep disorder breathing.
MOUTH BREATHING
Mouth breathing is typically a result of a number of reasons including allergies—day to day in life.
Sings include:
- Long face syndrome
- Lip incompetence
- Tongue thrust swallow
- TMJ issues
- Chronic headaches
- Daytime fatigue
- allergic shiners
- orthodontic relapse
- digestive concerns
- clenching or grinding
- ADD/ADHD
- sleep breathing disorder
THUMB SUCKING
Thumb sucking is a habit that is unfavorable due to the thumb’s ability to cause low tongue posture. The pressure of the thumb can push the roof of the mouth up, causing it to narrow. It can also push the teeth out and apart and cause the teeth to have an open bite where they are unable to come together. Thumb sucking can also cause a reverse swallowing pattern.
TONGUE TIE
A tongue-tie (ankyloglossia) is a condition that restricts tongue movement due to an abnormally short and thick band of tissue under the tongue, called a frenum. Unfortunately, it is not always detected and can lead to problems with growth and development in children and manifest into adulthood.
Symptoms of an untreated Tongue-Tie
- abnormal craniofacial growth and development (elongated face with retracted jaw)
- Allergic shiners
- Lip incompetence
- Speech Concerns
- An increased need for orthodontia and orthodontic relapse
- A tongue thrust swallow pattern
- Acid reflux and digestive concerns
- TMJ issues, clenching or grinding
- Head, neck or shoulder tension
- Chronic headaches
- Chronic congestion
- Night sweats and terrors
- Prolonged bed wetting
- Excessive daytime fatigue
- Behavioral issues
- Mouth breathing or Sleep Disordered Breathing (SBD)
TONGUE THRUST
A tongue thrust (or improper swallow) is a condition that forces the tongue to push toward the front of the teeth during the swallow. This is considered “improper” because the tongue is naturally supposed to push against the roof of the mouth when swallowing.
A tongue thrust can either be a learned behavior or the result of a tongue-tie. If a learned behavior, it is developed from habits adopted as a child such as digit sucking or the use of a pacifier. A tongue-tie results in low tongue posture, thus forcing the tongue swallow improperly. Mouth breathing can also result from a tongue thrust; however, the opposite is also true, a tongue thrust can develop from mouth breathing.
When a thrust is present, the tongue is almost always not able to rest at the roof of the mouth the way it is naturally meant to. What results is a high, narrow palate with crowded front teeth and an open anterior bite. This can lead to speech or articulation issues, challenges with swallowing, airway concerns, and orthodontic needs.
MALOCCLUSION
Malocclusion also known as crooked and crooked teeth, include crossbite, overjet, overbite, spacing, crowding.
Malocclusion refers to situations in which the upper and lower teeth, or jaw are misaligned and come together in ways that can damage or destroy teeth. Variations in teeth and bone can be caused by environmental or behavioral factors such as masticatory muscles, nocturnal mouth breathing and cleft lip or cleft palate.
OPEN MOUTH POSTURE
Open mouth posture can have serious permanent consequences: it can affect the dental development and growth of children which can impact dental health and occlusion. Research shows opened-mouth posture can result in an increased length of the face known as “Long Face Syndrome”, droopy eyes with dark circles, short upper lip and retruded chin. Can contribute to Ortho relapse.
SLEEP DISORDER BREATHING
Sleep Disorder Breathing (SDB) is a general term used to describe breathing difficulties during sleep. A sleep disorder can affect your overall health, safety, and quality of life. Some of the signs and symptoms of sleep disorders include excessive daytime sleepiness, irregular breathing or increased movement during sleep. There are many different types of sleep disorders. They’re often grouped into categories that explain why they happen or how they affect you. They include: Insomnia, sleep apnea, restless leg syndrome, narcolepsy.
OBSTRUCTIVE SLEEP APNEA (OSA)
OBSTRUCTIVE SLEEP APNEA (OSA) is the most common sleep disorder breathing, characterized by recurrent episodes of complete or partial obstruction of the upper airway leading to reduced or absent breathing during sleep. Obstructive sleep apnea is seen in every age group but the frequency increases with age and obesity.
What are some of the signs of Sleep Apnea in children?
- Snoring
- Long pauses in breathing
- Restless sleep
- Mouth breathing
- Clenching or grinding teeth
- A diagnosis of ADHD
- Prolonged bedwetting
- Behavioral issues
- Sleep walking
- Night sweats or night terrors
What are some of the signs of Sleep Apnea in adults?
- Loud snoring
- Gasping for air during sleep
- Excessive daytime sleepiness
- Difficulty staying asleep
- Mouth breathing
- Clenching or grinding teeth
- Dry mouth or dry throat
- Irritability or mood swings
What are some of the risks of untreated Sleep Apnea?
Sleep apnea is the most common sleep disorder after insomnia. It impacts at least 18 million Americans, 40-80% of Americans are not even aware they have it.
- High blood pressure
- Heart disease
- Stroke
- Diabetes
- Alzheimer’s Disease
- Depression
- Weight gain
- Cancer
SNORING
Nearly 33% of people who snore experience sleep apnea. Snoring and sleep apnea restrict your breathing and the amount of oxygen your brain receives. Snoring is typically caused by a narrowing of the upper airway. Tissues in the back of your throat relax in your sleep and drop down, partially blocking the passageway.
DIGESTIVE ISSUES
Acid reflux is the 3rd most common GI disorder in the USA and is one of the leading causes of disturbed sleep among the American population 45-64. Dr. Steven Park, MD states: “Sleep apnea and acid reflux go hand in hand. An obstruction causes a vacuum effect in the throat, which suctions up your normal stomach juices you’re your throat, causing more inflammation and swelling, causing more obstruction. If you have large tonsils, it becomes even more enlarged, causing severe breathing problems at night. Not only to the mucous membranes of the throat become swollen, the tongue swells up as well, leaving impressions on the sides of your tongue due to pressing on the teeth.” People with Upper Airway Resistance Syndrome suffer from digestive issues including; irritable bowel, chronic diarrhea, constipation, indigestion, gas or bloating.
BEDWETTING
Bedwetting can be caused by sleep apnea. Since breathing during sleep can be difficult for those with sleep apnea, the brain works harder to take in oxygen that it does to control other bodily functions, like bladder control.
ADD/ADHD
Over the past two decades, U. S. parents and teachers have reported epidemic levels of children with trouble focusing, impulsive behavior and too much energy that they are bounding off the walls. ADHD is a national crisis and America has spent billions of dollars looking into its cause. The growing number of research is showing that many of kids today aren’t getting the sleep they need, leading to challenging behaviors that mimic ADHD. Growing evidence suggests that a segment of children with ADHD are misdiagnosed and actually suffer from insufficient sleep, insomnia, obstructed breathing or another known sleep disorder.
CLENCHING & GRINDING (Bruxism)
It is estimated that 40 million American grind their teeth and 5-10% of teeth grinders have symptoms severe enough to cause significant damage to their teeth. Bruxism is characterized by an unconscious act of grinding, gnashing, or clenching one’s teeth tightly together. Bruxism is often found in patients with sleep apnea. It is an unconscious response to the collapsed airways by tightening the jaw muscles to prevent restrictions of airflow. Sleep related movement disorders is the physical movement during sleep which may be uncontrollable or involuntary. Other disorders in this class include: periodic limb movement disorder (PLMD), restless leg syndrome (RLS), sleep related leg cramps, and sleep related rhythmic movement disorder.
HEADACHES
People with migraines are 2-8 times more likely to experience sleep disorders. Morning headaches due to sleep apnea will fade in the first few hours of the day, as normal breathing resumes. They may be described as an ache, rather than a sharp pain.