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Tuesday, December 6, 2022

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CVOMT: The Tongue is “Your Face’s Braces”

Could orofacial myofunctional therapy help you with problems your child struggles with?

 

When she had her first child, Angela Richwine struggled with difficult nursing, mastitis, colic and her infant’s inability to eat or sleep normally. Over the course of her 28-year career as a registered dental hygienist, Richwine was introduced to the growing field of orofacial myofunctional therapy, or OMT.

OMT is a systematic, multidisciplinary approach to strengthening the muscles of the tongue and helping them to perform the functions many of us never think about, but which form the foundation of a healthy body. Goals include things like nasal breathing, a resting posture where the tongue is suctioned to the top of the mouth, lip seal and correct swallowing.

Richwine was astonished to learn that the struggles of her firstborn all those years ago could be tied to an orofacial myofunctional disorder. The International Association of Orofacial Myology (IAOM) estimates that such disorders affect 38 percent of the general population, and 81 percent of children who exhibit speech or articulation problems.

After taking specialized classes toward certification with IAOM, Richwine learned that her firstborn’s eating and sleeping problems in infanthood—and later sleep apnea, depression, behavior concerns, spinal problems and other symptoms—are linked to a tongue tie. A tongue tie is a condition when the tongue is literally tethered to the floor of the mouth by the frenum, or the thin piece of soft tissue that connects the tongue to the bottom of the mouth. The Children’s Hospital of Philadelphia has published research estimating that tongue tie affects nearly 5 percent of newborns.

But knowledge of the condition was limited when Richwine’s child was born. The lactation consultant she worked with told her that her son would grow out of it. Richwine’s memory of how frustrated and helpless she felt in her first months of motherhood is part of what motivated her to establish Central Virginia OMT to bring orofacial myofunctional therapy to the Fredericksburg region.

“I never want another mom to experience what I went through,” she says. “I want people to have this information.”

“Your face’s braces”

The tongue has eight muscles, and many people don’t realize what an important role it plays in the health of the entire body, Richwine says.

“Your tongue is your natural orthodontic appliance,” she says. The posture of the tongue at rest influences the formation of the palate, starting at birth. A properly functioning tongue is key to optimal health, growth and development that contributes to speaking, swallowing and breathing properly.

A Multidisciplinary Approach

OMT’s can be an important resource for parents whose children are having trouble with eating, sleeping, breathing or speech, but whose problems don’t seem to have a clear answer. Richwine’s process begins with a 90-minute comprehensive evaluation, where she takes photos, measures the palate, observes and records eating and swallowing techniques and asks a lot of questions.

“We want to find the root cause of the problem,” Richwine says.

After evaluation, patients may be referred to an ear nose and throat doctor, a speech language pathologist, orthodontist, body professional, dentist or oral surgeon, depending on what further treatment their individual problem may require.

But Richwine also works with patients on ongoing therapy that helps ensure some of those treatments will solve the problem.

For example, for a patient with a tongue tie, a dentist or oral surgeon may need to perform a frenectomy, where the tissue between the tongue and the floor of the mouth is cut or lasered to release the tethered oral tissue. Orofacial myofunctional therapy before and after this procedure can ensure that a patient is able to have full function of his or her tongue once it has more freedom of movement.

“Once you release it there is a whole newfound freedom. How are you going to speak? Where does the tongue rest? Let’s create functionality with the muscles and learn to function,” she said. Optimal wound healing is important for the least amount of scar tissue formation.

Therapy can also help children correct other orofacial myofunctional issues by building up the strength of the muscles in their tongue and face. For ages 5 and up, this includes exercises where children learn to make different sounds with the tongue that target specific muscles, exercises to promote breathing through the nose, blowing into balloons and through a straw to strengthen breathing techniques.

Therapy typically lasts 45 minutes once per week or once every two weeks.

Is OMT for My Child?

Richwine knows what it’s like to be a parent with a “gut feeling” that something is wrong. The symptoms of an orofacial myofunctional disorder are diverse and wide-ranging, and she offers a free 20-minute phone consultation to help determine if OMT could help a specific individual. Richwine works with individuals from birth through adulthood. While she does not take insurance, she does offer a super bill, a document that can be used to pursue reimbursement from your health insurer.

Some of the symptoms of an orofacial myofunctional disorder include:

Birth to age 4:

  • Mouth breathing
  • Colic
  • Spitting up
  • Inability to breastfeed or latch
  • Torticollis (a twisted or tilted neck)
  • Bleeding, cracked nipples or mastitis in breastfeeding mother
  • Overuse of pacifiers (Children should cease using pacifiers at 6 months to a year, and it should only be used in crib or bed and never during the day.)

Ages 5 and up

  • Open mouth breathing
  • Bed wetting, and waking several times in the night
  • Thumb sucking
  • Sleep apnea
  • ADD or ADHD induced by chronic lack of sleep
  • Snoring
  • Poor neck posture
  • Scalloped borders on the sides of the tongue because the palate is too small
  • Orthodontic relapse
  • Crowding of teeth
  • Open bite
  • Tongue tie
  • Tongue thrust

To learn more or to set up a call with Richwine, visit centralvirginiaomt.com.

Emily Freehling
Emily Freehling
Emily Freehling is an award-winning journalist who helps Fredericksburg Parent and Family's advertisers tell valuable stories through magazine advertorials and videos. Emily also produces content for a wide variety of other clients and outlets. Find her on LinkedIn and at emilyfreehling.com.

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