Myofunctional Therapy

If we accept that we are the result of the interaction between the genetic material and the environment, and one of the most important environmental factors for the teeth and jawbones are the more than 20 pairs of muscles that surround them, then I believe that orthodontics and dentistry should start with the muscles. In my experience in current practice they are most commonly ignored. In recent years I have turned my attention to this subject and have been happy to see improvements in treatment developments.

What can myofunctional therapy do?

 

What is myofunctional therapy?

In our area of ​​interest is a complex process that leads to dental and facial changes. It can be a simple re-education of muscle behavior or re-education associated with the application of a myofunctional device.

Unfortunately, it is often considered by doctors that a myofunctional device also does re-education. The myofunctional device only provides an environment in which re-education may or may not occur. Hence the inconsistent results obtained.

 

The present material is intended to be a guide focused on the myofunctional re-education component that can also be applied by the patient but ideally should be done under medical guidance.

When do we use muscles?

1. Swallowing
2. Chewing
3. Speech
4. Passive/Subconscious
   • In relaxation - What are my muscles doing when I look at 'social media'?
   • In stress/concentration

 

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Deglutition

Tongue has three parts that can move independently in the three different planes of space.

The Right Way to Swallow The tip of the tongue is on the palate, on the gum, just above the upper teeth. Swallowing begins with lips in contact and teeth in contact. The tongue presses against the roof of the mouth, behind the upper teeth, with a very light touch of them. The middle part of the tongue touches the palate. The back of the tongue touches the palate. The lips do not move or tremble while swallowing.

Swallowing reeducation This process can take around 40 days. Re-education is like rowing upstream. If you stop, the water will take you downhill.

Step 1 - 3-7 days in a row read the text about the Correct Way to Swallow and try to identify what is happening to you. Duration 3-5 minutes. When it is very clear to you the difference between the Correct Way to Swallow and what is happening to you then write down the differences to give to the attending physician and then proceed to Step II Report to the physician the number of days used for this step.

Step II - 3-7 days in a row take a glass of water and swallow 5 small mouthfuls 3 times a day trying to swallow correctly. When you are able to swallow properly with ease then proceed to Step III  Report to the doctor the number of days used for this step.

Step III - 30 days in a row, at every meal, pay attention to every sip to swallow correctly. According to studies in the neuroscience of habits, it takes 24 days to automate a voluntarily initiated muscle behavior, regardless of age.

 

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Chewing

I believe that chewing does not require re-education per se, but will be re-educated automatically, in about 6 months, depending on the occlusal relationships obtained following dental and/or orthodontic treatments.

 

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Speech

It is very important to find a speech pathologist interested in investigating the execution of phonation as well, and not just how it actually sounds. A ventriloquist can speak in his own voice without moving his lips. From here we can deduce that although it 'sounds' well, this does not mean that it is 'executed' correctly.

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Passive

Passive in relaxation
- when you watch TV -

Correct Position in Relaxation Lips in contact Teeth slightly apart The tip of the tongue in slight contact with the palate immediately above the upper incisors Rest of the tongue in slight suction with the palat

Passive re-education in relaxation This process can take from 6 months to 2 years. Re-education is like rowing upstream. If you stop, the water will take you downhill.

Consciously apply Correct Relaxation Position for 10 seconds then relax for 5 seconds. Repeat 20 times 3-5 times a day. Whenever you remember during the day check the position of your teeth, lips and tongue. If they are not in the Correct Relaxation Position then put them there and continue what you were doing. After about 3 months you will start to surprise yourself in both the old position and the correct position. Note this duration and communicate it to the attending physician. After about 6 months you will start to surprise yourself only in the right position. Note this duration and communicate it to the attending physician. From here continue for another 3 months with the exercises.

 

Passive in stress or concentration

When stressed or concentrating, some people bite their nails or tap their feet.

In our area of ​​interest, patients may bite their lips or cheeks, suck their fingers, suck their tongue, push their tongue in various directions, clench or grind their teeth (bruxism), support their head in their palm or fist, or simply to hold their mouth crooked in various positions - here I leave the list open because some of our fellows can be downright surprising... 

If these behaviours exceed 10-15 minutes a day then they can have a significant impact on the teeth and facial bones.

Stop doing this! - easier said than done you will say and I agree...

This process is the most difficult to improve. The best advice I have today, in an attempt to shorten the process, is to associate that gesture with something that you don't like, and whenever you catch yourself doing the gesture, consciously associate that 'something' that you do not like. 

 

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About Exercises  - They are time-consuming in the first month until the limbic system learns and automates them. After 24-30 days of rehearsal, you basically just have to initiate them voluntarily and then they execute on their own (like walking or driving) and you can do something else while they execute.