MYOFUNCTIONAL THERAPY Annette Hulse DO 9 18 2016

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MYOFUNCTIONAL THERAPY Annette Hulse, DO 9 -18 -2016 www. Santa. Cruz. Osteopathy. com/Slides

MYOFUNCTIONAL THERAPY Annette Hulse, DO 9 -18 -2016 www. Santa. Cruz. Osteopathy. com/Slides

Osteopathic Principles • Function and structure are reciprocally inter-related

Osteopathic Principles • Function and structure are reciprocally inter-related

Nose & nasopharynx: breathing

Nose & nasopharynx: breathing

Mouth & oropharynx: eating

Mouth & oropharynx: eating

Laryngopharynx: Speaking + coordinating

Laryngopharynx: Speaking + coordinating

Functions of the Face Mouth & Pharynx • Suck/Swallow • Breathe • Chew/Swallow •

Functions of the Face Mouth & Pharynx • Suck/Swallow • Breathe • Chew/Swallow • Speech

Infant (Visceral) Swallow • Jaws apart • Tongue between gum pads • Mandible stabilized

Infant (Visceral) Swallow • Jaws apart • Tongue between gum pads • Mandible stabilized by facial muscles (CN VII) & tongue • Vigorous lip/cheek contractions • Swallow guided/controlled lips and tongue

Mature Swallow • Teeth together • Mandible stabilized by muscles of mastication (CN V)

Mature Swallow • Teeth together • Mandible stabilized by muscles of mastication (CN V) • Tongue tip up on palate • NO lip contractions • Usually by 18 -24 months

How Do We Treat the Function?

How Do We Treat the Function?

Buteyko Breathing

Buteyko Breathing

Breathing • Wind instruments (e. g. Didgeridoo) • Singing (esp. choral)

Breathing • Wind instruments (e. g. Didgeridoo) • Singing (esp. choral)

Tongue

Tongue

Myofunctional Exercises • Tongue exercises include: • Move tongue along the superior and lateral

Myofunctional Exercises • Tongue exercises include: • Move tongue along the superior and lateral surfaces of teeth • Position the tongue tip up on hard palate (“the spot”) • Suck up entire tongue against palate (“caves”) • Force tongue onto floor of mouth

Facial Muscles

Facial Muscles

Myofunctional Exercises • Facial exercises • Lip (contraction and relaxation of the orbicularis oris)

Myofunctional Exercises • Facial exercises • Lip (contraction and relaxation of the orbicularis oris) • Buccinators (suction and expand) • Jaw muscles (lateral jaw movements)

Myofunctional Exercises • Stomatognathic functions (swallowing and chewing exercises) • swallowing with teeth together

Myofunctional Exercises • Stomatognathic functions (swallowing and chewing exercises) • swallowing with teeth together & tongue positioned in palate • alternating chewing sides

When Should You Refer?

When Should You Refer?

Tongue Tie

Tongue Tie

Mouth Breathing

Mouth Breathing

Sleep Apnea

Sleep Apnea

Systematic Review in 2015 • Myofunctional therapy decreases AHI by ~50% in adults and

Systematic Review in 2015 • Myofunctional therapy decreases AHI by ~50% in adults and 62% in children • Camacho M, Certal V, Abdullatif J, et al. Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis. Sleep. 2015; 38(5): 669 -675. doi: 10. 5665/sleep. 4652. • www. ncbi. nlm. nih. gov/pmc/articles/PMC 4402674/

Thumb/Finger Sucking

Thumb/Finger Sucking

Thumb/Finger Sucking

Thumb/Finger Sucking

Thumb/Finger Sucking

Thumb/Finger Sucking

Abnormal Tongue Postures

Abnormal Tongue Postures

How Do You Find a Myofunctional Therapist?

How Do You Find a Myofunctional Therapist?

Aomtinfo. org

Aomtinfo. org

Online Resources • www. youtube. com/watch? v=pd. Ds. MC v. DN 5 Q

Online Resources • www. youtube. com/watch? v=pd. Ds. MC v. DN 5 Q

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