Orofacial Myology: My Journey

Whether you realize it or not, each tiny muscle, ligament, and bone within the face and oral cavity are connected to the rest of your body and affect your everyday health.

By Sara Holmes, M.S., CCC-SLP

What is Orofacial Myology?

“The study and treatment of oral and facial muscles as they relate to speech, dentition, chewing/bolus collection, swallowing, and overall mental and physical health.”

-Sandra Holtzman

 

To further break it down, think about the skeletal song we learned as kids, “Your head bone is connected from your neck bone, and your neck bone is connected from your shoulder bone…” and how these muscles relate. Whether you realize it or not, each tiny muscle, ligament, and bone within the face and oral cavity are connected to the rest of your body and affect your everyday health.

 

Even as a Speech-Language Pathologist, I did not fully understand how much our anatomy plays into our overall health until I underwent my own orofacial myofunctional treatment program as an adult.

Now that I have had my tongue tie revised, completed myofunctional therapy, and finished orthodontia, I have experienced so much pain relief and increased my overall health and well-being.

My Journey

As a child, I experienced several orofacial myofunctional disorders (OMD) that went undiagnosed and unexplained throughout my development. As a young child, I did not experience any known feeding or speech issues, so no one thoroughly assessed how my jaw, tongue, and teeth worked together.

 

I did, however, experience headaches, scoliosis, neck/shoulder/lower back pain, IBS, and allergies. I also was told by my dentist and orthodontist at the time that my mouth was too small for all of my teeth and that I would need to have permanent teeth before braces. Little did I know then that all of these ailments were in some way related to my OMD. 

 

After removing two permanent teeth, I received my first set of braces in my 8th-grade year. I wore braces for two years, and although my teeth became straighter and my bite was corrected, I later developed a popping/clicking sound when opening my mouth on the right side. The popping caused no pain at the time, so my dentist was not concerned about the TMJ dysfunction. 

 

Years later, after becoming a Speech and Language Pathologist (SLP), I noticed my bite slope upward on one side. I attributed this to getting older until I woke up one day with intense pain on the left side of my jaw joint. I also constantly experienced neck, shoulder, and lower back tension.

 

I went to a chiropractor, had my neck and back aligned, and my jaw massaged and moved back into place. While this provided temporary relief, it did not progress to permanent relief.

 

I then decided to contact an orthodontist in the area to determine the cause of my misalignment and pain. Dr. Mary Paula at Zaytoun Orthodontics and I then went on a journey of which I previously had limited knowledge.

 

After a couple of months in my second round of braces, Dr. Mary Paula determined that I had a tongue tie that had never been released. The tongue tie restriction was likely attributed to my TMJ pain, bite misalignment, and the need to have a second set of braces.

 

Next, I called Kayla Uhl, a speech therapist at our ACT Therapy Services Charlotte office. She is also trained in orofacial myofunctional therapy and provided me with exercises to improve the strength and coordination of my tongue and orofacial muscles.

 

While completing the exercises, I made an appointment with a local ENT to revise my tongue tie. Unfortunately, the ENT claimed I had a decent range of motion. Since I was not experiencing any speech or swallowing issues, he determined I did not need a revision completed.

 

Even after explaining the research and all of my ailments (TMJ pain, neck/shoulder/ low back tension, sleep difficulties, scoliosis, IBS, allergies, etc), his only recommendation was for me to use a nasal spray. 

 

Thankfully, ACT Therapy Services has a great list of release providers in Charlotte that take a more holistic approach and deem revisions necessary based on symptoms and measurements.

 

Before the release, I could not reach my back molars with my tongue; my tongue rested between my teeth, and I could not achieve maximum opening. In December of 2022, I finally completed my tongue tie revision at Queen’s Road Dentistry and immediately felt relief in my neck and shoulder tension.

 

Following the release, I completed phases 2 and 3 of myofunctional therapy, and my orthodontist pulled my palate forward and out to allow it to expand as much as it could with two permanent teeth missing.

 

Now that I have had my tongue tie revised, completed myofunctional therapy, and finished orthodontia, I have experienced so much pain relief and increased my overall health and well-being. My tongue can rest properly (at the roof of my mouth and behind my front teeth), and I can use a correct swallowing pattern that I did not realize was incorrect before myofunctional therapy.

 

Correcting my tongue posture at rest has allowed me to breathe better and reduce forward-head rest posture. My tongue tie had been causing my head muscles to tilt low and forward, changing my facial symmetry and structure. This is also related to my neck/shoulder and lower back tension.

 

My facial symmetry is corrected, and I have reduced headaches and jaw pain. The corrected tongue resting posture also helped me breathe through my nose better, which led to better sleep patterns.

 

The photos below are before (left) and after (right) pictures my orthodontist took. You can see several changes by comparing the two without knowing my background history. The following are my results from a tongue tie revision, orthodontia round 2, and myofunctional therapy:

Discussing Before and After

  • Facial symmetry- notice how my jaw was shifting to the side before
  • Reduced forward headrest posture- notice the straightening and extension in my neck
  • Corrected tongue resting posture- notice the skin under my chin in the second photo
  • Increased sleep/ reduced brain fog- notice the change in my eyes
  • Reduced headaches
  • Reduced neck, shoulder, and lower back pain
  • Reduced TMJ popping and pain
  • Increased nasal breathing to decrease allergy symptoms
  • Overall increased health and well-being

 

Are you currently experiencing chronic neck/shoulder/back tension or headaches? Do you constantly wake up feeling tired despite getting 8 hours of sleep? These could be signs of an orofacial myofunctional disorder (OMD).

 

I became trained in orofacial myology to give my clients answers earlier to increase their overall health as young as possible. 

 

While it was a long journey to determine the cause of my symptoms, I am thankful to have gained this knowledge to help better support my clients. 

 

Please reach out to me if you have any questions regarding my journey or if you suspect you are experiencing symptoms of an orofacial myofunctional disorder. The earlier the detection, the easier the habituation into everyday lifestyles.

Email: sholmes@acttherapyservices.com

Phone: 919-747-9022

Sara graduated with her bachelor’s degree in Communication Sciences and Disorders and her master’s degree in Speech- Language Pathology from Appalachian State University. Sara has been providing skilled intervention and services to children exhibiting a wide variety of diagnoses and severities within the Raleigh community. She has clinical experience with a variety of developmental disorders such as Cerebral Palsy, Autism Spectrum Disorder (ASD), Auditory Processing Disorder, Down Syndrome, Dysphasia, and Apraxia of Speech. Sara is specialized in orofacial myology, gestalt language processing, augmentative and alternative communication, speech sound disorders, and early intervention based services. Sara loves working with the pediatric population, and forming bonds with her client’s and their families to supplement their communication skills. Sara works with the team at ACT Therapy Services.

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