Prevention of OMD’s

(Orofacial Myofunctional Disorders)

The key to minimizing orofacial myology problems is the prevention of improper oral rest posture, swallowing, chewing, and breathing and the promotion of healthy growth and development.  Parents of young children should focus on the following: feeding, oral habits, and breathing.

Feeding

 The nutritional and immune system benefits of breastfeeding are well known to the general population.  Many are unaware of the positive effects the muscular work of breastfeeding has on orofacial growth and development. 

Breastfeeding difficulties may be due to tethered oral tissues and should be evaluated by a professional trained specifically in assessment.  According to Dr. Richard Baxter, common signs of tongue or lip ties impacting breasting may present in both the mother and nursing infant. Mothers may experience any of the following: pain, poor latch, cracked/creased/flattened nipples, bleeding nipples, lipstick shaped nipples, poor breast drainage, plugged ducts, engorgement, mastitis, nipple thrush, need for a nipple shield, feeling like feeding the baby is a full time job (Baxter et al., 2018).  Babies may present with: blisters on upper lip, white coating on the tongue, poor weight gain, reflux, colic, hiccups, poor latch, falling asleep while feeding, gagging, gas, congestion, inability to use pacifier, frequent feedings (Baxter et al., 2018).

If a tongue or lip tie is suspected, the child may need to have a frenectomy done by an experienced provider to allow for successful breastfeeding.

When not feeding from the breast, baby bottles designed to mimic the flow of the breast are recommended.  Around 4-6 months babies can transition to an open cup instead of a bottle (Kellymom).     

Use of open cups or cups with straws is better for oral development than sippy cups (Meyer, 2008). While puree pouches are convenient, they promote an improper swallow and low rest posture of the tongue and should be avoided.       

As the child becomes ready for solids, parents should encourage eating foods that require chewing.  Chewing promotes development of the facial muscles and helps with growth of the upper and lower jaws (Kahn & Ehrlich, 2018).   Whole real foods provide needed nutrients for growing children. Processed food not only requires less muscular work to eat, but also makes the body more acidic leading to overbreathing and oral breathing (McKeown, 2015).

Habits

Minimize digit sucking and discontinue the use of pacifiers, baby bottles, and sippy cups by 12 months. Building self-soothing skills at 2-3 years old to transition away from thumbsucking and pacifier use is important (Meyer, 2008).  If these habits are prolonged not only can they alter the dental occlusion and shape of a child’s palate, but they can also have a long-term effect on tongue positioning.  These items force the tongue to be low in the mouth which increases the risk of oral breathing patterns and improper craniofacial growth.  Research shows that pacifier use can also stunt emotional development in boys due to the effect on the infant ability to mimic parent’s facial expressions (Niedenthal et al., 2012).  

Breathing

We are designed to breathe through our noses and not our mouths. Oral breathing provides poor oxygenation and impacts facial structure development (McKeown, 2015).  Nasal breathing humidifies air, filters air, and creates nitric oxide while oral breathing does not. Children should be encouraged to breathe through their noses. Parents should addressnasal congestion immediately.  A frequently stuffy nose can lead to breathing through the mouth and poor oral rest posture.   An oral breathing habit can be addressed with a collaborative approach utilizing an orofacial myofunctional therapist, otolaryngologist, and dentist.  

By closely monitoring breathing, addressing oral habits, and establishing good feeding practices parents can reduce the risk of their child developing an orofacial myofunctional disorder. 

Resources 

Baxter, R., Musso, M., Hughes, L., Lahey, L., Fabbie, P., Lovvorn, M., Emanuel, M., & Agarwal, R.  (2018). Tongue tied: how a tiny string under the tongue impacts nursing, feeding, speech, and more. Alabama Tongue-Tie Center.

https://kellymom.com/ages/newborn/newborn-concerns/alternative-feeding/

Kahn, S., & Ehrlich, P.R. (2018). Jaws: the story of a hidden epidemic. Stanford University Press.

Lin, S. (2018). The dental diet: the surprising link between your teeth, real food, and life-changing natural health. Hay House, Inc.

 McKeown, P. (2015). The oxygen advantage: the simple, scientifically proven breathingtechniques for a healthier, slimmer, faster, and fitter you. William Morrow.

 Meyer, P.G. (2008). Tongue lip and jaw differentiation and its relationship to orofacial myofunctional treatment. International Journal of Orofacial Myology. Volume 34.

Niedenthal, P.M., Augustinova, M., Rychlowska, D., Magdalena S., Zinner, L., Knafo , A. &       Brauer, M. (2012): Negative Relations Between Pacifier Use and Emotional Competence,      Basic and Applied Social Psychology, 34:5, 387-39