IAOM Certified Myologists

Orofacial
Myofunctional Therapy

You may have noticed something that doesn't seem quite right—your child breathes through their mouth, their tongue pushes forward when they swallow, or their speech sounds a little off despite years of effort. Our therapists are Qualified Orofacial Myologists through the International Association of Orofacial Myology (IAOM), and we specialize in figuring out exactly what's going on with the muscles of the face and mouth—and then retraining them so they work the way they should.

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Understanding OMT

What Is Orofacial
Myofunctional Therapy?

Think of it this way: the muscles of your face, mouth, and throat have habits, just like the rest of your body. Orofacial myofunctional therapy (OMT) works with those muscles when their habits have gone in the wrong direction—when the tongue rests in the wrong place, when swallowing relies on the wrong muscles, or when breathing defaults to the mouth instead of the nose. These patterns, called orofacial myofunctional disorders (OMDs), quietly affect how a person breathes, eats, speaks, and even how their face develops.

What surprises most parents is how common these issues actually are. Research suggests that up to 38% of the general population and as many as 81% of children with speech and language difficulties have some form of OMD. Left unaddressed, these patterns can contribute to crooked teeth, orthodontic relapse, speech errors that resist correction, jaw pain, disrupted sleep, and changes in facial growth.

At Speech Therapy Plus, our therapists hold the Qualified Orofacial Myologist credential through the IAOM—advanced training that goes well beyond standard speech-language pathology. We don't work in isolation, either. We coordinate closely with your child's dentist, orthodontist, ENT, or sleep specialist to make sure we're treating the full picture, not just one piece of it.

Treatment involves a structured series of exercises that retrain the tongue, lips, and facial muscles to do their jobs properly—at rest, during swallowing, and while speaking. We also work on breaking the habits that keep things stuck, like mouth breathing or thumb sucking. It takes consistency, but the changes hold because we're building real strength and new muscle memory.

38%
of the general population has an OMD
81%
of kids with speech difficulties
Therapist working with a child during an orofacial myofunctional therapy session

Common Causes of OMDs

  • Enlarged Tonsils & Adenoids — When the airway is partially blocked, kids naturally shift to mouth breathing, which over time changes how the tongue sits and how they swallow
  • Thumb Sucking & Pacifier Habits — Years of sucking pressure can reshape the palate and push the tongue into unnatural positions
  • Prolonged Bottle Feeding — Delays the shift from an infantile suck-swallow pattern to the mature swallowing that children need to develop
  • Tongue & Lip Ties — When the tissue under the tongue or lip is too tight, the tongue simply can't reach the positions it needs for proper rest, swallowing, and speech
  • Chronic Allergies & Nasal Congestion — A stuffy nose that never quite clears can make mouth breathing feel like the only option, and the habit sticks even after congestion improves
Comprehensive Care

Symptoms & Conditions We Treat

OMDs show up differently from person to person. Here are some of the most common issues we see and work with in our practice.

Tongue Thrust

When the tongue pushes forward against or between the teeth during swallowing—or just sits there at rest—it puts steady pressure on the teeth that can cause open bites and undo orthodontic work. It often shows up in speech too, especially with sounds like /s/, /z/, /sh/, and /ch/. We retrain the tongue to rest and swallow in the right position so the pattern doesn't keep coming back.

Open Mouth Posture

If your child's lips are always apart and they breathe through their mouth most of the time—awake or asleep—that's worth looking into. Chronic mouth breathing dries out the mouth, increases the risk of cavities, can change facial growth patterns, and disrupts sleep quality. We strengthen the lips and tongue so that a closed-mouth, nasal breathing posture becomes the new default.

Thumb & Finger Sucking

Most kids suck their thumb at some point, but when the habit persists past age 4 it can reshape the palate, shift teeth, and lock the tongue into poor posture. We use positive reinforcement and gentle accountability to help kids let go of the habit on their own terms, while also working on the myofunctional patterns underneath it.

Tongue Tie (Ankyloglossia)

A tongue tie is a tight or short band of tissue under the tongue that limits how far it can move. In babies it can make breastfeeding difficult; in older children and adults, it affects speech and swallowing. If a frenectomy (tongue tie release) is recommended, we work with your child both before and after the procedure—preparing the muscles for their new range of motion and making sure those gains stick.

Sleep-Disordered Breathing

There's a growing body of evidence connecting OMDs to obstructive sleep apnea and other sleep-disordered breathing problems. A weak tongue can fall back during sleep and partially block the airway. We strengthen the tongue and throat muscles and retrain resting posture to help keep that airway open at night. We coordinate with sleep medicine physicians when this is part of the picture.

Speech Articulation Errors

Sometimes a lisp or persistent speech distortion isn't just a speech issue—it's a muscle issue. When the tongue habitually rests or moves incorrectly, certain sounds come out wrong no matter how many times a child practices them. By fixing where the tongue sits and how it moves, we address the real reason behind these errors, which is why the improvements tend to last.

Our Process

Our Treatment Approach

Focus Areas

  • 1
    Where the tongue and lips rest when not in use
  • 2
    How the tongue and throat muscles work during swallowing
  • 3
    Shifting from mouth breathing to consistent nasal breathing
  • 4
    Clearing up speech sounds tied to muscle patterns
  • 5
    Breaking oral habits like thumb sucking and nail biting

Treatment Methods

  • Step-by-step exercises that build tongue, lip, and facial muscle strength
  • Habit change through positive reinforcement and accountability
  • Short daily home exercises to reinforce what we work on in sessions
  • Close coordination with your dentist, orthodontist, or physician
  • Guided therapy before and after tongue tie release procedures
Warning Signs

Signs Worth Paying Attention To

Mouth breathing during the day or while sleeping
Tongue visible between the teeth when swallowing or at rest
A lisp or speech sounds that aren't improving with practice
Snoring or noisy breathing during sleep
Teeth that shift back after braces or orthodontic treatment
Messy eating or difficulty chewing certain foods
Thumb or finger sucking past age 4
Jaw pain, clicking, or TMJ discomfort
Common Questions

Frequently Asked Questions

An OMD is essentially a pattern of muscle function in the face, mouth, or throat that has gone off track. The muscles might be too weak, or they've developed habits that interfere with everyday things like breathing, swallowing, chewing, and speaking. Some familiar examples: a tongue that pushes forward against the teeth during swallowing, a mouth that hangs open most of the time, or thumb sucking that's continued well past toddlerhood. Over time, these patterns can also affect jaw alignment and facial growth.
There's usually not one single cause. Enlarged tonsils or adenoids can push a child toward mouth breathing. Chronic allergies or congestion do the same thing. Prolonged thumb sucking or pacifier use reshapes the palate. Staying on a bottle too long delays the transition to mature swallowing. Tongue ties and lip ties physically limit what the tongue can do. And sometimes the jaw or palate structure itself plays a role. More often than not, it's a combination of several of these factors working together.
Most programs run about 6 to 12 months, though the exact timeline depends on the severity of the issue and how consistently the exercises are practiced at home. Sessions are typically weekly or every other week. The home practice part matters a lot—we're building new muscle habits, and that requires daily repetition. We track progress along the way and adjust the program as things improve.
Yes, and many do. OMDs are often spotted in childhood, but plenty of adults carry these patterns into their 30s, 40s, and beyond without knowing it. Adults come to us for chronic mouth breathing, TMJ pain, sleep apnea, tongue thrust, or because they're getting a tongue tie released and want to make the most of it. The muscles are still trainable at any age—it's genuinely never too late.
A tongue tie means the small band of tissue under the tongue is too short, tight, or thick, so the tongue can't move freely. That restriction makes it harder to maintain proper tongue posture, swallow correctly, or produce certain speech sounds—all of which feed into OMDs. When a frenectomy (the release procedure) is planned, myofunctional therapy beforehand prepares the muscles to actually use their new freedom, and therapy afterward helps retrain function so the old patterns don't just come right back.
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Ready to Take the Next Step?

Schedule a Myofunctional
Evaluation

If something on this page sounded familiar—whether it's your child or yourself you're thinking about—an evaluation is a good place to start. Our myologists will take a careful look at what's happening and put together a plan that makes sense for your situation.

Book an Evaluation Call (201) 509-8205