International Association of Orofacial Myology
Midwest Organization for the Study of Orofacial Myology and Advancement
Missouri Speech-Language-Hearing Association
American Academy of Private Practice in Speech Pathology and Audiology
American Dental Hygienists Association
Missouri Dental Hygienists Association
Greater St.Louis Dental Hygiene Association
Orofacial Myology (OFM) is the study and treatment of physical disorders of the face and mouth caused by the inappropriate use of muscles of the face, mouth, tongue, lips and jaws (most commonly seen in tongue thrusting and thumb or finger sucking). Cheek or nail biting and teeth clenching or grinding can also have negative effects on bite or jaw alignment.
Lips Apart Open Mouth|
Forward resting tongue posture
(hinders tooth development)
Long-term habits like those described above can open the bite beyond the normal resting position of the upper and lower teeth, affecting not only how the teeth align, but also how
speech is created and how the mouth and face look, resulting in Orofacial Myofunctional Disorders, or OMD. These disorders often manifest in mouth open, lips apart posture, forward resting posture of the tongue between and against the teeth, tongue thrusting during speaking and swallowing, and sleep-disordered breathing.|
If improper oral habits become ingrained, they may lead to misalignment of teeth (malocclusion) and changes affecting appearance, jaw growth and jaw position, hindering dental development of children and causing overeruption
of certain teeth in adults. They may also contribute as a precursor to sleep-disordered breathing.
What causes OMD?
OMD can result from a combination of factors:
• improper oral habits such as thumb/finger sucking, cheek or nail biting, teeth clenching and/or grinding
• restricted airway due to enlarged tonsils or adenoids, allergies and/or chronic nasal obstruction
• structural or physiological abnormalities such as a short lingual frenum (tongue-tie) or abnormally large tongue
• neurological or developmental abnormalities
• family history
The challenge is discovering all the factors that
may be involved in the disorder, making a multidisciplinary professional approach vital.
(restricted tongue movement)
Before OFM treatment
After OFM treatment
(before orthodontic braces)
What can be done to help?
The primary goal is to create, through training,
an oral environment in which the tongue and
other muscles function properly to minimize
impact on the teeth.
By eliminating sucking habits, tongue
thrusting, forward resting tongue postures, lips
apart posture and by opening a closed dental
rest posture, we can create or restore an oral
environment in which the normal processes of
dental development can occur, promoting long-term retention of dental or orthodontic correction. These same techniques have been shown to cure or significantly reduce the effects of sleep-disordered breathing in both children and adults.
When should therapy begin?
In certain cases, a child as young as 4 years can benefit from an evaluation to determine if any habits will need correction.
If the child has a sucking habit, the age of 5 is a good time to begin a program to eliminate the habit. Therapy to eliminate digit sucking requires that a child be able to cooperate, comprehend, remain on task, have a sense of pride and self-control, and be motivated to succeed. By keeping a positive attitude and remaining supportive, parents can contribute to their child’s success.
Wheeler & Associates provides a supplemental program that has proven very effective in the elimination of digit sucking for children who find it difficult to break the habit. For a description of this program, 1234 - I Declare a Thumb War , click here.
To be successful in the treatment of tongue thrust, a child must have the motor capabilities to perform the exercises needed for correction. By 7 to 8 years of age, most chidren undergoing therapy for tongue thrust have greater opportunities for success. Motivated adults of all ages can achieve success with therapy.
Is treatment effective?
Scientific studies reveal that treatment for OMD can be
80-90% effective in correcting swallowing and resting posture function. These corrections are retained years after successful completion of therapy.
Similar results are achieved in the use of myofunctional therapy for the treatment of sleep-disordered breathing. Studies have shown that the Apnea-Hypopnea Index (AHI) has been reduced by an average of 50% for adults and 62% for children. Similarly, Epworth Sleepiness Scores were reduced an average of 45% during a study involving 75 patients. Studies have also shown that the amount and intensity of snoring can be significantly reduced through the use of OFM.
(Camacho et al, Sleep Vol. 38, No. 5, 2015)
Who should provide treatment?
A collaborative, professional team approach
provides maximum benefit and assures that you receive the best care. Our team approach involves dentists, orthodontists, allergists, ENT physicians, sleep medicine physicians, cranio-facial specialists and physical therapists.
Treatment should be provided by a specially trained team of Speech Pathologists and Dental Hygienists certified in the practice of Orofacial Myology.
What we do
Before OFM and orthodontia
We apply proven therapeutic techniques and foster patient motivation to achieve lasting
functional and appearance results as well as higher self-esteem. Wheeler & Associates is unique in that we merge the disciplines of Speech Therapy and Dental Hygiene to achieve effective Orofacial Myofunctional Therapy. The results are lasting orthodontic treatment and dental stability, promoting a lifetime of good dental health.
After OFM and orthodontia
Who we are
Sara Lee Wheeler, MA, CCC/SLP, COM is a Speech Language Pathologist certified by the American Speech and Hearing Association (ASHA), certified by the International Association of Orofacial Myology (IAOM), and licensed by the state of Missouri. She is the owner of Wheeler & Associates Speech Pathology Services, a private, fully-certified practice specializing in Orofacial Myofunctional Therapy.
Sara Lee has been working with adults and children throughout metropolitan St. Louis for over 30 years. She is active in the International Association of Orofacial Myology (IAOM). She is also a member of the American Speech-Language-Hearing Association (ASHA), Missouri Speech-Language-Hearing Association (MSHA), and is currently Vice-President of the Midwest Organization for the Study of Orofacial Myology and Advancement (MOSOMA).
Sara Lee has specialized in treating orofacial myofunctional disorders (OMD) since 1993. She has presented to several dental practices, a sleep disorders study group, and has been a past speaker at the Missouri Academy of Pediatric Dentistry.
Renee Schwyhart, BS, RDH, COM has been a practicing dental hygienist in the St. Louis area for over 30 years. Renee is an active member of IAOM, MOSOMA, ADHA (American Dental Hygienists Association), MDHA (Missouri Dental Hygienists Association), and GSLDHA (Greater St. Louis Dental Hygienists Association). She is licensed by the Dental Board of the State of Missouri, certified by the International Association of Orofacial Myology (IAOM), and is a specialist in the treatment of OMD with Wheeler & Associates.
Sara Lee Wheeler
BS, RDH, COM(R)
Wheeler & Associates
815 Wildwood Circle Drive
St. Louis, Missouri 63126
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