Defining Terms in Myofunctional Therapy

As a speech language pathologist, I am passionate about defining terms and using them appropriately. There are many medical, often complicated, terms used in the world of orofacial myofunctional disorder. I created this page as a resource for patients to decode and understand the terms often associated with Orofacial Myofunctional Therapy:

Orofacial Myofunctional Disorder (OMD), “Myofunctional Disorder” and “Tongue Thrust”: these terms are interchangeable and all refer to a disorder characterized by improper tongue, jaw and lip positioning during swallowing, feeding and speaking.

Orofacial Myofunctional Therapist and Orofacial Myologist: a health professional, most frequently a speech language pathologist, dentist, orthodontist or dental hygienist (in the US), who provides evaluative and therapeutic services to diagnose and treat an orofacial myofunctional disorder. These two titles are differentiated by the bodies through which therapists receive certification; the Academy of Orofacial Myofunctional Therapy (AOMT) and the International Association of Orofacial Myology (IAOM), respectively.

Orofacial Myofunctional Therapy and Orofacial Myology: both therapies provide “neuromuscular re-education” or “re-patterning” of the oral and facial muscles and include behavior modification, mouth, face and tongue exercises and strategies to facilitate proper feeding, swallowing and oral rest tongue posture throughout the day. Once again, these terms are differentiated by the bodies through which therapists receive certification; the Academy of Orofacial Myofunctional Therapy (AOMT) and the International Association of Orofacial Myology (IAOM), respectively.

Oral Rest Tongue Posture: the placement of the lips, oral muscles and tongue when an individual is not swallowing or speaking. Correct oral rest tongue posture includes sealed lips gently resting together, the teeth slightly apart or barely touching, the tip of the tongue on the alveolar ridge and posterior 2/3’s of the tongue resting against the hard palate.

Frenulum: a small fold or ridge of tissue; often refers to the connective tissue between the tongue and floor of the mouth or between the lips and gums.

“Tongue-tie”: medically termed “ankyloglossia,” it refers to the ridge of tissue between the tongue and floor of the mouth being too thick and/or stiff. Tongue-ties restrict the tongue from full range of motion and are often associated with breasting feeding problems, sometimes speech sound disorder and normal oral development. Recent research from Stanford Sleep Medicine has also shown noteworthy correlations between an untreated tongue-tie and obstructive sleep apnea, pediatric obstructive sleep apnea and sleep-disordered breathing.

“Lip-tie”: medically termed “lip adhesion,” it refers to the small ridge of tissue between the lips and gums being too thick and/or stiff and restricting the lips from typical closure and/or movement. Lip-ties can interfere with breastfeeding, oral and dental development and breathing behaviors (as patient with difficulty sealing their lips often mouth breath and/or over-recruit facial muscles to compensate)

“Buccal-tie” or “cheek-tie”: refers to abnormal mucosal adhesion stretching from the gums to the cheeks that can interfere with breastfeeding and normal oral development.

Tethered Oral Tissues (TOTs): an overarching category that encompasses all restricted oral tissues, including tongue-ties, buccal-ties and lip-ties.

Frenectomy: refers to the cutting of frenula tissue, often to remediate tongue-ties, lip-ties and/or buccal-ties. Other terms include “tongue-tie release,” “lip-tie release” and/or “buccal-tie release.” This procedure is most often performed by a medical doctor, dentist and/or dental surgeon. The procedure can be performed with a laser or scalpel, depending on dentist or physician’s preference.

Obstructive Sleep Apnea (OSA): “a sleep-related disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. It occurs when the muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway.” (American Academy of Sleep Medicine)

Pediatric Obstructive Sleep Apnea (POSA): “a sleep disorder in which [the] child’s breathing is completely or partially blocked repeatedly during sleep. The condition is due to narrowing or blockage of the upper airway during sleep.” (Mayo Clinic)

Sleep-Disordered Breathing (SDB): “refers to a collapse at any level of the upper airway resulting in abnormal breathing patterns during sleep. SDB can reduce oxygenation of the brain, change in neural physiology and function and a lack of restorative sleep essential to optimal daytime functioning.” (Nicole Archambault, ASHA Leader, February 2018).