Oral myology

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Oral myology (also known as "orofacial myology") is the field of study that involves the evaluation and treatment (known as "orofacial myofunctional therapy") of the oral and facial musculature, including the muscles of the tongue, lips, cheeks, and jaw.

Contents

Use

Orofacial myofunctional therapy [1] [2] treatment is most commonly used to retrain oral rest posture, swallowing patterns [3] in the oral phase, and speech. [4]

Tongue thrust and thumb sucking

A major focus of the field of oral myology and treatment of orofacial myofunctional disorders include tongue posture and establishing equilibrium between the tongue, lips and the cheek muscles. Tongue exercise proved to be successful in treating tongue thrust. [5] Tongue exercise alone was reported to be successful in cessation of thumb sucking and treatment of anterior open bite malocclusion. [5] When the tongue rests against the palate it begins to expand the maxilla by applying a slow and consistent force to the lingual (tongue side) surfaces of the teeth. This may aid in the treatment of crooked teeth and under-developed face.

Sleep apnea and snoring

Oral myology plays also an important role in the management of patients with sleep breathing disorders and snoring where oropharyngeal exercises were found to reduce the severity and primary symptoms of obstructive sleep apnea. [6] Poor positioning of the tongue affects breathing and allows a series of events to occur that can affect the orofacial complex. [7] Patients with sleep apnea and other breathing difficulties usually have decreased tone and mobility in the cheek, tongue, lip, and soft palate, and sensory alterations due to a tendency to engage in mouth breathing rather than nasal breathing. [8] In treatment of sleep apnea, oral myology therapy involves a series of exercises designed to improve tongue position and tongue function for a better control of the extrinsic tongue muscles and place the tongue in a ‘‘proper posture during function and at rest.’’ [9]

Dysphagia

Disruption of normal swallowing, referred to as dysphagia, has a variety of reasons, among which is tongue muscles weakness and fatigue. The tongue is a critical organ in swallowing, providing the driving forces that transport food and liquid through the mouth and pharynx. Fatigue in the tongue muscles may contribute to incomplete food clearance (residue), prolonged time to complete a meal and reduced intake. Tongue exercise to increase the muscle tone is therefore an important part of the oral myology therapy of dysphagia. [4] [ non-primary source needed ]

Speech disorders

Dentofacial and functional malocclusions can also affect normal speech. Non-physiologic function of the tongue has been considered an important aetiological factor of malocclusions. The tongue is an important organ contributing to deglutition, speech, growth and development of the jaws, and alignment of the teeth in occlusion. The effect of the tongue on growth of the jaws and development of the occlusion is a result of its pressure on the teeth and other areas during rest and function. The number of tongue movements and the contact point of the tongue with the palate are different in the pronunciation of consonants and words. These can be affected by tongue malfunction such as tongue thrust. Accordingly, treatment of tongue thrust is essential for treatment of speech disorders, and oral myology therapy aiming at tongue muscles training is an important part of speech therapy. [3] [ non-primary source needed ]

Intra-oral adhesive pads in oral myology

The use of intra-oral adhesive pads as part of oral myology therapy is a new technique to induce and assist in tongue exercise. One study suggests the use of adhesive pads was efficient in treatment of anterior open bite malocclusion and thumb sucking in children. [5] [ non-primary source needed ]

Further reading

Related Research Articles

<span class="mw-page-title-main">Sleep apnea</span> Disorder involving pauses in breathing during sleep

Sleep apnea is a sleep-related breathing disorder in which repetitive pauses in breathing, periods of shallow breathing, or collapse of the upper airway during sleep results in poor ventilation and sleep disruption. Each pause in breathing can last for a few seconds to a few minutes and occurs many times a night. A choking or snorting sound may occur as breathing resumes. Common symptoms include daytime sleepiness, snoring, and non restorative sleep despite adequate sleep time. Because the disorder disrupts normal sleep, those affected may experience sleepiness or feel tired during the day. It is often a chronic condition.

<span class="mw-page-title-main">Bruxism</span> Disorder that involves involuntarily grinding or clenching of the teeth

Bruxism is excessive teeth grinding or jaw clenching. It is an oral parafunctional activity; i.e., it is unrelated to normal function such as eating or talking. Bruxism is a common behavior; reports of prevalence range from 8% to 31% in the general population. Several symptoms are commonly associated with bruxism, including aching jaw muscles, headaches, hypersensitive teeth, tooth wear, and damage to dental restorations. Symptoms may be minimal, without patient awareness of the condition. If nothing is done, after a while many teeth start wearing down until the whole tooth is gone.

<span class="mw-page-title-main">Snoring</span> Vibratory sound made while asleep

Snoring is the vibration of respiratory structures and the resulting sound due to obstructed air movement during breathing while sleeping. The sound may be soft or loud and unpleasant. Snoring during sleep may be a sign, or first alarm, of obstructive sleep apnea (OSA). Research suggests that snoring is one of the factors of sleep deprivation.

Upper airway resistance syndrome (UARS) is a sleep disorder characterized by the narrowing of the airway that can cause disruptions to sleep. The symptoms include unrefreshing sleep, fatigue, sleepiness, chronic insomnia, and difficulty concentrating. UARS can be diagnosed by polysomnograms capable of detecting Respiratory Effort-related Arousals. It can be treated with lifestyle changes, functional orthodontics, surgery, mandibular repositioning devices or CPAP therapy. UARS is considered a variant of sleep apnea, although some scientists and doctors believe it to be a distinct disorder.

<span class="mw-page-title-main">Mandibular advancement splint</span>

A mandibi splint or mandibi advancement splint is a prescription custom-made medical device worn in the mouth used to treat sleep-related breathing disorders including: obstructive sleep apnea (OSA), snoring, and TMJ disorders. These devices are also known as mandibular advancement devices, sleep apnea oral appliances, oral airway dilators, and sleep apnea mouth guards.

<span class="mw-page-title-main">Macroglossia</span> Medical condition

Macroglossia is the medical term for an unusually large tongue. Severe enlargement of the tongue can cause cosmetic and functional difficulties in speaking, eating, swallowing and sleeping. Macroglossia is uncommon, and usually occurs in children. There are many causes. Treatment depends upon the exact cause.

<span class="mw-page-title-main">Obstructive sleep apnea</span> Sleeping and breathing disorder

Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder and is characterized by recurrent episodes of complete or partial obstruction of the upper airway leading to reduced or absent breathing during sleep. These episodes are termed "apneas" with complete or near-complete cessation of breathing, or "hypopneas" when the reduction in breathing is partial. In either case, a fall in blood oxygen saturation, a disruption in sleep, or both, may result. A high frequency of apneas or hypopneas during sleep may interfere with the quality of sleep, which – in combination with disturbances in blood oxygenation – is thought to contribute to negative consequences to health and quality of life. The terms obstructive sleep apnea syndrome (OSAS) or obstructive sleep apnea–hypopnea syndrome (OSAHS) may be used to refer to OSA when it is associated with symptoms during the daytime.

<span class="mw-page-title-main">Malocclusion</span> Medical condition

In orthodontics, a malocclusion is a misalignment or incorrect relation between the teeth of the upper and lower dental arches when they approach each other as the jaws close. The English-language term dates from 1864; Edward Angle (1855–1930), the "father of modern orthodontics", popularised it. The word "malocclusion" derives from occlusion, and refers to the manner in which opposing teeth meet.

<span class="mw-page-title-main">Tongue thrust</span>

Tongue thrust is a pseudo-pathological name of what is either considered a normal adaptive lip seal mechanism, whereby normal nasal breathing or normal swallowing can occur, or seen as an oral myofunctional disorder a tongue muscle pattern that is perceived as clinically abnormal and in which the tongue protrudes anteriorly to seal otherwise incompetent lips.

<span class="mw-page-title-main">Ankyloglossia</span> Congenital disorder of tongue mobility

Ankyloglossia, also known as tongue-tie, is a congenital oral anomaly that may decrease the mobility of the tongue tip and is caused by an unusually short, thick lingual frenulum, a membrane connecting the underside of the tongue to the floor of the mouth. Ankyloglossia varies in degree of severity from mild cases characterized by mucous membrane bands to complete ankyloglossia whereby the tongue is tethered to the floor of the mouth.

Mouth breathing, medically known as chronic oral ventilation, is long-term breathing through the mouth. It often is caused by an obstruction to breathing through the nose, the innate breathing organ in the human body. However, by the early 20th century, the term "mouth-breather" had developed a pejorative slang meaning connoting a stupid person.

Hypopnea is overly shallow breathing or an abnormally low respiratory rate. Hypopnea is defined by some to be less severe than apnea, while other researchers have discovered hypopnea to have a "similar if not indistinguishable impact" on the negative outcomes of sleep breathing disorders. In sleep clinics, obstructive sleep apnea syndrome or obstructive sleep apnea–hypopnea syndrome is normally diagnosed based on the frequent presence of apneas and/or hypopneas rather than differentiating between the two phenomena. Hypopnea is typically defined by a decreased amount of air movement into the lungs and can cause oxygen levels in the blood to drop. It commonly is due to partial obstruction of the upper airway.

Orofacial myofunctional disorders (OMD) are muscle disorders of the face, mouth, lips, or jaw due to chronic mouth breathing.

Obligate nasal breathing describes a physiological instinct to breathe through the nose as opposed to breathing through the mouth.

A sleep-related breathing disorder is a sleep disorder in which abnormalities in breathing occur during sleep that may or may not be present while awake. According to the International Classification of Sleep Disorders, sleep-related breathing disorders are classified as follows:

Sleep surgery is a surgery performed to treat sleep disordered breathing. Sleep disordered breathing is a spectrum of disorders that includes snoring, upper airway resistance syndrome, and obstructive sleep apnea. These surgeries are performed by surgeons trained in otolaryngology, oral maxillofacial surgery, and craniofacial surgery.

Oral pressure therapy (OPT) is a treatment for obstructive sleep apnea (OSA) that uses negative pressure in the mouth to shift the soft palate and tongue forward. The negative pressure is created by a bedside console connected by a small tube to a mouthpiece worn inside the mouth during sleep. The device is successful in between a quarter and a third of people.

Open bite is a type of orthodontic malocclusion which has been estimated to occur in 0.6% of the people in the United States. This type of malocclusion has no vertical overlap or contact between the anterior incisors. The term "open bite" was coined by Carevelli in 1842 as a distinct classification of malocclusion. Different authors have described the open bite in a variety of ways. Some authors have suggested that open bite often arises when overbite is less than the usual amount. Additionally, others have contended that open bite is identified by end-on incisal relationships. Lastly, some researchers have stated that a lack of incisal contact must be present to diagnose an open bite.

Oral manifestations of systematic disease are signs and symptoms of disease occurring elsewhere in the body detected in the oral cavity and oral secretions. High blood sugar can be detected by sampling saliva. Saliva sampling may be a non-invasive way to detect changes in the gut microbiome and changes in systemic disease. Another example is tertiary syphilis, where changes to teeth can occur. Syphilis infection can be associated with longitudinal furrows of the tongue.

Tongue training is a technique used to encourage proper tongue motion. Tongue training is used to treat individuals suffering from Ankyloglossia and other tongue dysfunctions. It is important for individuals suffering from orofacial myological disorders. Tongue training is a method used to teach the correct accent of any language.

References

  1. ↑ Benkert KK (1997). "The effectiveness of orofacial myofunctional therapy in improving dental occlusion". Int J Orofacial Myology. 23: 35–46. doi:10.52010/ijom.1997.23.1.6. PMID   9487828.
  2. ↑ Hemmings K, Griffiths B, Hobkirk J, Scully C (August 2000). "ABC of oral health. Improving occlusion and orofacial aesthetics: tooth repair and replacement". BMJ. 321 (7258): 438–41. doi:10.1136/bmj.321.7258.438. PMC   1127801 . PMID   10938058.
  3. 1 2 Namasivayam, Ashwini M.; Steele, Catriona M.; Keller, Heather (October 2016). "The effect of tongue strength on meal consumption in long term care". Clinical Nutrition. 35 (5): 1078–1083. doi:10.1016/j.clnu.2015.08.001. hdl: 11375/27087 . PMID   26321499.
  4. 1 2 Eslamian, L.; Leilazpour, A. P. (25 September 2006). "Tongue to palate contact during speech in subjects with and without a tongue thrust". The European Journal of Orthodontics. 28 (5): 475–479. doi:10.1093/ejo/cjl020. PMID   17000716.
  5. 1 2 3 Huang, Boyen; Lejarraga, Carla; Franco, Christopher S.; Kang, Yunlong; Lee, Andrew; Abbott, John; Takahashi, Katsu; Bessho, Kazuhisa; Pumtang-on, Pongthorn (October 2015). "Influence of non-orthodontic intervention on digit sucking and consequent anterior open bite: a preliminary study". International Dental Journal. 65 (5): 235–241. doi: 10.1111/idj.12178 . PMC   9376527 . PMID   26235294.
  6. ↑ Guimarães, Kátia C.; Drager, Luciano F.; Genta, Pedro R.; Marcondes, Bianca F.; Lorenzi-Filho, Geraldo (15 May 2009). "Effects of Oropharyngeal Exercises on Patients with Moderate Obstructive Sleep Apnea Syndrome". American Journal of Respiratory and Critical Care Medicine. 179 (10): 962–966. doi:10.1164/rccm.200806-981OC. PMID   19234106. S2CID   36092658.
  7. ↑ Cooper, Abbey (March 2010). "Orofacial Myology and Myofunctional Therapy for Sleep Related Breathing Disorders". Sleep Medicine Clinics. 5 (1): 109–113. doi:10.1016/j.jsmc.2009.10.002.
  8. ↑ Camacho, M; Certal, V; Abdullatif, J; Zaghi, S; Ruoff, CM; Capasso, R; Kushida, CA (1 May 2015). "Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis". Sleep. 38 (5): 669–75. doi:10.5665/sleep.4652. PMC   4402674 . PMID   25348130.
  9. ↑ Takahashi, S; Kuribayashi, G; Ono, T; Ishiwata, Y; Kuroda, T (January 2005). "Modulation of masticatory muscle activity by tongue position". The Angle Orthodontist. 75 (1): 35–9. PMID   15747813.
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