This study compared the progress made by school children in speech language therapy provided through videoconferencing and conventional face-to-face speech language therapy. The children were treated in two groups. In the first group, 17 children received telemedicine treatment for 4 months, and then subsequently conventional therapy for 4 months. In the second group, 17 children received conventional treatment for 4 months and then subsequently telemedicine treatment for 4 months. The outcome measures were student progress, participant satisfaction and any interruptions to service delivery. Student progress reports indicated that the children made similar progress during the study whichever treatment method was used. There was no significant difference in GFTA-2 scores (Goldman-Fristoe Test of Articulation) between students in the two treatment groups. Satisfaction surveys indicated that the students and parents overwhelmingly supported the telemedicine service delivery model. Videoconferencing appears to be a promising method of delivering speech language therapy services to school children.

Recent studies suggest that speech, solid feeding, and sleep difficulties may be linked to restricted tongue function. In this study thirty-seven patients participated in the study with ages ranging from 13 months to 12 years. Children with tongue restrictions and speech, feeding, and sleep issues underwent lingual frenectomies with a CO2 laser paired with oral motor or myofunctional exercises. This study is the first prospective study to report improvement in solid feeding after tongue-tie release, and the results demonstrate that children with dysphagia, difficulty managing a food bolus, and other feeding issues should be evaluated for tongue-ties which limit posterior tongue elevation and impair swallowing. Questionnaires were completed before, 1 week after, and 1 month following treatment. Overall, speech improved in 89%, solid feeding improved in 83%, and sleep improved in 83% of patients as reported by parents.

Chronic mouth breathing may adversely affect craniofacial development in children and may result in anatomical changes that directly impact the stability and collapsibility of the upper airway during sleep. Mouth breathing is a multifactorial problem that can be attributed to structural, functional, and neurological etiologies, which are not all mutually exclusive. While therapeutic interventions such as myofunctional and speech therapy may address the functional and behavioral factors that contribute to mouth breathing, progress may sometimes be limited by restrictive lingual and labial frenums that interfere with tongue and lip mobility. This paper presents a case study on a three-year-old girl with mouth breathing, snoring, noisy breathing, and oral phase dysphagia that was successfully treated with lingual and labial frenuloplasty as an adjunct to myofunctional therapy. Within four days of the procedure, the patient had stopped snoring and demonstrated complete resolution of open mouth breathing.

This study aimed to identify structural and functional craniofacial characteristics that correlate with high incidence of probable sleep bruxism in children. From March 2018 to March 2019, a cross-sectional clinical study was performed with ninety-six healthy children ages 6-12 years who presented for routine dental examination at the UCLA pediatric dental clinic. Variables of interest included: (1) assessment of probable bruxism based on parental awareness on the frequency of tooth grinding during sleep and clinical signs of bruxism based on tooth wear; (2) parental reports of mouth breathing while awake and asleep, snoring during sleep, difficulty breathing and/or gasping for air during sleep; (3) parental reports of psychosocial distress; (4) assessment of tonsil hypertrophy, tongue mobility, and nasal obstruction. The conclusion was that probable sleep bruxism was found to be significantly associated with impaired nasal breathing, habitual mouth breathing, restricted tongue mobility, and/or tonsillar hypertrophy. Restricted tongue mobility was found to be an independent risk factor for bruxism among individuals with normal nasal breathing. The study further shows that tonsillar hypertrophy, restricted tongue mobility, and nasal obstruction may have a synergistic association on the presentation of probable sleep bruxism.

Impact of treatment with lingual frenuloplasty and orofacial myofunctional therapy

This paper looked at twelve professional or recreational voice users that were diagnosed with ankyloglossia and were surveyed on their symptoms of muscle tension dysphonia (a condition affecting the feeling or quality of the voice due to increased muscle tension in and/or around the neck and larynx) before and after treatment with lingual frenuloplasty and pre- and post-operative orofacial myofunctional therapy. Eleven out of twelve patients (91.6%) reported clinical improvement in the use of their voice after functional frenuloplasty. Five primary themes were noted: improved vocal quality, improved ease of singing and/or speaking, increased stamina, increased pitch range and improved breath support. The findings of the study suggested a possible association between muscle tension dysphonia and restricted tongue mobility due to underlying myofascial tension.

Common indications for removal of maxillary frena in children (lip-tie) include difficulty performing oral hygiene, oral incompetence resulting in difficulty producing bilabial speech sounds (/b/, /p/, /m/), difficulty removing food from a spoon, habitual open mouth breathing, improving the cosmetic appearance of the smile line, lip fullness and diastema closure. In the mid 1900’s surgical procedures to correct lip ties fell out of favor and practitioners were counselled that if a diastema (horizontal space between teeth-typically the upper two front teeth) was present, it was best to wait until after orthodontic closure to release the tight maxillary frenum. This paper presents a cohort study where 192 consecutively treated pediatric patients underwent maxillary labial frenectomy in a private pediatric dentistry clinic from January 2015 to May 2018. The maxillary labial frenectomy was performed using a diode or CO2 laser. The conclusion was that with treatment of a diastema with proper technique and case selection there was a 94.5% closure in the diastema and in their sample did not leave scar tissue that impedes orthodontic closure. The authors concluded that maxillary frenectomy should be considered in patients with hypertrophic maxillary frenum causing symptoms of difficulty with oral hygiene, cosmetic concerns, bilabial speech sounds, or anterior caries without the worry of scar tissue formation.

This paper provided a review of literature evaluating myofunctional therapy as treatment for obstructive sleep apnea (OSA) in children and adults and to perform a meta-analysis on the polysomnographic, snoring, and sleepiness data. The searches were performed through June 18, 2014. The conclusion was that current literature demonstrates that myofunctional therapy decreases apnea-hypopnea index by approximately 50% in adults and 62% in children. Oxygen saturation, snoring, and sleepiness outcomes improve in adults. Myofunctional therapy could serve as an adjunct to other obstructive sleep apnea treatments.

This paper was a breakthrough with Dr. Soroush Zaghi, M.D. and Sandra Valcu-Pinkerton RDH-AP leading the way for providing standards for a functional frenuloplasty procedure as an effective way to surgically correct lingual, labial and buccal frenums. The method involved analyzing 348 completed surveys (ages 29 months to 79 years) of patients who were treated with myofunctional therapy and lingual frenuloplasty for indications of mouth breathing, snoring, dental clenching, and/or myofascial tension. All procedures were performed by a single surgeon using scissors and suture techniques. Safety and efficacy were assessed greater than 2 months postoperatively by means of patient-reported outcome measures. The surveys showed a 91% satisfaction rate and 87% rate of improvement in quality of life. Mouth breathing improved in 78.4 %, snoring improved in 72.9%, clenching improved in 91% and myofascial tension improved in 77.5%. Minor complications occurred in less than 5% of cases including complaints of prolonged pain or bleeding, temporary numbness of the tongue-tip, salivary gland issues, minor wound infection or inflammation and need for revision to excise scar tissue. There were no major complications. The conclusion was that lingual frenuloplasty with myofunctional therapy is safe and potentially effective for the treatment of mouth breathing, snoring, clenching, and myofascial tension in appropriately selected patients.

This article provides a thorough review on the evaluation and management of buccal-ties including diagnosis, classification, symptoms and treatment, by surveying healthcare providers with experience evaluating and managing oral restrictions. The article provides two separate appendixes on Examination and treatment protocol for infants and for children and adults for assessing the impact of restricted buccal, labial or lingual frena. It’s a helpful article to help understand what the universal protocol should be when assessing and treating restricted buccal, labial or lingual frena.

Fifteen adult patients with skeletal mandibular prognathism or openbite underwent surgical and orthodontic treatment, and then received myofunctional therapy.

The purpose of this paper is to share information about the digit-(thumb/finger) sucking behavior including how it begins; the biological psychological and physiological connections; how it becomes perpetuated; problems related to prolonged sucking activity; guidelines for referral; and considerations for appropriate patient selection to enhance successful therapy.

A specialist explains the hazards of continued digit (thumb/finger) sucking habits and offers advice on breaking the habit. The article explains that children who persist in sucking a thumb or finger beyond early childhood risk significant dental problems as well as learning, speech and emotional difficulties.

The authors summarize the current state of knowledge about the relationships between oral myofunctional therapy and articulation therapy. They conclude that considerable evidence has been obtained that indicates that oral myofunctional therapy techniques can improve articulation of sibilant sounds.

The purpose of this article was to evaluate cephalometric tracings regarding the impact that the cessation of thumb-sucking had on the developing dentition in two cases. Only orofacial myofunctional therapy principles were utilized to bring the thumb habit under control. In both case reports, it appeared that some of the abnormal growth tendencies were reversed by eliminating the active digit sucking habit.

This study presents convincing evidence that the incidence of tongue thrust does not decline through adolescence, but rather increases slightly.

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The purpose of this retrospective study was to determine if dental occlusion improved when patients received orofacial myofunctional therapy. The most significant findings of this study definitively established the beneficial effect of orofacial myofunctional therapy on improving dental occlusion, decreasing dental open bite and decreasing dental overjet.

A small study of the effect of tongue-thrust therapy on stability of overjet correction suggests a beneficial effect.

This study examined the effects of orofacial myofunctional therapy (OMT) on speech intelligibility in adults with persistent articulation impairments.

This professional article describes how OMTs