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HOW CAN ONE SUPPRESS HABITS, SUCH AS FINGER SUCKING AND PACIFIER OVERUSE?
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The first step is to understand how these habits began and why are they still occurring. The child must be understood and not ridiculed. Awareness is crucial to gain the cooperation of the child. Depending on the case, the Orofacial Myofunctional Therapy Specialist may indicate exercises for strengthening the orofacial muscles (especially the lips and tongue), and the balance of the stomatognathic functions (breathing, chewing and swallowing). An occupational therapist may also be indicated for consultation.
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WHY DO SOME YOUNG CHILDREN LOVE TO EAT VERY SOFT FOOD?
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The preference for soft foods may be related to the reduction of the strength of the muscles of mastication (chewing) and also because of enlarged tonsils. Some children prefer foods with such consistency, as they would not need to chew much or at all. Feeding early on with different consistencies may stimulate the strength of the orofacial muscles and enhance harmonious development of the face.
CAN CHEWING ON ONE SIDE ONLY BE HARMFUL?
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Yes it is. By chewing only on one side, only the muscles of one side of the face are emphasized. This can cause a facial asymmetry over time. In addition, the bite can be altered and the temporomandibular joint (TMJ, the joint that connects the jaw to the skull and allows the mouth to open and close) on the opposite side of mastication, may suffer an overload.
WHAT CAN CAUSE AN OPEN BITE?
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An open bite corresponds to a problem of occlusion caused by multiple factors. Harmful habits (such as finger sucking or pacifier use) as well as the presence of functional disorders (such as mouth breathing and inadequate pressure for an optimal position of the tongue during swallowing and /or speech).
SHOULD OROFACIAL MYOFUNCTIONAL THERAPY OCCUR BEFORE OR AFTER ORTHODONTIC TREATMENT?
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WHAT IS TEMPOROMANDIBULAR JOINT DYSFUNCTION?
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WHAT CAUSES TMD?
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TMD may be related to various factors such as dental changes (loss or wear of the teeth, poorly fitting dentures), unilateral chewing, mouth breathing, lesions due to trauma or degeneration of the TMJ, muscle strains caused by psychological factors (stress and anxiety) and poor habits (nail biting, biting objects or food too hard, resting a hand on the chin, grinding or clenching teeth during sleep).
WHAT ARE THE MAIN SIGNS AND SYMPTOMS OF TMD?
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Pain may be present around the TMJ (it may radiate to the head and neck), along with earache, tinnitus, ear fullness, sounds when opening or closing the mouth (popping or other noises in the TMJ), pain or di!culties when opening the mouth, and pain when moving the jaw and the muscles involved in chewing.
WHAT ARE THE MAIN PROBLEMS RELATED TO OROFACIAL MYOFUNCTIONAL DISORDERS (OMDS)?
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The main problems related to OMDs are alterations in breathing, sucking, chewing, swallowing and speech, as well the position of the lips, tongue (including what is known as oral rest posture), and cheeks.
WHAT IS THE LINK BETWEEN FEEDING AND SPEECH?
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Feeding a child stimulates the orofacial muscles and this promotes the growth of the face. In the same way, proper suction and chewing prevents dental alterations and di!culties when structures such as the lips and tongue are moving. This is fundamental in the production of speech sounds.
WHAT ARE THE ADVANTAGES OF BREASTFEEDING?
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Besides all the nutritional and immunological benefits, the practice of breastfeeding stimulates the proper functioning of the structures of the mouth and face. Breast feeding strengthens the orofacial muscles of the infant, reducing risk of future problems in important functions such as breathing, chewing, swallowing and speaking.
HOW CAN FINGER SUCKING AND PACIFIER USE HARM A CHILD?
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Depending on the child’s facial features, the intensity, frequency and the duration of these oral habits may cause changes in facial growth, alteration of tooth position (anterior open bite), problems in the orofacial muscles, impairment of breathing functions, chewing, swallowing, and may also lead to slurred speech, such as an anterior lisp (placing the tongue between the teeth). The pacifier soothes the baby, because it satisfies the need to suck, but its use can be eliminated as soon as possible.
Orthodontic and Orofacial Myofunctional Therapy can be closely related with each directly impacting the other. Each case must be analyzed and discussed by the professionals involved. Treatment may be indicated before, during, and or after orthodontics. Orofacial Myofunctional Therapy specialists promote a balance of the muscle and orofacial functions, improving the oral rest posture of the tongue and thus the stability of these cases treated by orthodontists by helping diminish orthodontic relapse after the removal of braces.
The term temporomandibular dysfunction (TMD) is used to define some problems that can a"ect the temporomandibular joint (TMJ), as well as muscles and structures involved in chewing.
HOW IS OROFACIAL MYOFUNCTIONAL THERAPY CARRIED OUT FOR PATIENTS WITH TMD?
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Most cases of TMD should be treated by a team of allied health professionals such as an Orofacial Myofunctional Therapy Specialist, dentist, psychologist, physical therapist, neurologist and otolaryngologist. The Orofacial Myofunctional Therapy Specialist, after conducting a thorough assessment, working in an allied approach, may apply techniques to rebalance the muscles of the mouth, face and neck, and restore the functions of breathing, chewing, and swallowing. With this, there may be attenuation and/or elimination of the signs and symptoms of TMD. The patient should be made aware about any harmful oral habits and oriented to contribute to the evolution of its clinical case.
WHAT IS SNORING?
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Snoring is defined as partial obstruction of the upper airways causing noise and vibration produced by some muscles of the mouth and throat during sleep.
DOES SNORING CONTRIBUTE TO THE EMERGENCE OF OBSTRUCTIVE SLEEP APNEA?
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Yes, due to constant vibration, the muscles of the mouth and throat become larger, and may bring about changes in size, width and thickness. This may contribute to the appearance of total or partial obstruction of breathing during sleep.
WHAT IS OBSTRUCTIVE SLEEP APNEA?
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Obstructive Sleep Apnea Syndrome is defined as an obstruction of the airflow channel during sleep.
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HOW AND WHEN SHOULD TONGUE-TIE BE TREATED?
Mouth breathing refers to breathing performed predominantly by the mouth. In this way of breathing, the individual does not use, or uses very little, the nose to inhale and exhale the air.
The person may have one or more of the following characteristics: nasal congestion, open mouth at rest; parched lips, lip color change, appearance of a large tongue that may be recessed and projected forward; long face syndrome; forward head posture; dark circles under the eyes, sagging cheeks, wheezing, and snoring. In such cases it is recommended that an otolaryngologist (ENT) and/or allergist be consulted.
Yes, when breathing is done through the nose, the air is filtered (cleaned), warmed and humidified, and thus it reaches the lungs with less impurities that are in the air. When you breathe through your mouth the air does not go through this process and reaches the lungs full of impurities. The oral rest posture of the tongue and the mandible when mouth breathing may also alter mandibular posture, palate width, and other craniofacial growth patterns as well as posture of the head, neck, and upper body.
The most common causes of mouth breathing are: allergic rhinitis, sinusitis, bronchitis, enlarged adenoids; enlarged tonsils; weakness or low tone of facial muscles that may lead to open mouth rest posture, habits such as thumb sucking, tumors in the region of the nose, enlarged turbinates, and nose fractures, amongst others.
Keeping an open mouth posture can cause: dry and chapped lips, short and fast breathing; diminished strength of the muscles of the lips, cheeks, jaw and tongue; a lowered and more anterior oral rest posture of the tongue, leading to changes in aesthetics and position of teeth/occlusion (improper fit of the teeth); elongated face, retruded mandible, and palate (“roof of the mouth”) becoming more narrow and /or deep.
Mouth breathing leads to chewing food with lips apart, which becomes faster, noisier and less efficient than with lips closed. This can lead to greater digestive problems and potential for choking due to the poor coordination between breathing, chewing, and an increase in the swallowing of air. It’s hard to breathe through the mouth when the mouth is full, thus an individual will need to choose whether to chew or to breathe. In the process of swallowing, one may also notice changes such as: anterior projection of the tongue, noise, contraction of muscles that wrap around the mouth and movements of the head. There may also be excessive production of saliva and an anterior lisp: which is a distortion of speech characterized by placing the tongue between the front teeth during sound production of /s/ and /z/.
When sleeping with the mouth open, a person may have some of these characteristics: restless sleep, snoring, headaches, drooling on the pillow, thirst when waking up, morning sleepiness, sleep apnea (breathing interruptions during sleep), and decreased oxygen saturation in the blood.
Mouth breathers may have poor appetite, lower strength for chewing and swallowing di!culties. Thus they may prefer softer foods and the use of liquid to assist feeding. The feeding of mouth breathers may also be impaired because of decreased olfaction (smell) and taste (taste). As a result of changes in chewing, smell, and taste, the individual may have decreased appetite, gastric changes, constant thirst, gagging, pallor, anorexia, and weight loss with less physical improving or, conversely, obesity.
Sleep disturbances that have been previously explained can generate agitation, anxiety, impatience, decreased levels of alertness, impulsiveness and discouragement. All of these changes can cause difficulties with attention, concentration, memory problems, and subsequent learning difficulties in children. During the critical periods of a child’s development, mouth breathing can be more detrimental to learning.
Tongue-tie is a popular term used to characterize a common condition that often goes undetected. It occurs during pregnancy when a small portion of tissue that should disappear during the infant’s development remains at the bottom of the tongue, restricting its movement. When an infant is born with tongue-tie, it is important to research other family members, since this change has a genetic influence.
When the tongue cannot perform all the necessary movements and thus jeopardizes the way of sucking, swallowing, chewing or talking, a small surgery or frenotomy in the tongue is indicated. The “cut” of the frenum in infants is a simple procedure done with scissors, scalpel, or laser and anesthetic gel, which lasts about five minutes. In older children and adults the most common procedure is the frenectomy (partial removal of the lingual frenulum).
WHAT CAN HAPPEN WITH AN INFANT IF NOT TREATED?
Many people with tongue-tie suffer the consequences without knowing the cause. There are infants who have changes in the feeding cycle, causing stress for the infant and for the mother; there are also children with difficulties in chewing, children and adults with speech problems affecting communication, social relationships and professional development. With the chronic oral rest posture of the tongue in the floor of the mouth, many of the Orofacial Myofunctional Disorders (OMDs) enumerated above may result.
HOW COULD OROFACIAL MYOFUNCTIONAL THERAPY BE RELATED TO CASES OF SNORING?
WHAT IS MOUTH BREATHING?
CAN MOUTH BREATHING CAUSE DAMAGE?
HOW CAN ONE IDENTIFY A PERSON WHO BREATHES THROUGH THE MOUTH?
IS THERE A DIFFERENCE BETWEEN NASAL AND ORAL/MOUTH BREATHING?
WHAT CAN CAUSE MOUTH BREATHING?
HOW CAN MOUTH BREATHING CAUSE CHANGES TO THE STRUCTURE OF THE MOUTH AND THE FACE?
HOW CAN MOUTH BREATHING AFFECT FUNCTIONS RELATED TO THE MOUTH AND FACE?
WHAT ARE KEY ISSUES THAT MAY BE CAUSED BY MOUTH BREATHING DURING SLEEP?
WHAT ARE DISADVANTAGES THAT MOUTH BREATHING MAY CONTRIBUTE WITH REGARDS TO FEEDING AND BODY WEIGHT?
WHAT ARE THE MAIN DISADVANTAGES TO LEARNING CAUSED BY MOUTH BREATHING?
WHAT ARE THE MAIN DISADVANTAGES OF MOUTH BREATHING REGARDING BODY POSTURE?
WHAT IS TONGUE-TIE?
Whoever snores and presents Obstructive Sleep Apnea should be treated by a multidisciplinary team including a sleep specialist. In this team, the Orofacial Myofunctional Specialist may help by directing and performing specific exercises to strengthen the muscles of the mouth and throat and exercises that may help, if indicated, in improving oral rest posture.
Yes in several aspects, such as the mouth’s and face’s structures and their function, including sleep, feeding, learning, hearing and speech.
One major alteration is a change in the head’s postural position. The head will go forward seeking a larger space to breathe better, as often the tongue is resting in the floor of the mouth. We can also find other changes in the body caused by mouth breathing, as the abdominal muscles are weakened and stretched; dark circles with asymmetric positioning of the eyes, tired eyes, and shoulders that may come forward and compresses the abdomen.