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Orofacial Myology8 min read

What Is Orofacial Myology?

A practical introduction to orofacial myofunctional disorders, the muscles involved, and why clinicians across dentistry and speech-language pathology are adding this specialty to their practice.

By Emilia del Pino, M.S., CCC-SLP/COM®

Defining the field

Orofacial myology is the study and treatment of the muscles of the face, mouth, and throat — and the patterns those muscles create. When those patterns deviate from normal function, the result is an orofacial myofunctional disorder (OMD): a disruption in the resting posture or movement of the tongue, lips, jaw, or related structures.

The term was formalized in the 1970s, but the clinical observations behind it go back much further. Orthodontists noticed that certain malocclusions returned after treatment. Speech-language pathologists observed that some articulation errors were structural, not phonological. Dentists saw patterns of wear and skeletal change that no appliance alone could explain. Orofacial myology emerged as the connective tissue between these observations.

Today, the field is recognized by ASHA, AGD/PACE, and the International Association of Orofacial Myology (IAOM), and it is practiced by SLPs, registered dental hygienists, occupational therapists, and other licensed healthcare professionals.

What counts as an OMD?

Orofacial myofunctional disorders are not a single condition. They are a category of patterns, each with its own presentation and downstream effects. The most commonly identified include:

  • Tongue thrustThe tongue pushes forward against or between the teeth during swallowing, speech, or at rest. This is the most frequently treated OMD and is closely associated with open bite malocclusion.
  • Low tongue resting postureThe tongue rests on the floor of the mouth rather than against the palate. Over time, this can contribute to narrow arch development and airway compromise.
  • Mouth breathingHabitual oral breathing bypasses the nasal airway, altering craniofacial development, sleep quality, and oral health. It is both a cause and a consequence of other OMDs.
  • Lip incompetenceThe lips do not close at rest without muscular effort, often co-occurring with low tongue posture and mouth breathing.
  • Non-nutritive sucking habitsProlonged thumb, finger, or pacifier use beyond developmental norms can reshape the dental arches and alter tongue function.

These patterns rarely exist in isolation. A patient with a tongue thrust often also presents with low tongue posture and some degree of mouth breathing. The myofunctional evaluation looks at the full picture, not individual symptoms.

Why OMDs matter clinically

Left unaddressed, orofacial myofunctional disorders can affect multiple body systems over time. The research literature has linked OMDs to:

  • Malocclusion and orthodontic relapse after treatment
  • Temporomandibular joint (TMJ) dysfunction
  • Sleep-disordered breathing, including pediatric and adult obstructive sleep apnea
  • Articulation disorders, particularly interdental and lateral lisps
  • Feeding and swallowing difficulties in pediatric populations
  • Craniofacial growth alterations in children

The connection to sleep medicine has been particularly significant for the field's growth. As awareness of pediatric sleep-disordered breathing has increased, clinicians in ENT, pulmonology, and sleep medicine have begun referring patients for myofunctional therapy as a component of comprehensive airway management.

For orthodontists, the relationship is equally direct: myofunctional therapy before and after orthodontic treatment improves stability of results. A tongue that continues to push forward against the teeth will undo alignment over time, regardless of how well the case was treated mechanically.

Who treats orofacial myofunctional disorders?

Orofacial myology is a specialty, not a standalone profession. Clinicians who practice it come from a range of licensed backgrounds and add myofunctional assessment and therapy to their existing scope of practice.

The most common professional backgrounds include:

  • Speech-Language Pathologists (SLPs) — who address the speech, feeding, and swallowing dimensions of OMDs
  • Registered Dental Hygienists (RDHs) — who identify OMDs during oral health assessments and provide therapy within their scope
  • Occupational Therapists (OTs) — particularly in pediatric feeding and sensory contexts
  • Physical Therapists (PTs) — especially in craniofacial and TMJ rehabilitation
  • Dentists and orthodontists — who may refer, co-treat, or in some cases provide therapy directly

The COM® credential — Certified Orofacial Myologist — is the recognized professional designation in the field, administered by the IAOM. It requires completion of an approved course, clinical hours, and a written examination.

Importantly, orofacial myology is not a self-contained practice. Effective treatment almost always involves collaboration: the myofunctional therapist works alongside the orthodontist, the ENT, the sleep physician, or the pediatric dentist. The muscle patterns are one piece of a larger clinical picture.

What does myofunctional therapy look like?

Myofunctional therapy is exercise-based. The goal is to establish correct resting posture of the tongue, lips, and jaw, and to normalize the swallowing pattern. Sessions typically involve:

  • Targeted exercises to strengthen and retrain the tongue, lips, and facial muscles
  • Nasal breathing retraining, often in coordination with ENT or allergy management
  • Swallowing pattern correction — moving from a tongue-forward to a palate-contact pattern
  • Habit elimination for non-nutritive sucking behaviors
  • Home exercise programs that reinforce in-session work

Treatment length varies by patient age, severity, and compliance, but most programs run 6 to 12 months. Pediatric patients often progress more quickly than adults because their neuromuscular patterns are less established.

The evidence base for myofunctional therapy has grown substantially over the past decade. Systematic reviews have demonstrated efficacy for tongue thrust remediation, orthodontic stability, and as an adjunct to CPAP and surgical interventions for sleep-disordered breathing.

Continuing Education

Ready to add orofacial myology to your practice?

The POM introductory course provides 28 AGD/PACE CE hours and 2.8 ASHA CE Credits. October 23–26, 2026 in Tarrytown, NY. Enrollment is limited to 20 participants.