Orofacial Myofunctional Disorders: The Basics for SLPs

This text-based course is a written transcript of the course, "Orofacial Myofunctional Disorders: The Basics for SLPs", presented by Marsha Lee-White on March 7, 2011.

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This text is being provided in a rough draft format. Communication Access Realtime Translation is provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings.


>> Amy Hansen: Good afternoon, everyone. Welcome to today's expert seminar entitled, "Orofacial Myofunctional Disorders: The Basics for SLPs", presented today by Marsha Lee White. Marsha Lee White is a speech language pathologist at the Cincinnati Children's Medical Center providing services at the Mason neighborhood location. Marsha is a certified orofacial myologist through the International Association of Orofacial Myology and a certified member of ASHA. She has been providing clinical services to patients with orofacial myofunctional disorders and tongue thrust for approximately 20 years and has presented on this topic at the local and State level. So welcome, Marsha, and thank you for sharing your expertise for with us today.

>> Marsha: Thank you. I'm looking forward to it. Let's go ahead and jump into this.

Structure Development

I want to talk a bit about structure development just so that we're all on the same page. When we're looking at this type of a disorder, keep in mind that the tongue is adult size by the time the child is about 8 years of age. We still have some maxillary and also some mandibular growth but the maxilla is adult size by age 8 with some residual growth occurring around age 12. Once children go through puberty there is a little bit of growth until the age of 20.

Mandibular growth is about the same as the maxillary growth, although usually the mandible slows down by about 8 to 10 years of age. It slows down a little bit earlier than the maxilla but again growth continues up into the early 20s.

Tonsils and adenoids are of concern when we're looking at this type of a disorder. When we're looking at tonsils and adenoids, they are maximum size by the time children are somewhere between 9 and 12 years of age and after that point in time the tissue starts to atrophy. Usually by about the age of 20, for most people, we don't see tonsil tissues any longer. Sometimes we may see it but for the most part it is small enough that it is really not an issue.

Typical Occlusion - Class I

Below is an image of a typical occlusion.

Image 1. Typical Occlusion



So when we're looking at patients, we're looking at those beautiful smiles. This is what we would like to see. We would like to see the upper teeth covering the lower teeth by just a little bit, about one third of the tooth. We shouldn't see a lot of spaces in between the teeth either between two teeth that are side by side or top and bottom teeth. Any time we see extra spaces in teeth, that's a bit of a cause for concern and we try to figure out what else is going on there. But this is really what we would like to be seeing. Again, the below image is a normal occlusion - a beautiful smile that we would like to be seeing with these types of patients.