By Dr. Kristen Sander, DDS, MS — practicing orthodontics since 2016 | Read Dr. Sander's full bio
If you've come across the term "myofunctional therapy" while researching your child's bite, you may be wondering whether it's something they need alongside braces, or instead of them. The short answer: most children don't. Orofacial myofunctional therapy (OMT) is a program of exercises that retrains how the tongue, lips, and facial muscles rest and move, including tongue posture, lip seal, breathing patterns, and swallowing. It isn't orthodontic treatment, and it isn't something every patient needs.
At every orthodontic exam in my Andover office, I look at whether a child's tongue posture or swallowing pattern could work against their treatment goals. For a smaller group of patients, I recommend an evaluation with a trained myofunctional therapist alongside orthodontic care. I don't provide this therapy in my office. When an evaluation makes sense, I refer families from Andover and the greater Wichita area to an appropriately trained provider.
Below, I'll walk through what OMT is, the signs worth bringing up, and where it fits alongside orthodontic treatment.
This post is general educational information and isn't a substitute for an individualized evaluation. If you have concerns about your child's bite, breathing, or oral habits, the best next step is an exam.
What Is Orofacial Myofunctional Therapy?
OMT uses exercises and habit retraining to improve how the tongue rests, how the lips close, how a child breathes (through the nose, when that's physically possible), and how they swallow. It also works on coordination of the muscles of the mouth and face.
What it doesn't do is move teeth. That's the work of braces and clear aligners. OMT also isn't a routine part of orthodontic treatment.
Orthodontists have studied how oral muscles affect tooth position for more than a century, and views on OMT have shifted over that time. Today, it's generally seen as a reasonable add-on for select patients when a properly trained therapist provides it, not as a cure-all.
What Is a Tongue Thrust, and Why Does It Matter?
"Tongue thrust" generally describes a swallowing pattern where the tongue moves forward or between the teeth rather than staying in a more typical position. But swallowing is only part of the picture, resting tongue posture matters just as much, since teeth are exposed to light forces from the tongue, lips, and cheeks for many hours each day.
A tongue-forward posture or atypical swallow can sometimes appear alongside:
An anterior open bite
Spacing or flaring of the front teeth
Difficulty keeping the lips comfortably together at rest
A mouth open resting posture
Certain speech patterns
It's important to note that association isn't the same as causation. A tongue posture or swallowing pattern can sometimes be an adaptation to a child's anatomy, airway, enlarged tonsils or adenoids, oral habits, or other factors. In many cases, we can't say definitively that the tongue "caused" the bite.
How Would I Know If My Child Needs This?
I wouldn't encourage parents to self diagnose tongue thrust based on a single observation. In my Andover practice, signs I look for that might warrant a conversation include:
The tongue visibly coming between the front teeth during swallowing or at rest
An open bite where the front teeth don't overlap
A persistent mouth open posture
Difficulty comfortably closing the lips at rest
A bite that seems resistant to correction or tends to reopen
Certain persistent speech concerns
A history of prolonged oral habits, such as finger or thumb sucking or extended pacifier use
Having one of these signs doesn't automatically mean a child needs Myofunctional therapy — it's a reason to bring it up, not a diagnosis on its own.
When would an orthodontist refer my child to a myofunctional therapist?
I consider a referral case by case, never routinely. Usually it's because I see a persistent tongue posture or swallowing pattern that could interfere with correcting the bite or keeping it stable long term. Open bites are one situation where I pay especially close attention to how the tongue rests and moves. I may also suggest a referral when a habit continues after the dental problem itself has been corrected.
The goal isn't to add another item to every child's treatment plan. It's to find the smaller group of patients for whom treating both structure and function is worth the added time and cost. A beautifully aligned smile should also be one that lasts.
What if my child breathes through their mouth?
If a child seems to have difficulty breathing comfortably through the nose, the first question shouldn't simply be how to train them to keep their mouth closed. Mouth breathing can have multiple causes, including nasal obstruction or enlarged tonsils and adenoids. Myofunctional therapy shouldn't substitute for appropriate medical evaluation when an airway concern is suspected, depending on the findings, I may recommend evaluation by a child's pediatrician, ENT, allergist, or another appropriate provider. Therapy aimed at establishing a nasal-breathing pattern only makes sense once a child can physically breathe adequately through the nose. It's also worth noting that myofunctional therapy does not skeletally expand the palate the way an orthodontic palate expander does.
Does Myofunctional Therapy Replace Braces or Invisalign?
No. OMT and orthodontic treatment address different things. Braces, aligners, and other orthodontic appliances are designed to move teeth and, in growing patients, may guide or support dental and facial growth. Myofunctional therapy focuses on muscle patterns and oral function. In a patient who needs both, the two can complement one another but OMT shouldn't be presented as a way to straighten teeth, expand jaws, or correct a significant bite issue on its own.
Who provides myofunctional therapy?
Myofunctional therapy may be provided by professionals with additional training in orofacial myology, commonly speech language pathologists or dental hygienists, depending on their credentials and scope of practice. "Myofunctional therapist" can describe people from different professional backgrounds, so training matters. When I recommend it, I refer the patient rather than providing the therapy myself, and ideally the orthodontist and therapist stay in communication about what we're seeing and trying to accomplish.
Does Myofunctional Therapy Help With Speech Issues?
Myofunctional therapy isn't automatically the answer to a speech concern. Some tongue posture patterns coexist with speech articulation issues, and a speech language pathologist is the right professional to evaluate those. Some SLPs are trained in Myofunctional therapy and can serve a dual role, but not all are depending on the child, speech therapy, Myofunctional therapy, orthodontic treatment, or some combination may be the right path.
Frequently Asked Questions
Does Sander Orthodontic Arts provide myofunctional therapy in office? No. When an evaluation seems appropriate, Dr. Sander refers patients to a trained myofunctional therapist rather than providing the therapy directly.
Is myofunctional therapy a standard part of orthodontic treatment? No. It's considered case by case, usually when a persistent tongue posture or swallowing pattern seems likely to affect orthodontic correction or long-term stability. It isn't a routine addition to every treatment plan.
Can myofunctional therapy fix my child's bite on its own? No. It doesn't move teeth or widen the upper jaw the way orthodontic treatment does. It addresses muscle function and can complement orthodontic treatment for select patients, but it isn't a substitute for it.
What should I do if I notice signs of tongue thrust in my child? Mention it at your child's next orthodontic visit. Signs like an open bite, the tongue showing between the teeth when swallowing, or a mouth that often stays open are worth a conversation, not a reason to self-diagnose.
At what age should my child first see an orthodontist? The American Association of Orthodontists recommends a first orthodontic check-up no later than age 7. Many children won't need treatment yet, but an early visit lets us spot habits and bite patterns while there's still time to plan ahead.
How do I find a myofunctional therapist near Wichita or Andover? If Dr. Sander recommends an evaluation, our team will suggest an appropriately trained provider in the area. When you research therapists on your own, ask about their professional background and their specific training in orofacial myology.