Orofacial Myofunctional Techniques
Diana is an advanced practitioner trained in the discipline of orofacial myofunctional therapy and recognises the importance of strengthening the surrounding oral muscle structures and tissues, to support the tongue to regain its function post tongue-tie division (see 'About Me' for my career history!).
In infants, the tongue tie procedure (frenulotomy) is usually indicated when the lingual frenulum restricts the tongue's movement and compromises infant feeding. Correct posture and function of the tongue is crucial for milk transfer. Optimal tongue function requires the mobility of the full tongue to create a vaccuum which engages the nipple/teat to stimulate the sucking reflex to elicit the peristaltic action of the tongue through to a timely audible rhythmical swallow (not gulp!) and transfer of milk.
The styloglossus muscle of the tongue retracts and elevates the tongue. This muscle runs from the tongue tip to an area near the temporomandibular joint. A tongue tie makes movement of this muscle more difficult and therefore achieving a nice wide open gape in order to achieve efficient pain-free feeding is unable to be sustained or maintained and in some cases not at all. I frequently hear gestational parents recalling how when feeding their infant they latch with a wide gape, but then the infants mouth 'slips' to a shallow latch or unable to maintain it at all requiring frequent attempts at latching.
Orofacial Myofunctional Exercises are performed differently for infants, as babies are unable to do the exercises following a command.
Instead, babies respond to stimuli and reflex. So, in order to strengthen the muscles necessary for feeding, breathing and sleeping, suggested exercises for the adult caregiver to perform on the infant work well. These are gentle, and relaxing and can easily be incorporated into a busy lifestyle.
Feeding an infant stimulates the orofacial muscles and this promotes the growth of the face. In the same way, correct suction and chewing prevents dental alterations and difficulties when structures such as the lips and tongue are moving. An orofacial myofunctional practitioner is trained to, after conducting a thorough assessment, and 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. Neurological re-education exercises are prescribed to assist the normalisation of the developping or developped crainiofacial structures and function. The concern is not the appearance of the lingual frenulum (tongue tie), it is how the oral function is affected and the long term consequences of decreased oral function.
Orofacial myofunctional therapy has 3 distinct roles that help improve the success of the frenulotomy (tongue-tie) procedure:
1) Prior to a frenulotomy procedure, orofacial myofunctional therapy builds strength coordination awareness and behaviour modification through the application of neuro-muscular re-education. Diana will provide you with an exercise sheet and program to support you through the stages of neuro-muscular re-education.
2) Orofacial myofunctional therapy aids the healing process by engaging tongue function and movement by encouraging strength to the previously weakened areas of the mouth allowing it to work towards improved innate feeding abilities.
3) Rehabilitation of the oral structures to restore and improve correct oral function. Similar to physical therapy following a surgical procedure, orofacial myofunctional treatment fills the same role to help improve the success of a frenulotomy.
© DIANA WARREN IBCLC, RGN