What Are Orofacial Myofunctional Disorders (OMDs)?

Orofacial myofunctional disorders, or OMDs, are atypical muscle patterns that develop when the tongue, lips, and jaw do not rest or move the way they should. Orofacial myofunctional therapy corrects them with targeted, repeated exercises, much like physical therapy for the mouth and face. It works for children, teens and adults alike.

6 Most Common Orofacial Myofunctional Disorders

Orofacial Myofunctional Therapy (OMT) is a specialized service designed to help clients learn how to use and manage their oral structures, including the tongue, teeth, lips, and palate, in a healthy and functional manner. Discover the 6 most common conditions that can have significant impacts on various aspects of your health, including dentition, sleep, and breathing.

1. Tongue Tie (Ankyloglossia)

  • What it is: A band of tissue under the tongue that is too short or too tight, limiting how far the tongue can lift, extend or move side to side.

  • What you'll notice: Difficulty with breastfeeding in infancy, trouble licking an ice cream cone, a heart-shaped tongue tip when the child tries to stick it out, or speech sounds that stay unclear past the usual age.

  • Why it matters: A tongue that cannot reach the roof of the mouth cannot rest there, and resting posture shapes the palate as a child grows. Release surgery alone often is not enough. The muscles have to be retrained afterward or the old pattern returns.

2. Tongue Thrust

  • What it is: A swallowing pattern where the tongue pushes forward against or between the teeth instead of pressing up against the palate.

  • What you'll notice: An open bite that will not close, a lisp on s and z sounds, food or liquid escaping at the front of the mouth, or braces that keep needing adjustment.

  • Why it matters: A person swallows around 1,000 times a day. That is 1,000 daily pushes against the front teeth, which is why tongue thrust is one of the most common reasons orthodontic work relapses after the braces come off.

3. Mouth Breathing

  • What it is: Habitually breathing through the mouth rather than the nose, at rest and during sleep, once any airway obstruction has been ruled out or treated.

  • What you'll notice: Lips apart at rest, dry or chapped lips, snoring, restless sleep, waking up tired, chronic bad breath, or frequent throat and ear infections.

  • Why it matters: Nasal breathing filters and humidifies air and holds the tongue against the palate. Long-term mouth breathing is associated with changes in facial growth, dental crowding and disrupted sleep, and children who sleep badly are often described as inattentive rather than tired.

4. Low Resting Tongue Posture

  • What it is: The tongue sitting low in the mouth or against the lower teeth at rest, instead of gently suctioned to the roof of the mouth.

  • What you'll notice: It is the quietest of the six and usually spotted by a dentist or hygienist rather than a parent. Scalloped edges on the tongue and a narrow, high palate are common signs.

  • Why it matters: The tongue is the natural retainer for the upper arch. When it rests low, the palate narrows over years of growth, which is why resting posture is usually the first thing a myofunctional therapist works on.

5. Thumb, Finger and Pacifier Sucking

  • What it is: A sucking habit that continues past the age when it would normally fade, generally past age three or four.

  • What you'll notice: The habit itself, plus a callus on the thumb, an open bite, flared upper front teeth, or a child who reaches for the thumb specifically when tired or anxious.

  • Why it matters: Reminders, bitter polish and rewards mostly fail because the habit is soothing, not deliberate. A structured habit-elimination program replaces it rather than punishing it, and it usually works in a few weeks after years of trying.

  • 6. Enlarged Tonsils and Adenoids

  • What it is: Enlarged tissue at the back of the nose and throat that physically blocks nasal airflow, forcing the mouth open to breathe.

  • What you'll notice: Loud snoring, a nasal-sounding voice, difficulty breathing through the nose even when healthy, and pauses in breathing during sleep.

  • Why it matters: This one is not a muscle problem and myofunctional therapy will not fix it on its own. It needs an ENT. But once the airway is open, therapy is what teaches the mouth to stop breathing the old way, which is why the two so often go together.

The honesty in that last one is deliberate. Saying plainly that therapy will not fix a blocked airway is exactly what earns referrals from ENTs and dentists.

What These  Orofacial Myology Disorders Affect

Resolve Tongue Ties, Posture & Thrusts

These can manifest as enlarged adenoids or tonsils, poor resting tongue posture, and tongue thrust, necessitating the expertise of an orofacial myofunctional therapist (OMT).

Orthodontia & Dentition Challenges

Conditions like high palates, overlapping teeth, thumb sucking, and ongoing orthodontic work may be the result of these issues. They can often be effectively treated through a systematic series of training and exercises.

Challenges with Feeding & Related Habits

Problems related to feeding, sleep disruptions, and frequent illness can also be associated with orofacial myology disorders. OMTs play a key role in helping individuals establish new, healthier habits to counteract the effects of these conditions.

How Orofacial Myofunctional Disorders Are Treated

Treatment is a series of small, specific exercises practiced daily, usually for a few minutes at a time, with weekly sessions to check form and progress. The goal is always the same: get the tongue resting against the palate, restore nasal breathing, and correct the swallow. Most programs run several months, and how quickly it goes depends far more on the daily practice than on the number of appointments.

Beech Street Speech provides myofunctional therapy through licensed speech-language pathologists.

See how myofunctional therapy in Portland works, including insurance and scheduling.

Common Questions about Orofacial Myofunctional Disorders

  • Usually a combination: a restriction like a tongue tie, a blocked airway from enlarged tonsils or allergies, or a prolonged habit like thumb sucking. Once the mouth adapts around the problem, the pattern stays even after the original cause is gone.

  • Most therapy programs start around age four or five, when a child can follow and practice exercises independently. Earlier intervention is possible for feeding and tongue tie concerns, and adults respond well at any age.

  • Rarely. Muscle patterns are habits, and habits reinforce themselves thousands of times a day. Some children outgrow a thumb habit, but the dental and airway effects that built up in the meantime usually do not resolve without help.

  • A dentist, orthodontist, ENT, pediatrician or speech-language pathologist commonly spots the signs first. A comprehensive myofunctional evaluation by a trained therapist is what confirms it and identifies which patterns to target.

  • They overlap. Myofunctional therapy is a specialization, and it can be delivered by a speech-language pathologist with additional training or by a provider from another background. An SLP-delivered program is more likely to be billable through insurance and to address speech sound errors at the same time.

Have more questions about Orofacial Myofunctional Disorders?

Beech Street Speech is a speech & language clinic that helps patients with OMD make progress and meaningfully improve their child's speech and language development.

If you’re local, you can contact us for help answering your questions and guiding you every step of the way.

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Last updated: September 2026. Reviewed by Nikki Hinsley, M.S., CCC-SLP.