Orofacial myofunctional therapy is a personalized program of exercises designed to improve the function of the tongue and surrounding muscles. Its goals include establishing proper oral resting posture, supporting nasal breathing, encouraging healthy palate growth, and improving sleep quality.

This therapy is used to treat orofacial myofunctional disorders (OMDs), which may contribute to issues such as snoring, sleep apnea, persistent fatigue, sinus problems, teeth grinding and TMJ discomfort, misaligned teeth, orthodontic relapse, tongue thrust, cavities, chewing or swallowing challenges, reduced facial muscle tone, postural strain, headaches, and more.

Breathing through the mouth can dry the oral tissues, increasing the risk of tooth decay and inflammation. It also bypasses the nose’s natural filtering system, making it easier for allergens, germs, and airborne particles to enter the body. In children, long-term mouth breathing may impact the normal development of facial structures and airway size.

The nose filters, warms, and humidifies incoming air while producing nitric oxide, a gas that helps optimize oxygen delivery throughout the body. Nose breathing tends to be slower and more regulated, which can support relaxation, cardiovascular health, focus, and overall energy. Proper tongue posture against the palate is also easier to maintain when breathing through the nose.

At rest—both during sleep and waking hours—the lips should be gently closed, breathing should occur through the nose, the tongue should rest lightly suctioned against the palate, and the teeth should remain slightly apart (a small “freeway space”). This posture may be difficult if nasal passages are blocked or if tongue strength or mobility is limited.

Correct tongue placement supports:

• Positioning the tongue forward and away from the throat

• Activation of the vagus nerve and its calming “rest and digest” response

• Maintenance of lip seal and nasal breathing

• Healthy jaw growth and adequate space for teeth, tongue, and airway development

SDB refers to a range of conditions that affect airflow during sleep. Snoring, for example, occurs when air passes through relaxed, partially collapsed airway tissues. More severe obstruction can lead to sleep apnea, where breathing temporarily stops. A sleep study is typically used to diagnose obstructive sleep apnea and measure how often these pauses occur.

A trained myofunctional therapist can evaluate for tongue or lip ties and determine their severity. Not all ties are obvious; some are located deeper (such as posterior ties) and may interfere with function rather than being visibly apparent. A thorough functional assessment is necessary to understand how tissue restrictions may affect movement and development.

Therapy may be used preventively or alongside orthodontic treatment. When oral muscles function properly, the tongue can help shape the palate while the lips and cheeks help maintain tooth alignment. Without addressing underlying dysfunction, orthodontic corrections may relapse over time, as soft tissues can exert pressure that shifts teeth back out of place.

If the airway becomes narrowed by the tongue during sleep, the body may activate muscles to reposition it. This can lead to clenching, jaw shifting (bruxism), and strain on the temporomandibular joint. Over time, this may result in pain, headaches, reduced function, and damage to the teeth.

Symptoms often associated with ADHD and similar conditions can overlap with signs of poor sleep. Since breathing and sleep quality significantly influence overall health, assessing airway and myofunctional factors may help identify underlying contributors before other treatments, such as medication, are pursued.

Education on airway-focused and myofunctional health is still emerging in many dental, hygiene, and speech training programs. It can take years for new scientific insights to become widely adopted in clinical practice, so some providers may lack training in screening for these concerns.

Several modern factors may contribute, including:

• Increased exposure to environmental pollutants and allergens

• Softer, processed diets that do not adequately stimulate jaw development

• Extended use of bottles, pacifiers, and sippy cups affecting oral muscle patterns

• Higher rates of oral tissue restrictions, such as tongue or lip ties

• Limited awareness among both the public and professionals

• A healthcare model that often prioritizes treatment over prevention

• Barriers to care, such as cost or access

• Inconsistent continuing education and interdisciplinary collaboration among providers