How to Know if Your Child Needs Myofunctional Therapy: 7 Warning Signs Most Parents Miss
Have you ever watched your child sleep or play and noticed a tiny quirk? Maybe your child always sleeps with their mouth wide open, snores like a little freight train, or struggles with a lisp that speech therapy has not quite cleared up.
While it is easy to brush these habits off as harmless childhood phases, they are often your child's body telling you that their facial and oral muscles need a little extra support.
When the muscles in your child's lips, tongue, and cheeks are weak or uncoordinated, it affects far more than just their smile. It alters how your child breathes, eats, sleeps, and grows. Here is a deep dive into the most common signs that your child may need myofunctional therapy and why getting to the root cause matters so much.
Why Does My Child Sleep With Their Mouth Open?
Habitual mouth breathing and resting with the lips apart are two of the biggest red flags for orofacial dysfunction.
We are built for nasal breathing. Your child's nose acts as a natural air filter and humidifier, but it also produces nitric oxide, an essential molecule that helps their lungs absorb oxygen efficiently. When your child rests with their lips apart, their tongue automatically drops to the floor of their mouth so air can pass through.
At night, this low tongue position causes the tongue to fall backward into the throat, creating physical resistance in your child's airway. You might notice your child waking up with:
Dry, cracked lips or persistent morning thirst.
Dark under-eye circles (often called "allergic shiners" or venous pooling caused by poor nasal circulation)
Morning bad breath, inflamed gums, or frequent tooth decay near the gumline.
If your child rests with their mouth open while watching TV, reading, or sleeping, it is a sign that their facial muscles lack the tone needed to maintain a comfortable, effortless lip seal.
Is It Normal For My Child To Grind Their Teeth At Night?
Hearing your child grind or clench their teeth while they sleep can be deeply concerning.
Pediatric sleep bruxism (teeth grinding) is strongly linked to mouth breathing, nasal congestion, enlarged tonsils, and restricted tongue mobility.
When your child struggles to pull enough air through a restricted airway during sleep, their brain enters a mild "fight-or-flight" stress response. To keep your child from suffocating, their brain automatically signals their jaw to clench, grind, or push forward to forcefully reopen the airway.
This nighttime airway struggle is also directly tied to another puzzling symptom: bedwetting past three years of age.
When your child works extra hard to pull air into their lungs during sleep, the physical pressure changes inside their chest cause the heart to release a hormone called Atrial Natriuretic Peptide (ANP). ANP tells their kidneys to excrete water and sodium, increasing nighttime urine production. Combined with a deep sleep disruption that prevents the brain from recognizing a full bladder, your child simply can’t help wetting the bed.
Could My Child's ADHD Symptoms Be Related To Poor Sleep?
When adults suffer from poor sleep, they get sluggish and slow. When your child suffers from sleep-disordered breathing, their body often reacts in the exact opposite way: they become hyperactive, impulsive, or emotionally volatile during the day.
During Stage 3 deep sleep, your child's body releases its primary surge of growth hormone, which is critical for physical development and muscle recovery. When mouth breathing or airway resistance repeatedly pulls your child out of deep sleep, it can lead to:
Daytime Hyperactivity: Mood swings, aggression, or trouble sitting still in school.
Stunted Physical Growth: Reduced growth hormone release during disrupted sleep cycles.
Brain Structure Changes: Large clinical studies show that pediatric sleep-disordered breathing is associated with reduced gray matter volume in frontal brain regions responsible for impulse control, focus, and emotional regulation.
Many children diagnosed with ADD or ADHD are actually just chronically sleep-deprived due to an underlying airway or muscle issue.
How Can I Tell If My Child Has A Tongue Thrust Or Low Tongue Posture?
In a healthy mouth, your child's entire tongue should rest flat against the roof of their mouth (the palate) like a jigsaw puzzle piece, with the tip gently touching the ridge behind their front upper teeth.
When your child has low tongue posture, their tongue rests on the floor of the mouth or pushes against their front teeth. This almost always creates a tongue thrust swallowing pattern.
You can spot a tongue thrust by watching your child eat or drink. Instead of making a clean, backward wave with their tongue to swallow, your child will push their tongue forward against their teeth. To force the food down, your child will compensate by using their facial muscles:
Facial Grimace & Lip Pursing - Tightening or puckering the lips tightly when swallowing liquids or solids.
Active Mentalis Muscle - The chin muscle bunches up or looks like an "orange peel" during a swallow.
Noisy or Messy Eating - Smacking lips, loud chewing, or difficulty keeping food inside the mouth.
Food Pocketing & Texture Sensitivities - Stashing food in the cheeks or refusing foods that require heavy chewing.
Hyperactive Gag Reflex - Gagging easily on textures or struggling to swallow pills.
Why Does My Child Have Frequent Ear Infections Or Speech Lisps?
Did you know that your child's tongue plays a major role in keeping their ears healthy?
Every time your child swallows correctly with their tongue resting against the palate, it creates a gentle pumping motion that helps drain the Eustachian tubes (the canals connecting the middle ear to the back of the throat). If your child has a low tongue posture, a tongue-tie, or a tongue thrust swallow, those tubes cannot drain properly. Fluid accumulates in the middle ear, leading to chronic ear infections or the need for surgical ear tubes. Combine this with neurological stress that our pediatric chiropractors are trained to remove, and you have a recipe for chronic ear infections.
Poor oral muscle tone also makes clear speech production much harder. You might notice your child struggling with:
A frontal or lateral lisp when trying to pronounce S or Z sounds.
Slushy or muddled sounds on Ch, J, or SH.
Distortion on precision sounds like T, D, N, L, or R.
A general lack of speech clarity, frequent mumbling, or a flat, nasal voice tone.
Here Are Signs Your Child May Need Myofunctional Therapy
If you check off two or more items in this table, your child likely has underlying orofacial muscle dysfunction that myofunctional therapy can help address:
Daytime Posture - Open mouth rest posture, low tongue position, forward head posture, lips parting frequently.
Eating & Swallowing - Tongue thrusting, chin straining when swallowing, picky eating, food pocketing, loud chewing.
Sleep & Breathing - Snoring, teeth grinding, restless sleeping positions, bedwetting, waking up tired or cranky.
Speech & ENT - Lisping, mumbling, chronic ear infections, ear tubes, seasonal allergies, dark eye circles.
Dental Development - High narrow palate, crowded teeth, crossbite, open bite, or history of orthodontic relapse.
What Should I Do If I Notice These Symptoms In My Child?
The most encouraging news for parents is that your child's facial muscles and growing bones are remarkably adaptable! Myofunctional therapy provides targeted, fun exercises that retrain your child's brain and body to achieve Four Core Goals:
Breathing through the nose full-time, day and night.
Resting with lips sealed comfortably without facial strain.
Resting the whole tongue in the palate to naturally expand their growing smile and airway.
Swallowing smoothly without using extra facial muscles.
Combine in-office therapy sessions with brief 5-minute at home sessions practiced in front of a mirror, your child can rebuild healthy muscle tone, break harmful habits, and set the stage for a lifetime of proper breathing, restful sleep, and confident smiles.
If you suspect your child is struggling with any of these signs, reach out to our team today to schedule an evaluation!
