What Is Myofunctional Therapy and How Can It Help My Child?
Have you ever noticed your child sleeping with their mouth wide open, snoring softly, or struggling to swallow? Maybe their dentist mentioned they have a narrow palate, or their orthodontist warned that they might need braces or that their teeth might shift back after braces.
While these patterns might seem like simple childhood quirks, they are often signs that the muscles in your child’s face, mouth, and throat are not working together the way nature intended.
Myofunctional therapy is essentially physical therapy for the muscles of the face, mouth, and tongue. Just like a physical therapist helps rebuild strength and coordination after a knee injury, a myofunctional therapist teaches children simple exercises to rebuild healthy muscle tone, correct rest postures, and restore proper breathing.
What Are the Goals of Myofunctional Therapy?
Instead of focusing on a endless list of exercises, myofunctional therapy centers around Four Core Goals:
Exclusive Nasal Breathing: Breathing through their nose all day and all night.
Lip Seal at Rest: Keeping their lips resting gently together without strain when they are not talking or eating.
High Resting Tongue Posture: The entire tongue should be resting against the roof of the mouth, from the tip all the way to the back.
Correct Swallowing Pattern: Chewing thoroughly on their back teeth and swallowing smoothly without pushing their tongue against their teeth or straining their face.
When your child achieves these four goals, their muscles work in harmony to support normal facial growth, healthy airways, and stable dental alignment.
What Are the Signs My Child Needs Myofunctional Therapy?
Many children develop subtle patterns that mask oral muscle weaknesses. Here are common red flags that you can watch for at home:
Daytime Signs
Habitual mouth breathing or resting with the lips apart.
Low resting tongue posture (tongue sitting in the bottom of the mouth or pushing against the front teeth).
A "tongue thrust" swallow (you will see the facial muscles, lips, or chin strain when swallowing food or liquids).
Messy or loud eating, picky eating due to texture sensitivities, or a hyperactive gag reflex.
Speech articulation challenges, such as a lisp or difficulty pronouncing sounds like S, R, L, T, or D.
Nighttime Signs
Snoring, noisy breathing, or sleeping with an open mouth.
Restless sleep, tossing and turning, or sleeping in unusual positions with the neck extended.
Grinding or clenching teeth during sleep (pediatric sleep bruxism).
Dark under-eye circles, often called "allergic shiners" or venous pooling.
Frequent bedwetting past three years of age.
Why Does Mouth Breathing Change a Child's Face and Overall Health?
Human bodies are designed for nasal breathing. Their nose acts like an air filter and humidifier, but it also releases nitric oxide, a compound produced in the nasal passages that increases oxygen absorption efficiency in the lungs by up to 18 percent.
When your child habitually breathes through their mouth, their tongue drops to the floor of the mouth to clear the airway. The upper arch loses the constant internal support of the tongue, which acts as a natural palatal expander. Over time, this lack of support can lead to:
Narrow, Vaulted Palate - Dental crowding, crossbites, and a higher risk of orthodontic relapse.
Vertical Facial Growth - A long, narrow face shape ("adenoid face") with flatter cheekbones.
Set-Back Lower Jaw - A small chin appearance and a narrowed upper airway.
Forward Head Posture - The neck tilts forward subconsciously to force the airway open.
How Does Tongue Position Affect My Child's Sleep and Behavior?
When the tongue rests low in the mouth during the day, it is far more likely to fall backward into the throat at night. This causes physical resistance in their upper airway, forcing their body to work much harder to breathe while asleep.
This condition, known as Sleep-Disordered Breathing (SDB), fragments a child's sleep quality. During deep Stage 3 sleep, their body releases its primary pulse of growth hormone for physical repair and regeneration. When breathing disruptions constantly pull a child out of deep sleep, you might observe:
Daytime Hyperactivity: Unlike adults who get sluggish when we are tired, sleep-deprived children often become hyperactive, impulsive, or emotional. Many children diagnosed with ADHD are actually struggling with underlying sleep-disordered breathing.
Stunted Physical Growth: Disrupted deep sleep can blunt normal growth hormone release.
Cognitive Fatigue: Large population studies have linked pediatric sleep-disordered breathing with reduced gray matter volume in frontal brain regions responsible for impulse control and self-regulation.
Does My Child Need Tongue-Tie Surgery for Myofunctional Therapy to Work?
A tethered oral tissue, or tongue-tie (ankyloglossia), occurs when an abnormally restrictive fold of tissue under their tongue limits its natural range of motion. If their tongue is physically anchored to the floor of their mouth, your child simply can’t lift it to their palate, no matter how hard they try.
To determine if a tongue-tie is present, we evaluate five key pillars:
Visual Appearance: Heart-shaped tip notches, surface cupping, or a deep midline groove.
Function: Ability to lift, point, and suction the tongue flat against the palate.
Measurements: Objective testing using the Tongue Range of Motion Ratio (TRMR) to check anterior and posterior tongue mobility.
Compensations: Watching if the child lifts the floor of their mouth, strains their neck, or twists their jaw just to move their tongue.
Symptoms: Sleep disruptions, speech struggles, clenching, or swallowing issues.
Do All Tongue-Ties Require Surgery?
No. Mild restrictions can sometimes be successfully managed through therapy alone.
For kids who do need a surgical release, pre-operative and post-operative myofunctional therapy is essential. Performing therapy for 4 to 6 weeks before surgery builds tongue strength, removes compensation patterns, and teaches proper suction mechanics. Post-operative therapy guides wound healing, prevents restrictive scar tissue reattachment, and retrains the brain to use its new mobility.
What Does a Myofunctional Therapy Program Look Like?
A standard myofunctional therapy protocol is structured, supportive, and manageable for busy families:
12-15 Main Sessions: Spread out every week to two weeks over 7 to 9 months to give new neurological habits time to lock in.
5 Minutes, Twice a Day at home Exercises: Exercises are brief! Practicing short, active sessions twice daily in front of a mirror builds strong habits without causing compliance fatigue.
Focus on Technique Over Quantity: Doing two exercises correctly without compensating is far more effective than rushing through a giant folder of drills.
Nasal Hygiene Protocols: Therapy includes fun tools and techniques, like saline rinses, breathing exercises, and aromatherapy sticks, to clear nasal passages so breathing through the nose feels easy and natural.
Ready to Explore How Myofunctional Therapy Can Help?
If you suspect your child is struggling with mouth breathing, restless sleep, or poor tongue posture, early intervention can make a world of difference for their overall health, sleep, and growing smile.
Contact our team today to schedule an initial evaluation and start your child's path toward healthy breathing and natural function!
