Dimensions Brand Ambassador Brittny Sciarra, RDH, BS, COM, discusses how she became a certified orofacial myologist, and how dental hygiene students can pursue a degree in this specialization.
I knew at an incredibly young age that I wanted to be a dental hygienist. I remember going for my 6-month recare appointments and my mother having to tell me to stop touching everything when my hygienist left the room. Smiles were and still are something I always notice first when I meet someone or even see a stranger walking on the street. However, the way I assess those smiles has changed now that I am a certified orofacial myologist (COM®) or orofacial myofunctional therapist.
GETTING STARTED IN THE PROFESSION
Orofacial myology or orofacial myofunctional therapy is not taught in dental hygiene programs, it is a specialized field. I first learned of myofunctional therapy while reading an article in one of our professional magazines. I remember thinking, “I’ve been an RDH for 5 years, how do I not know about this?” and “I need to know about this, NOW.” I researched more and found different introductory courses I could take. Two months later I began my very first, four-day, introductory course. I began implementing what I learned immediately and wanted to shout what I learned from the rooftop. In 2018, 2 years later, I took my certification and became a COM.
Orofacial myology is defined as the study and treatment of oral and facial muscles as they relate to speech, dentition, chewing/bolus collection, swallowing, and overall mental and physical health.1 Myofunctional therapy can be a key component in the treatment of sleep-related breathing disorders for adults and children, malocclusion and orthodontic stability, and temporomandibular joint dysfunction, and can help prevent health problems into adulthood by guiding the child through craniofacial growth and development. Dental hygienists will encounter patients with symptoms of orofacial myofunctional disorders. These include, but are not limited to:
- Mouth breathing
- Prolonged non-nutritive sucking habits (thumb, finger, pacifier)
- Open mouth rest posture
- Forward, interdental, lateral, or low tongue rest posture
- Tongue thrust
- Restricted lingual frenulum
THE ROLE OF A CERTIFIED OROFACIAL MYOLOGIST IN THE DENTAL OFFICE
Yes, straight teeth are attractive, but it is not an accurate depiction of oral health. A patient can have straight teeth, but a deficient maxilla or retrusive mandible. The maxilla is the base of the nasal cavity. What do you think that patient’s airway would look like on a CBCT? Is it something you ever thought of? I did not when I first graduated from dental hygiene school. It was not until I began my journey as a COM that I connected the dots, a true “aha” moment.
I believe dental hygienists make remarkable COMs because of the knowledge we already have of the orofacial complex. Building on that foundation, taking continuing education classes, and staying up to date on evidence-based research—we can go so much further than impacting our patients in our dental operatories. A small conversation between you and your patient can spark a fire that leads to life-changing results that affect whole-body health. As hygienists, we are on the frontline. Observe and assess your patients not only when they are in your dental chair, but also as they sit in the waiting room or walk into your operatory:
- Are their lips together or apart?
- Are they breathing through their nose or their mouth?
- Do they present with scalloped tongue?
- Are their palatal rugae prominent?
- Do they thrust their tongue forward or laterally when they swallow?
- Has their orthodontic treatment relapsed?
- Do you struggle to scale their mandibular anteriors because you are fighting their lower lip?
- Is their tongue ALWAYS in the way?
- Do they have chronic head, neck, and shoulder tension?
- Do they have forward head posture?
I look at patients’ overall body posturing. Do they have a forward head posture? Are their shoulders rolled? How are they breathing? Do they sound nasally? Do they snore or have a record of nighttime bruxism? Do they strain to keep their lips closed? The detective in me comes full surface.
It is important to work as an interdisciplinary team and make referrals when necessary. A COM may not be the only piece to the puzzle, but they are certainly a core element. Myofunctional therapy encourages proper facial and oral development by promoting good habits and behaviors. Facial and tongue exercises are given to neurologically reeducate the muscles of the face, lips, tongue, and pharyngeal airway to promote optimal breathing, oral rest posture, and chewing and swallowing patterns.
Myofunctional therapy is expanding at a fast pace as more education is offered to healthcare professionals and the general public. Be on the forefront of airway health as a COM and impact your patients’ lives in more ways than one.
- Holtzman SR. Orofacial Myology: From Basics to Habituation. Orlando, Florida: Neo Health Services; 2014.