Oral Rest Posture Program

Orofacial Myofunctional Disorder (OMD)

What is an orofacial myofunctional disorder (OMD)?

Orofacial myofunctional disorders include one or a combination of the following:

1. Chronic oral habits not related to nourishment, such as finger sucking, tongue sucking, lip sucking, cheek sucking, sucking habits with objects (e.g., pacifier, blanket, pencil, etc.)

2. Poor oral rest posture (i.e., sitting with mouth open and tongue low and forward)

3. Tongue thrust during speaking and/or swallowing (i.e., tongue moving forward or laterally between the teeth).

What is proper oral rest posture?

Proper oral rest posture includes: lips together, teeth slightly parted and tongue resting on the roof of the mouth.

How does oral rest posture link to speech?

From a speech (articulation) perspective, one’s oral rest posture is the starting place for all speech sounds. Our tongue will move only as far as it needs to, to produce a sound that is ‘good enough’. When someone rests their tongue between their teeth, they are more likely to produce sounds from this position as well. 

What causes an OMD?

During infancy, one’s tongue sits low and forward in the mouth and the inside of the cheeks are large. Therefore, babies use a low, forward swallow pattern to suckle, also known as a tongue thrust. As the child grows the cheek pads diminish and the tongue sits further back in the mouth, leading to proper oral rest posture. The tongue resting against the roof of the mouth helps the palate develop into the correct shape. If something affects the normal development of the dental arches or position of the teeth, an OMD can occur. The most common factors leading to an OMD include: 

1. Oral habits- prolonged thumb, finger sucking, cheek/nail biting, tooth clenching etc.

2. Restricted nasal airway- enlarged tonsils, allergies, asthma, sinusitis, or a restricted airflow through the nasal cavity can promote a habitual open-lip posture

3. Structural abnormalities- short lingual frenum (tongue-tie), micrognathia (abnormally small jaw)

4. Neurological or developmental abnormalities

What does this mean for my child?

When there is a combination of an OMD and a related speech error, it is often difficult to correct the speech problem through traditional speech therapy, until the OMD has been corrected.

The speech-language pathologist assesses oral rest posture and swallowing in order to determine programming tasks for remediation. The goal of treatment is to set the client up for orthodontic success and retention, improve swallowing patterns facilitate readiness for successful articulation therapy.