Hygiene Tribune U.S. No. 5, 2011
National Museum of Dentistry presents a ‘Tooth Fairy Day’ / Myofunctional therapy / Back to school? / California children continue to face oral health epidemic
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HYGIENE TRIBUNE
The World’s Dental Hygiene Newspaper · U.S. Edition
May 2011
www.dental-tribune.com
Vol. 4, No. 5
Myofunctional therapy
A structured, individualized treatment for retraining and restoring normal oral function
By Stephanie Wall, RDH, MSDH, MEd
Orofacial myology, or myofunctional therapy, is the treatment of an
orofacial muscle imbalance, incorrect swallowing pattern, TMJ muscle dysfunction and/or the elimination of bruxing, clenching or noxious oral habits. The main muscles
of concern to the orofacial myologist include the temporalis, masseter, internal and external pterygoid,
buccinator, orbicularis oris and the
mentalis.
Orofacial myofunctional therapy is a form of oral facial physical therapy. It involves exercises
and stimulation designed to inhibit
inappropriate oral behaviors and/
or strengthen appropriate muscle
functioning.
Resting postures of the tongue,
jaw and lips are very important
in normal oral growth. When the
tongue rests between the posterior teeth, they may not fully erupt,
resulting in an open bite appearance. If the tongue rests against the
maxillary anterior teeth, especially
if the upper lip is short or weak, the
teeth may begin to protrude too far
forward. When the lips are not in a
closed resting position, the growth
and development of the mouth can
be adversely affected.
Excessive non-nutritive or nonspeech oral behaviors, such as
clenching, bruxing, thumb or digit
sucking and nail biting, can also
affect the condition of the teeth
and health and functioning of the
mouth, especially the jaw. When
any oral behavior is excessive in
intensity, duration and frequency,
the pressures or collision forces
can have a serious impact on normal facial appearance and orofacial
health and functioning.
One of the most commonly seen
disorders, tongue thrust, refers to a
pattern of swallowing in which the
tongue pushes forward and/or sideways against or between the teeth
during swallowing. Swallowing
occurs hundreds of times each day
with little to no conscious thought.
When the tongue presses against or
between the teeth during swallow-
ing, the pressure can have adverse
effects on the position of the teeth,
bone growth, soft-tissue condition
and mouth functioning. Some of the
symptoms that occur with tongue
thrust include:
• aerophagia,
• difficulty swallowing pills or
firm foods,
• the inability to wear dentures,
• a residual effect on the hard palate from a digital habit,
• chronic mouth breathing,
• continued nasal stuffiness,
• orofacial muscle strain and
imbalance,
• chronic headaches or facial
spasms or pain.
Additional types of patients the
orofacial myologist may treat include
individuals with the following:
• high arched hard palate,
• weak lip structure,
• facial grimace when swallowing,
• ankylosed lingual frenum,
• protrusion of the tongue when
in repose,
• over developed mentalis muscle,
• sleep apnea.
Upper airway infections and
obstructions are frequently identified as causes of orofacial myofunctional disorders, especially when
these problems cause the mouth to
rest in an open position. Reduced
oral muscle tone or poor orofacial
muscle postures appear to negatively impact the growing mouth and
facial structures.
Long-term non-nutritive sucking
habits can also malform the oral
structure. Sometimes poor speech
articulation patterns may indicate
neurological or physical deficits. It
is often difficult to determine why
an orofacial myofunctional disorder
exists because the behaviors can be
the result of stimuli no longer fully
obvious.
Regardless of cause, once inappropriate oral behavioral patterns
are established, they tend to continue until some external stimulus or
g HT page 3C, THERAPY
What do fairies do with all those
teeth? Grab your wand and put on
your wings to meet the Tooth Fairy
herself and find out at Tooth Fairy
Day at the National Museum of Dentistry on Saturday, May 14, from 10
a.m.–4 p.m.
Discover how to have a sparkling
smile during an afternoon filled with
“tooth-riffic” hands-on activities and
fun. Make fairy wands and wings, a
box to hold your lost tooth and more!
“Healthy smiles start young, so it’s
important to teach kids early how to
take care of their teeth,” said Jonathan Landers, executive director of
the National Museum of Dentistry.
“Tooth Fairy Day is an opportunity
to have fun while learning skills that
will make an impact for a lifetime.”
Kids can try their hands at fairy
work by making a tooth necklace,
decorating maracas, learning about
animal teeth and exploring the
museum on a scavenger hunt to
learn about false teeth, including
the most famous false teeth of all
(hint: they belonged to the first president of the United States). In addition, children can explore hands-on
exhibits throughout the museum
about all things toothy and how to
have a healthy smile.
Tooth Fairy Day is included with
regular museum admission: $7 for
adults, $5 for seniors, $3 for children, free for two and under and
active duty military and immediate
family.
The National Museum of Dentistry, an affiliate of the Smithsonian
Institution, is located at 31 S. Greene
St. in downtown Baltimore. Call
(410) 706-0600 or visit www.
smile-experience.org for more information. HT
(Photo/National Museum of Dentistry)
National Museum of Dentistry
presents a ‘Tooth Fairy Day’
[2] =>
2C
Editor’s Letter
Hygiene Tribune | May 2011
Back to school?
The bachelor’s of science in
dental hygiene degree is becoming
more difficult to obtain due to the
closing of many traditional four-year
programs. This leaves many hygienists with an associate’s degree in
hygiene. While an associate’s degree
allows a graduate to practice dental
hygiene, a four-year degree is preferable for many positions associated
with dental hygiene. If one has aspirations of being employed in dental
hygiene education, corporate positions, sales, etc., a bachelor’s degree
is sometimes mandatory.
Degree completion programs
are available to obtain a bachelor’s
degree in dental hygiene and there
are hygienists who wish to pursue
that degree. For those interested in
a career in dental hygiene education, this is usually the mandatory
path. In many programs, full-time
teaching positions may even require
a master’s degree in dental hygiene
education.
For the other positions, the course
of study is not as important. Bachelor’s degrees in other courses of
study mix nicely with the profession
of dental hygiene. Hygienists can
often be heard saying they feel like
counselors. Understanding the way
human beings learn, think and are
motivated help hygienists relate to
patients. For these reasons, clinical
dental hygiene is well complemented by a parallel degree in psychology.
For those interested in a sales
position, a degree in business may
prove to be a good parallel degree.
A hygienist who likes to write might
want to consider a degree in journalism. Those who have a patient
base that speaks languages other
than English may benefit from a
degree in a foreign language. Clinicians interested in research might
want to consider majoring in a field
they would like to research, such as
biology. A four-year degree in something other than dental hygiene may
open doors to other career opportunities if one decides to leave the
dental hygiene profession.
These degrees can be obtained
in a variety of ways. There are the
traditional avenues, such as attending courses on a campus. However,
this may not be the most convenient
for working adults. With the inception of non-traditional learning, the
working adult population can continue to work and complete a fouryear degree.
There are universities that offer
evening classes in an accelerated
format that meet in person and/or
online. A quick inquiry of local colleges and universities can provide
information about one’s options.
Paying for an education up front
might pose a hurdle for some students. Adults can apply for financial
aid. This is a relatively easy process and filing an application will
let a potential student know what
to 1 million, according to the CDHA.
According to the Pew Report, California falls short in these key oral
health-care policy benchmarks:
• Only 27 percent of California
drinking water supplies are fluoridated — far less than the national
average of 75 percent.
• Nationwide, the percentage of
dentists’ fees reimbursed by Medicaid
is 60 percent, while California lagged
behind with 34 percent.
The CDHA continues to voice
related concerns. For instance, many
dentists are not comfortable treating
infants or very young children, and
instead they refer them to a pedodontist. CDHA officials say this demonstrates why the role of a dental
hygienist is so vital.
“The dental hygienist can provide
mothers of infants and young children with simple nutritional counseling to help prevent dental decay,”
said Standley. “We are a trusted and
reliable source of information about
everything from proper brushing to
the safe use of bottles and sippy cups.”
The World’s Dental Hygiene Newspaper · U. S. Edition
Publisher & Chairman
Torsten Oemus
t.oemus@dental-tribune.com
Chief Operating Officer
Eric Seid
e.seid@dental-tribune.com
Group Editor & Designer
Robin Goodman
r.goodman@dental-tribune.com
Editor in Chief Hygiene Tribune
Angie Stone, RDH, BS
a.stone@dental-tribune.com
Managing Editor/Designer
Implant, Endo & Lab Tribunes
Sierra Rendon
s.rendon@dental-tribune.com
Managing Editor/Designer
Ortho Tribune & Show Dailies
Kristine Colker
k.colker@dental-tribune.com
assistance is available. If one is not
eligible for grants or scholarships,
student loans are another option.
These loans often have low interest
over a long period for repayment.
Acquiring a bachelor’s degree is
doable and well worth the time and
effort. If you have been thinking
about going back to school, there is
no time like the present to do some
investigation of the possibilities, get
all of your ducks in a row and actually “take the plunge.” You will likely not regret having expanded upon
your educational horizons. HT
Online Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.
com
Account Manager
Mark Eisen
m.eisen@dental-tribune.com
Marketing Manager
Anna Wlodarczyk
a.wlodarczyk@dental-tribune.com
Sales & Marketing Assistant
Lorrie Young
l.young@dental-tribune.com
C.E. Manager
Julia E. Wehkamp
j.wehkamp@dental-tribune.com
Best Regards,
C.E. International Sales Manager
Christiane Ferret
c.ferret@dtstudyclub.com
Angie Stone, RDH, BS
Dental Tribune America, LLC
116 West 23rd Street, Suite 500
New York, NY 10011
Tel.: (212) 244-7181
Fax: (212) 244-7185
California children continue
to face oral health epidemic
Despite being one of the most preventable of all diseases, tooth decay
continues to rank as the most widespread public health issue for California children, according to the California Dental Hygienists’ Association
(CDHA). The warning comes on the
heels of a report identifying California
as being “off track” when it comes to
addressing the dental needs of children.
“Poor oral care contributes to
speech impediments, low self-esteem
and a wide range of health problems involving infections,” said Ellen
Standley, CDHA president. “It is
unfortunate that one in four children
have never even been to a dentist and
that tooth decay is five times more
prevalent than asthma.”
The Pew Center, a not-for-profit
organization dedicated to improving
public policy, which issued the report,
issued a “C” grade to California, where
it says more than 750,000 elementary
school children had untreated tooth
decay in 2006; conventional wisdom
suggests that number is now closer
HYGIENE TRIBUNE
Additionally, disparities exist across
race, ethnicity and type of insurance
when it comes to the length of time
between dental care visits. Most dental practices don’t accept Medicaidenrolled children of any age, said
Standley, and children are seen on an
average of 10 times in a medical office
before the first dental exam is ever
scheduled.
“The CDHA continues to make it a
priority to raise awareness of pediatric oral health among policy makers,
parents and the public health community,” said Standley. “The good news
is that with knowledge and public
education, we can make headway in
reducing tooth decay in our children.”
The CDHA is the authoritative
voice of the state’s dental hygiene
profession. The organization was
established 25 years ago when two
regional associations merged to form
a unified professional group. The
CDHA represents thousands of dental hygienists. HT
(Source: PRWEB)
Published by Dental Tribune America
© 2011 Dental Tribune America, LLC
All rights reserved.
Hygiene Tribune strives to maintain
utmost accuracy in its news and clinical
reports. If you find a factual error or
content that requires clarification, please
contact Group Editor Robin Goodman at
r.goodman@dental-tribune.com.
Hygiene Tribune cannot assume
responsibility for the validity of product
claims or for typographical errors.
The publisher also does not assume
responsibility for product names or
statements made by advertisers. Opinions
expressed by authors are their own and
may not reflect those of Dental Tribune
America.
Tell us what you think!
Do you have general comments or criticism you would like to share? Is there
a particular topic you would like to see
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us know by e-mailing feedback@dentaltribune.com. We look forward to hearing
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at database@dental-tribune.com and be
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to process.
[3] =>
Hygiene Tribune | May 2011
f HT page 1C, THERAPY
treatment alters enough of the patterns so that new behaviors can be
learned. Sometimes the changes of
the oral environment by an orthodontist may bring improved oral
functioning.
However, orofacial myofunctional therapy may be necessary when
there are indications that dental
treatment or orthodontic intervention alone may not bring about the
desired changes in oral behaviors.
Adverse oral behaviors can often
interfere with dental or orthodontic
treatment and the stability and condition of the mouth.
Orofacial myofunctional therapy
is a structured, individualized treatment for retraining and restoring
normal oral functioning. It seeks
to inhibit incorrect muscle movements and develop normal, easy
functions of oral rest posture, oral
stage of swallowing and speech
articulation. Therapy may include
any or all of the following:
• elimination of damaging oral
habits,
• reduction of unnecessary tension and pressure in the muscles
of the face and mouth,
• strengthening of muscles that do
not adequately support normal
functioning,
• development of normal resting
postures of the tongue, lips, jaw
and facial muscles,
• establishment of normal biting,
chewing and swallowing patterns.
The length and timing of therapy
depends on the severity and nature
of the disorder. In most cases, therapy is a short-term process with
the active stage of treatment lasting
about three to six months. Follow-up visits may be required with
decreasing frequency over a period
of six to 12 months.
Orofacial myofunctional therapists have received specialized
training to evaluate and treat a vari-
About the author
S t e p h a nie Wall has
been a dental
hygienist
for more than
25 years. She
owns her own
business, Cranioral Health
Solution, where she practices
orofacial myology and craniosacral therapy. In her spare time,
she is a writer for www.dentinal
tubules.com and other dental
and dental hygiene publications.
Wall is also a four-time
attendee of CareerFusion, manages the organization’s newsletter and blog site and is available
for speaking engagements.
You may contact her at
walls879@aol.com.
ety of orofacial disorders. Many clinicians have additional professional
training in the areas of speech language pathology, dental hygiene,
dentistry or another health-related
field. Most are members of the
International Association of Orofacial Myology (IAOM).
The IAOM regulates how orofacial myology is practiced, how
the course material is constructed
and delivered, and monitors the
certification process that assigns
the credential of Certified Orofacial
Myologist (COM). Certification is
not required in order to practice,
however, it is highly recommended.
To learn more about the IAOM
and the profession of orofacial
mycology, please visit www.iaom.
com. HT
Clinical
3C
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