Symptoms and Conditions

Tongue Tie (Lingual Frenulum)

  • Tongue-tie is a popular term used to characterize a common condition that often goes undetected. It occurs during pregnancy when a small portion of tissue that should disappear during the infant’s development remains at the bottom of the tongue, restricting its movement. When an infant is born with tongue-tie, it is important to research other family members, since this change has a genetic influence.

  • In infants, surgery is usually indicated when the lingual frenulum restricts the tongue’s movement and compromises breastfeeding. In older children and adults, the indication is made when the tongue is visibly restricted and affecting proper function.

  • Many people with tongue-tie suffer the consequences without knowing the cause. There are infants who have changes in the feeding cycle, causing stress for the infant and for the mother.

Mouth Breathing

  • Mouth breathing refers to breathing performed predominantly by the mouth. In this way of breathing, the individual does not use, or uses very little, the nose to inhale and exhale the air.

  • The person may have one or more of the following characteristics: nasal congestion, open mouth at rest; parched lips, appearance of a large tongue that may be recessed and projected forward; long face syndrome; forward head posture; dark circles under the eyes, sagging cheeks, wheezing, and snoring. In such cases it is recommended that an otolaryngologist (ENT) and/or allergist be consulted.

  • Yes, when breathing is done through the nose, the air is filtered (cleaned), warmed and humidified, and thus it reaches the lungs with less impurities that are in the air. When you breathe through your mouth the air does not go through this process and reaches the lungs full of impurities. The oral rest posture of the tongue and the mandible when mouth breathing may also alter mandibular posture, palate width, and other craniofacial growth patterns as well as posture of the head, neck, and upper body.

  • The most common causes of mouth breathing are: allergic rhinitis, sinusitis, bronchitis, enlarged adenoids; enlarged tonsils; weakness or low tone of facial muscles that may lead to open mouth rest posture, habits such as thumb sucking, enlarged nasal concha, and nose fractures.

  • Keeping an open mouth posture can cause dry and chapped lips, short and fast breathing, diminished strength of the muscles of the lips, cheeks, jaw and tongue; a lowered and more anterior oral rest posture of the tongue, leading to changes in aesthetics and position of teeth/occlusion (improper fit of the teeth); elongated face, retruded mandible, and palate (“roof of the mouth”) becoming more narrow and/or deep.

  • When sleeping with the mouth open, a person may experience restless sleep, snoring, headaches, drooling on the pillow, thirst when waking up, morning sleepiness, sleep apnea (breathing interruptions during sleep), and decreased oxygen saturation in the blood.

  • Sleep disturbances can generate agitation, anxiety, impatience, decreased levels of alertness, impulsiveness, and discouragement. These changes can cause difficulties with attention, concentration, memory problems, and subsequent learning difficulties in children. During the critical periods of a child’s development, mouth breathing can be detrimental to learning.

Chewing and Open Bite

  • The term Temporomandibular Dysfunction (TMD) is used to define some problems that can affect the Temporomandibular Joint (TMJ), as well as muscles and structures involved in chewing.

  • Most cases of TMD should be treated by a team of allied health professionals such as an Orofacial Myofunctional Therapy Specialist, dentist, psychologist, physical therapist, neurologist and otolaryngologist. The Orofacial Myofunctional Therapy Specialist, may apply techniques to rebalance the muscles of the mouth, face and neck, and restore the functions of breathing, chewing, and swallowing. There may be attenuation and/or elimination of the signs and symptoms of TMD. The patient should be made aware about any harmful oral habits and oriented to contribute to the evolution of its clinical case.

  • Pain may be present around the TMJ (it may radiate to the head and neck), along with earache, tinnitus, ear fullness, sounds when opening or closing the mouth (popping or other noises in the TMJ), pain or difficulties when opening the mouth, and pain when moving the jaw and the muscles involved in chewing.

Sleep Apnea

  • Yes, due to constant vibration, the muscles of the mouth and throat become larger, and may bring about changes in size, width, and thickness. This may contribute to the appearance of total or partial obstruction of breathing during sleep.

  • Obstructive Sleep Apnea Syndrome is an obstruction of the airflow channel during sleep. According to the Mayo Clinic Obstructive sleep apnea is the most common sleep-related breathing disorder. It causes you to repeatedly stop and start breathing while you sleep.

    There are several types of sleep apnea, but the most common is obstructive sleep apnea. This type of apnea occurs when your throat muscles intermittently relax and block your airway during sleep. A noticeable sign of obstructive sleep apnea is snoring.

    Treatments for obstructive sleep apnea are available. One treatment involves using a device that uses positive pressure to keep your airway open while you sleep. Another option is a mouthpiece to thrust your lower jaw forward during sleep. In some cases, surgery might be an option too.

  • Whoever snores and presents with Obstructive Sleep Apnea should be treated by a multidisciplinary team including a sleep specialist. In this team, the Orofacial Myofunctional Specialist may help by directing and performing specific exercises to strengthen the muscles of the mouth and throat. Exercises that may help, if indicated, in improving oral rest posture, will be included. Although OMT does not cure sleep apnea, studies suggest that OMT can reduce a patient's apneic events by 50%