Abstract
Orofacial muscle imbalance, with its ancillary disorders of tongue thrust swallow, poor tongue posture habit, mouth breathing, thumb sucking, and other orolingual habits or activities, presents some problems related to the time when a referral should be made. These referrals may originate from the dentist, orthodontist, allergist, otorhinolaryngologist, neurologist, speech pathologist, or the myofunctional clinician, to mention a few. This paper was written to discuss some of the conditions which should be considered in determining if a referral should be made, and if so, to whom? Along with the more typical referral reasons, the referring clinician may wish to consider growth factors, tongue size, patency of the nasal airway and related problems of lisping and tongue thrust, resting postures, diet, masticatory muscle tonus, and signs of neuromuscular dysfunction.