International Journal of Orofacial Myology and Myofunctional Therapy

13 pages, 532 KB

Open AccessSystematic Review

Mouth Breathing and Obstructive Sleep Apnea in Children: An Umbrella Review

by Mariana Pires Comune Biscuola, Daniel Mendes Lobato and Almiro José Machado Júnior

Int. J. Orofac. Myol. Myofunct. Ther. 2025, 51(2), 13; https://doi.org/10.3390/ijom51020013 - 5 Nov 2025

Background: Mouth breathing and obstructive sleep apnea (OSA) in children are interrelated conditions that can negatively impact neurocognitive development and overall quality of life. This study aimed to critically analyze the available evidence regarding the relationship between these conditions, highlighting their prevalence, clinical [...] Read more.

Background: Mouth breathing and obstructive sleep apnea (OSA) in children are interrelated conditions that can negatively impact neurocognitive development and overall quality of life. This study aimed to critically analyze the available evidence regarding the relationship between these conditions, highlighting their prevalence, clinical consequences, and therapeutic approaches. Methods: To this end, an umbrella review was conducted, including systematic reviews and meta-analyses retrieved from scientific databases, following rigorous inclusion criteria. Results: A total of six systematic reviews met the inclusion and exclusion criteria and were included in the final analysis. These studies explored various aspects of the topic and underwent a thorough assessment of methodological quality. Conclusions: The findings indicated that mouth breathing may act as both a predisposing and aggravating factor for OSA, while OSA itself may contribute to the persistence of this breathing pattern. However, the methodological heterogeneity among the included studies posed a challenge to synthesizing the findings, underscoring the need for more standardized research. It is concluded that early interventions and multidisciplinary approaches are essential for the effective management of these conditions. Furthermore, this review provides a foundation for future research in this area. Full article

(This article belongs to the Special Issue 50 Years of the IJOM: Perspectives and Future Directions in Orofacial Myology and Myofunctional Therapy)

► Show Figures

Figure 1

1 pages, 193 KB

Open AccessEditorial

Tribute to Dr. Marvin Hanson

by Robert M. Mason

Int. J. Orofac. Myol. Myofunct. Ther. 2025, 51(2), 12; https://doi.org/10.3390/ijom51020012 - 29 Oct 2025

Viewed by 151

Abstract

Dr [...] Full article

(This article belongs to the Special Issue 50 Years of the IJOM: Perspectives and Future Directions in Orofacial Myology and Myofunctional Therapy)

18 pages, 334 KB

Open AccessArticle

Lingual Frenuloplasty with Myofunctional Therapy: Improving Outcomes for the Treatment of Ankyloglossia (Tongue-Tie) with Refined Techniques and Endpoints

by Soroush Zaghi, Amanda Ramirez, Sabrina Espadas, Gloria Nguyen, Lesley McGovern Kupiec, Nora Ghodousi-Zaghi, Maryam Nouri-Norouz, Sandraluz Gonzalez, Sanda Valcu-Pinkerton, Jennifer Rodriguez, Chad Knutsen and Leyli Norouz-Knutsen

Int. J. Orofac. Myol. Myofunct. Ther. 2025, 51(2), 11; https://doi.org/10.3390/ijom51020011 - 27 Oct 2025

Viewed by 1371

Abstract

Purpose: Ankyloglossia (tongue-tie) can lead to oromyofascial dysfunction which affects breathing, swallowing, speech, and posture. This study presents the evolution and outcomes of a refined lingual frenuloplasty protocol that integrates individualized myofunctional therapy to address compensatory patterns. Methods: A prospective cohort of 445 [...] Read more.

Purpose: Ankyloglossia (tongue-tie) can lead to oromyofascial dysfunction which affects breathing, swallowing, speech, and posture. This study presents the evolution and outcomes of a refined lingual frenuloplasty protocol that integrates individualized myofunctional therapy to address compensatory patterns. Methods: A prospective cohort of 445 patients (≥4 years) was treated between 2021 and 2023 using a fascia-preserving CO₂ laser protocol with structured pre- and postoperative myofunctional therapy. Patients were stratified as pediatric (<12 years) or adolescent/adult (≥12 years). Key refinements included fascia-sparing dissection, reduced suture tension with cyanoacrylate adhesive, defined functional endpoints, structured myofunctional therapy, and standardized wound-healing strategies. Results: Among 379 patients (85% response) with >2 months follow-up, the 2025 protocol achieved an 86% satisfaction rate and significantly fewer complications compared with 2019 (pain 3.7% vs. 15.8%; bleeding 1% vs. 13%; revision 2.1% vs. 6.6%). Deeper genioglossus dissection increased swelling risk (OR = 4.0, p < 0.0001) but did not affect satisfaction. Conclusions: The refined 2025 protocol represents an outcome-tracked advancement in ankyloglossia management. By emphasizing fascia preservation, functional diagnostics, and integrated myofunctional therapy, the approach improves safety, efficacy, and patient-centered outcomes. Full article

(This article belongs to the Special Issue 50 Years of the IJOM: Perspectives and Future Directions in Orofacial Myology and Myofunctional Therapy)

► Show Figures

Graphical abstract

20 pages, 644 KB

Open AccessReview

Myofunctional Therapy in Atypical Swallowing: A Scoping Review

by Pedro Contreras Salinas, Felipe Inostroza-Allende, Cristóbal Caviedes-Ulloa, Patricio Soto-Fernández and Giédre Berretin-Felix

Int. J. Orofac. Myol. Myofunct. Ther. 2025, 51(2), 10; https://doi.org/10.3390/ijom51020010 - 15 Oct 2025

Viewed by 795

Abstract

Background: Orofacial myofunctional therapy (OMT) is frequently applied to correct atypical swallowing, yet its therapeutic strategies remain heterogeneous and poorly standardized. Objective: This scoping review aimed to characterize the strategies described in the literature for OMT in individuals diagnosed with atypical swallowing. Methods: [...] Read more.

Background: Orofacial myofunctional therapy (OMT) is frequently applied to correct atypical swallowing, yet its therapeutic strategies remain heterogeneous and poorly standardized. Objective: This scoping review aimed to characterize the strategies described in the literature for OMT in individuals diagnosed with atypical swallowing. Methods: Following Joanna Briggs Institute and PRISMA-ScR guidelines, and with a registered protocol, we included clinical and experimental studies without age restriction, conducted in clinical or research contexts. Studies were retrieved from PubMed, EMBASE, and Cochrane Library using MeSH terms and specific keywords. Data were extracted using a standardized form and summarized descriptively. Results: Twelve studies published between 1989 and 2024, involving 164 participants aged 5–26 years, were included. Interventions were mainly performed by speech-language pathologists in pediatric and adolescent populations, combining tongue posture exercises, muscle strengthening, orofacial mobility, and functional swallowing training. Treatment duration ranged from 8 weeks to 6 months, with weekly sessions and home practice recommendations. In 83% of studies, improvements in swallowing patterns and tongue posture were reported, especially when combined with orthodontic treatment. Conclusions: OMT is characterized as a multifactorial intervention integrating muscle training and functional re-education, but variability in protocols and lack of standardization limit clinical comparability. Future multicenter studies with greater methodological control are needed. Full article

(This article belongs to the Special Issue 50 Years of the IJOM: Perspectives and Future Directions in Orofacial Myology and Myofunctional Therapy)

► Show Figures

Figure 1

12 pages, 1220 KB

Open AccessArticle

Objective Assessment of Orofacial Muscle Strength: Validation of an Alternative Low-Cost Measurement Device

by Eduardo J. Correa, James Curtis, Laura Rodriguez Alcalá, Juan Antonio Ibañez-Rodriguez, Marta Morato-Galán, Gislaine Aparecida Folha, Cristina Rodriguez Alcalá, María Teresa García Iriarte, Guillermo Plaza and Carlos O'Connor-Reina

Int. J. Orofac. Myol. Myofunct. Ther. 2025, 51(2), 9; https://doi.org/10.3390/ijom51020009 - 29 Sep 2025

Viewed by 413

Abstract

Objective: Accurate measurement of orofacial muscle strength is essential for phenotyping patients with obstructive sleep apnea (OSA), and particularly those with hypotonic phenotypes. High costs associated with gold standard devices such as the Iowa Oral Performance Instrument (IOPI^®) limit their clinical [...] Read more.

Objective: Accurate measurement of orofacial muscle strength is essential for phenotyping patients with obstructive sleep apnea (OSA), and particularly those with hypotonic phenotypes. High costs associated with gold standard devices such as the Iowa Oral Performance Instrument (IOPI^®) limit their clinical use. This study aims to validate the Sandway^® manometer, a low-cost alternative to the IOPI^®, by comparing its performance against the IOPI^® and the Tongue Digital Spoon (TDS) in both laboratory and clinical settings. Methods: We conducted a two-phase study. In the laboratory phase, pressure readings from the IOPI^® and Sandway^® devices were compared using standardized force application methods. In the clinical phase, 60 patients with moderate-to-severe untreated OSA underwent orofacial strength evaluation using IOPI^®, Sandway^®, and TDS devices. Intraclass Correlation Coefficient (ICC), Bland–Altman analysis, and Pearson correlation were used to assess reliability and agreement. Results: The Sandway^® showed excellent reliability for anterior tongue and lip strength measures (ICC = 0.978). Bland–Altman plots revealed minimal bias and narrow limits of agreement compared to the IOPI^®, indicating strong agreement for both tongue and lip measurements. A high correlation was also observed between Sandway^® and TDS results (r = 0.863, p < 0.001), supporting secondary validation. Conclusions: The Sandway^® manometer demonstrates high reliability and strong agreement with gold standard instruments, representing a valid, accessible alternative for objective assessment of orofacial muscle strength in clinical practice. Full article

► Show Figures

Graphical abstract

11 pages, 691 KB

Open AccessProtocol

Effect of Orofacial Myofunctional Therapy with Auto-Monitoring on the Apnea–Hypopnea Index and Secondary Outcomes in Treatment-Naïve Patients with Mild to Moderate Obstructive Sleep Apnea (OMTaOSA): A Multicenter Randomized Controlled Trial Protocol

by Harald Hrubos-Strøm, Diana Dobran Hansen, Xin Feng, Hanna Mäkinen, Unn Tinbod, Andres Köster, Heisl Vaher, Ole Klungsøyr, Jose M. Saavedra, Helge Skirbekk, Toril Dammen and Triin Jagomägi

Int. J. Orofac. Myol. Myofunct. Ther. 2025, 51(2), 8; https://doi.org/10.3390/ijom51020008 - 9 Sep 2025

Viewed by 2161

Abstract

Background: The aim of this article is to describe the protocol of a large, multicenter randomized controlled trial evaluating the effects of orofacial myofunctional therapy with auto-monitoring (OMTa) versus auto-monitoring alone on obstructive sleep apnea (OSA) assessed by the apnea–hypopnea index and other [...] Read more.

Background: The aim of this article is to describe the protocol of a large, multicenter randomized controlled trial evaluating the effects of orofacial myofunctional therapy with auto-monitoring (OMTa) versus auto-monitoring alone on obstructive sleep apnea (OSA) assessed by the apnea–hypopnea index and other pre-specified outcomes. Method: The OMTaOSA study protocol was registered at ClinicalTrials.gov (NCT06079073) in August 2023, and data collection ended in January 2025. One hundred and four participants with mild and moderate OSA were included. Randomization was conducted in a 1:1 ratio, using sex-stratified blocks. The intervention was a standardized protocol of OMT exercises previously shown to be effective, auto-monitoring with a Withings scan watch, and feedback from self-reports. Controls received watches and access to the same application without the exercise module. Sleep was measured over three nights at baseline and after three months. The sleep scorer and researchers evaluating other outcomes were blinded to the treatment allocation. Change in the apnea–hypopnea index was defined as the primary outcome. Secondary outcomes are published on Clinicaltrials.gov. Results: The results of the trial are still in preparation. Conclusions: By addressing the limitations of previous OMT studies, this trial may clarify the effectiveness of digitally delivered OMT for patients with mild to moderate OSA. Full article

► Show Figures

Figure 1

20 pages, 777 KB

Open AccessArticle

Multidisciplinary Approaches to Tongue Thrust Management in Australia: An Exploratory Study

by Sharon Smart, Julia Dekenah, Ashleigh Joel, Holly Newman and Kelly Milner

Int. J. Orofac. Myol. Myofunct. Ther. 2025, 51(2), 7; https://doi.org/10.3390/ijom51020007 - 14 Jul 2025

Viewed by 2464

Abstract

Background/Objectives: Tongue thrust (TT) occurs when abnormal tongue movements cause anterior tongue placement with pressure and contact against or between the teeth, potentially affecting the oral phase of swallowing, impacting eating, breathing and speaking. There is limited literature on the diagnostic and treatment [...] Read more.

Background/Objectives: Tongue thrust (TT) occurs when abnormal tongue movements cause anterior tongue placement with pressure and contact against or between the teeth, potentially affecting the oral phase of swallowing, impacting eating, breathing and speaking. There is limited literature on the diagnostic and treatment approaches for TT, as well as involvement of health practitioners in its management. This study aims to examine the current knowledge and practices related to TT diagnosis and treatment among health professionals in Australia. Methods: A two-phase explanatory sequential mixed methods approach was adopted, comprising an online survey that collected participants’ demographic information and details on assessment, diagnosis, management, referral practices, and relevant experience and training. Phase one involved 47 health professionals from various disciplines in Australia who completed an online survey in its entirety. Phase two included in-depth interviews with seven speech-language pathologists (SLPs) to gain further insights into their experiences in managing TT. Survey data were analysed descriptively, and interview data was analysed thematically. Results: Most participants diagnosed TT using clinical assessments, such as general observation and oral motor examinations. Treatment approaches commonly included orofacial myofunctional therapy and the use of myofunctional devices. Interviews with SLPs identified four key themes: tongue thrust as a symptom rather than a diagnosis, facilitators to effective treatment, multidisciplinary approaches to management, and training and education gaps in clinical practice. Conclusions: This study provides valuable insights into how TT is identified, assessed, diagnosed, and managed by health professionals in Australia. It highlights the perspectives of SLPs on treatment approaches, as well as their views on the availability and adequacy of training and education in this field. The findings suggest the need for a broader understanding of TT management, emphasising the importance of multidisciplinary collaboration and professional development. These insights are globally relevant, as they stress the shared challenges and the value of international collaboration in improving TT diagnosis and treatment practices. Full article

(This article belongs to the Special Issue 50 Years of the IJOM: Perspectives and Future Directions in Orofacial Myology and Myofunctional Therapy)

► Show Figures

Figure 1

25 pages, 1824 KB

Open AccessArticle

Orofacial Myofunctional Therapy for Patients with Obstructive Sleep Apnea—A Mixed Methods Study of Facilitators and Barriers to Treatment Adherence

by Diana Dobran Hansen, Unn Tinbod, Xin Feng, Toril Dammen, Harald Hrubos-Strøm and Helge Skirbekk

Int. J. Orofac. Myol. Myofunct. Ther. 2025, 51(2), 6; https://doi.org/10.3390/ijom51020006 - 30 Jun 2025

Viewed by 5850

Abstract

Orofacial myofunctional therapy (OMT) for obstructive sleep apnea (OSA) is a promising, new treatment. We aimed to study patients’ experiences and adherence to OMT. Twelve patients with OSA were included in the study, and they engaged in OMT exercises three times daily for [...] Read more.

Orofacial myofunctional therapy (OMT) for obstructive sleep apnea (OSA) is a promising, new treatment. We aimed to study patients’ experiences and adherence to OMT. Twelve patients with OSA were included in the study, and they engaged in OMT exercises three times daily for 12 weeks. Participants tracked their sleep and OMT exercise activities in an electronic diary. Exercise techniques were guided by a certified therapist. Patients’ experiences with OMT were assessed through semi-structured individual interviews conducted after a 12-week intervention, and the transcripts were analyzed using thematic analysis. The findings revealed an overarching theme that captured both facilitators of and barriers to OMT, organized into three subthemes: (1) motivation, (2) perceived support, and (3) perceived effects. Motivation was driven by a desire to improve general health and avoid continuous positive airway pressure treatment, and was supported by a sense of mastery and perceived effectiveness. Key facilitators included a trusting patient–therapist relationship, as well as developing routines and a sense of control. Barriers involved managing the comprehensive treatment protocol, insecurities around exercise execution and the potential impact of OMT, sickness burden, and previous negative healthcare experiences. These themes were supported by quantitative findings, which demonstrated high treatment adherence, while sleep data indicated modest individual improvements in subjective sleep quality and efficiency. By recognizing facilitators and barriers and addressing the individual differences among OSA patients, healthcare providers can better tailor their approach to meet diverse patient needs. This personalized approach, supported by emerging sleep improvements, may enhance patient engagement and improve adherence to OMT. Full article

(This article belongs to the Special Issue 50 Years of the IJOM: Perspectives and Future Directions in Orofacial Myology and Myofunctional Therapy)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Int. J. Orofac. Myol. Myofunct. Ther., Volume 51, Issue 2 (December 2025) – 8 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI