Orofacial Motricity: From the Emergence of a Field to the Path Toward Global Terminology Standardization

Abstract

Background: The consolidation of specialized fields in health care requires not only scientific evidence and clinical refinement, but also clearly defined scope, competencies, and language, since terminological ambiguity increases overlap and hinders communication, comparability, education, and the organization of care. In this context, Orofacial Motricity was first recognized in Brazil as a field of practice, supported by institutional milestones that have defined its scope, standardized its terminology, and updated professional competencies. Furthermore, it has been consistently adopted in Latin American and European countries (e.g., Peru, Chile, and Portugal). In English-speaking countries, professionals working with Orofacial Myofunctional Disorders (OMDs) and Orofacial Myofunctional Therapy (OMT) are often organized under the designation Orofacial Myology, within diverse institutional and educational frameworks. Methods: This manuscript was developed as a non-institutional position paper based on structured reports from international collaborators, a documentary review of institutional and regulatory sources, and an exploratory terminological survey of databases. Results: Heterogeneity was observed in the use and conceptual level of these designations across countries and institutions, with more frequent convergence at the level of clinical condition and intervention (OMDs/OMT) than at the level of field or area. Conclusion: Clarifying the distinction among field/area, clinical condition, and therapeutic intervention may reduce ambiguities and foster scientific and educational comparability in the international context.

1. Introduction

The development and consolidation of specialized fields in health care tend to emerge from the need to organize more specific technical–scientific responses to the rapid expansion and increasing complexity of knowledge and care demands. This scenario has driven ongoing reviews and updates of educational and training pathways over time [1,2]. At present, greater complexity and interdependence among professions can be observed, highlighting the need to clarify boundaries and roles and to reduce ambiguities that affect the quality, safety, and organization of teamwork [3]. The consolidation of a field depends not only on evidence and clinical refinement, but also on the explicit definition of its scope, competencies, and specialized language. In this regard, terminological imprecision increases conceptual overlap and hinders professional communication, scientific comparability, education, and the organization of care [3,4,5].

Within this context, Orofacial Motricity may be understood as an expression of this broader movement of scientific and professional expansion. Over recent decades, advances in knowledge regarding structure-function relationships within the stomatognathic system and orofacial myofunctional disorders have contributed to broadening the scope and centrality of this topic in Speech–Language Pathology (SLP) practice. In Brazil, this process has been accompanied by institutional milestones that formally recognized Orofacial Motricity as a field/specialty [6], established technical–scientific terminology for the area [7], and updated the professional competencies of speech–language pathologists in the assessment and treatment of the orofacial myofunctional system and orofacial functions [8] thereby supporting the clinical management of related conditions. At the same time, the designation Orofacial Motricity has also been identified in other countries (Chile [9,10,11,12], Peru [13,14,15], and Portugal [16,17,18,19,20]), although formal recognition is not yet a reality in all of them.

In dialogue with this movement, the literature on professional language and disciplinary boundaries emphasizes that terminological divergences are related to the ways in which fields negotiate scope, professional identities, competencies, and evidentiary frameworks. These differences may re-emerge as practice and scientific production evolve and new terms arise [4,21]. In addition, a particularly robust institutional indicator of nominal standardization can be observed when scientific and professional organizations consistently retain the label of the field in their official names, as occurs in institutions in the areas of Audiology [22,23,24,25,26,27,28] and Dysphagia [29,30,31,32,33,34,35,36], suggesting greater stability at the field/area level.

Despite the growing international use of terms such as Orofacial Myology, Orofacial Myofunctional Disorders (OMDs), Orofacial Myofunctional Therapy (OMT), and Orofacial Motricity, there is still insufficient conceptual clarity regarding the distinction among field of knowledge, clinical condition, and therapeutic intervention/approach. Accordingly, this manuscript aims to analyze institutional and terminological traditions across different countries and to present a comparative synthesis. This work seeks to identify shared conceptual elements, make points of divergence explicit, and foster dialogue toward gradual international convergence.

2. Methods

This qualitative–descriptive study was structured as a non-institutional position paper and developed through an international collaborative initiative involving speech–language pathologists with recognized specialization and/or professional practice in Orofacial Motricity across different countries. The manuscript was prepared based on a narrative qualitative synthesis and a documentary analysis of institutional and regulatory sources relevant to the field, complemented by an exploratory terminological review of databases.

2.1. Collaborators and Eligibility Criteria

Experts, researchers, and/or clinicians with recognized experience in Orofacial Motricity in their respective countries were considered eligible as collaborators, based on at least one of the following criteria: (i) relevant academic output in the field (e.g., articles, book chapters, books, or technical documents); (ii) involvement in teaching, clinical training, and/or coordination of courses or training activities in the area; (iii) leadership or participation in professional, scientific, or academic organizations related to the field; and/or (iv) professional recognition based on an established career trajectory and consolidated clinical practice. Collaborators were invited by the coordinating authors according to these eligibility criteria and were included as co-authors of the manuscript. International collaborators also contributed to the critical appraisal, complementation, and contextual verification of information related to their respective countries, particularly with regard to terminological usage, educational milestones, institutional recognition, and relevant references.

2.2. Data Collection and Organization Procedures

Data collection and organization were conducted through a documentary review of institutional sources from regulatory bodies, professional/scientific associations, and educational organizations related to the topic. Whenever available, the review sought to identify formal definitions, scope/competencies, and the institutional use of the designations (e.g., Orofacial Motricity, Orofacial Myology, OMDs, OMT, and related terms) and their conceptual levels (field–clinical condition–intervention), as well as other complementary information, such as the main designations used for the field in the countries participating in the study, educational arrangements (undergraduate education, specialization programs, courses, and research lines), and institutional/regulatory recognition, when applicable. To this end, public websites and documents from the main professional/scientific organizations related to the field were reviewed, including the American Speech–Language–Hearing Association (ASHA); International Association of Orofacial Myology (IAOM); British Society of Myofunctional Therapy (BSMFT); Associazione Squilibrio Muscolare Orofacciale Italia (Italian Association of Orofacial Muscle Imbalance; SMOF Italia); Academy of Orofacial Myofunctional Therapy (AOMT); Academy of Applied Myofunctional Sciences (AAMS); Australian Academy of Orofacial Myology; Australian Association of Orofacial Myology; the Departamento de Motricidade Orofacial da Sociedade Brasileira de Fonoaudiologia (Orofacial Motricity Department of the Brazilian Speech–Language–Hearing Society; SBFa); the Departamento de Motricidade Orofacial da Sociedade Portuguesa de Terapia da Fala (Orofacial Motricity Department of the Portuguese Speech and Language Therapy Society; SPTF); and the Associação Brasileira de Motricidade Orofacial (Brazilian Association of Orofacial Motricity; ABRAMO). Selection prioritized organizations with an explicit institutional scope (e.g., definitions, scope/competencies, certification/training, and/or regulatory documents) and recognized relevance in their respective countries.

As an additional verification step, an exploratory terminological search was conducted in biomedical and Ibero-Latin American databases: MEDLINE (Medical Literature Analysis and Retrieval System Online) via PubMed (National Library of Medicine, USA); SciELO (Scientific Electronic Library Online); Scopus (Elsevier); Web of Science (WoS); Dialnet; Redalyc (Red de Revistas Científicas de América Latina y el Caribe, España y Portugal); Cochrane Library; Embase (Excerpta Medica database); and Google Scholar. A time filter covering the last 5 years was applied, comparing two lexical families: (1) “Orofacial Motricity” and its English and Spanish equivalents, and (2) “Oral/Orofacial Myology” and its Portuguese and Spanish equivalents. For descriptive comparison purposes between these terminological families, the counts of records retrieved within the defined time frame were summarized by family and expressed as a retrieval ratio (Q1/Q2) and as their proportion of the combined total [Q1/(Q1 + Q2) and Q2/(Q1 + Q2)]. Search strategies, search fields/indexes, and application of the time filter varied across databases (e.g., PubMed in All fields; Google Scholar via allintitle; SciELO, Dialnet, and Redalyc via general search; Embase via general search with time filter; and Cochrane Library via general search with the time filter applied through the interface). For the analysis, two coordinating authors conducted the searches independently and subsequently compared the numbers of retrieved records. The results were checked for consistency, and any discrepancies were resolved by consensus.

After the initial compilation, one collaborating representative from each country reviewed, supplemented, and verified the contextual and terminological adequacy of the syntheses related to their national context, in addition to contributing suggestions for revisions and additional references when appropriate. Subsequently, the final version was reviewed by the coordinating authors to ensure that the text accurately reflected the reported local/institutional perspective and framing.

2.3. Data Analysis and Synthesis of Data Sources

Initially, the information extracted from the institutional and documentary sources, as well as the review and complementary contributions provided by the collaborators, was organized into a synthesis matrix presented in the Section 3. These data were then analyzed comparatively across the different national contexts, with priority given to identifying terminological, scope-related, and conceptual convergences and divergences. The counts retrieved through the exploratory terminological verification were used descriptively and comparatively across the lexical families, without any intention of statistical inference. Editorial adjustments were made to ensure internal consistency and analytical uniformity while preserving the substantive content reported and reviewed for each country. The results of the terminological verification conducted in the databases were presented in the Section 3. The findings from the institutional analysis and database searches, as well as the group’s discussion of the study position and its interpretations, were presented and discussed in the Section 3, which was organized into two subsections: (i) conceptual aspects and current status: terminological convergences and divergences; and (ii) proposal and next steps: pathways toward convergence.

2.4. Ethical Aspects

This manuscript did not involve the recruitment of human participants, the collection of clinical data, identifiable data, or patient information. Rather, it consisted of a synthesis of author contributions and an analysis of publicly available sources; therefore, it did not require ethical review, since the research did not involve human subjects.

3. Results and Discussion

3.1. Conceptual Aspects and Current Status: Terminological Convergences and Divergences

From a narrative–qualitative perspective, the historical analysis of Orofacial Motricity and Orofacial Myology across different countries reveals diverse trajectories. Despite this, there is convergence in recognizing that the stomatognathic system, in interaction with other systems, plays a fundamental role in human communication, craniofacial development, feeding, and breathing, with implications for overall health and sleep quality [37,38,39,40]. This expanded clinical and scientific understanding has strengthened both Orofacial Motricity and Orofacial Myology as strategic fields in different countries. This strengthening has occurred, not only within SLP but also across other health professions through multiprofessional engagement. This development has resulted from pioneering efforts that established models of care, foundational theoretical-practical training principles, and scientific societies in a variety of contexts. Although there are country-specific particularities and different forms of professional organization, a global movement can be observed toward strengthening Orofacial Motricity as a field/area. This movement also reaffirms orofacial functions as an integrating axis of SLP care in this domain and reinforces the need for shared guidelines to support its continued development.

Within this context of international expansion and consolidation, the stabilization of a field depends not only on the accumulation of evidence and clinical refinement, but also on processes of institutionalization, educational organization, and scientific leadership. In the United States, historical-professional accounts have identified a core group of pioneering professionals in the 1970s who promoted and consolidated the tradition of Orofacial Myology in its early stages, most notably Bill Zickefoose, Marvin Hanson, Richard H. Barrett, Barbara Moore, and Galen Peachey. These individuals are associated with some of the earliest organizational decisions in the field, including the development of internal standards, the discussion of a representative designation for the emerging domain, and explicit goals aimed at raising educational standards and promoting research [41]. In Brazil, the developmental trajectory of Orofacial Motricity is often linked to a technical–scientific and professional–political movement articulated since the 1980s, with a central role attributed to Dr. Irene Queiroz Marchesan. The formal regulatory recognition of Orofacial Motricity as a specialty within SLP dates back to 1995, followed by subsequent international expansion through courses, specialization programs, scientific meetings, and scholarly production, with dissemination and growth across Latin American countries as well as in European dialogues (e.g., Portugal, Spain, and Italy) [42]. Taken together, these trajectories show that different designations and traditions were consolidated through different leaderships and dissemination networks, thereby underscoring the need to clarify, in the following section, how Orofacial Motricity and Orofacial Myology have been defined and operationalized in institutional sources and how this relates to the position proposed in this perspective.

At the level of institutional definitions, these trajectories have taken shape through different ways of delineating the field and its competencies. In Brazil, the regulatory definition issued by the Federal Council of Speech–Language Pathology and Audiology (Conselho Federal de Fonoaudiologia, CFFa) described Orofacial Motricity as the field within SLP dedicated to the study, research, prevention, assessment, diagnosis, development, habilitation, improvement, and rehabilitation of the structural and functional aspects of the orofacial and cervical regions [6]. Its scope of practice extends across all stages of life, from birth to senescence, and across different levels of care, including outpatient, rehabilitation, and hospital settings, while maintaining continuous integration with medical and dental specialties as well as other health and education professions [6,8,43]. In Brazil, this scope includes, among other areas of focus, structural and/or myofunctional changes related to sucking, breathing, chewing, swallowing, and speech; breastfeeding [44] and pediatric feeding disorders [45]; temporomandibular, craniofacial, cervical, neurological, and muscular disorders; sleep-disordered breathing [46] and bariatric surgery [47]; and adaptations associated with facial aesthetics and aging [6], in addition to health promotion and disease prevention actions [8]. This delimitation, already established by regulation for the specialty in the country since 1995 [48], has been reinforced by recent regulatory documents issued by the CFFa [8], which update and further specify professional competencies and skills involving the assessment, diagnosis/prognosis, and (re)habilitation of the orofacial and cervical myofunctional system, including orofacial functions.

By contrast, in contexts where the designation Orofacial Myology has historically become established, the delineation of the domain tends to appear less as a normative definition of a “specialty” and more as a combination of field of study, clinical condition, and intervention. In a classic formulation of the area, Orofacial Myology is defined as the study of normal and abnormal patterns of mouth and facial use and their relationships with dentition, speech, and vegetative functions [49]. In professional scope documents, Orofacial Myology is also described operationally as a clinical practice aimed at recognizing/identifying and treating OMDs across the lifespan, with goals often centered on lip seal, tongue resting posture against the palate, optimized swallowing patterns, and the reduction/correction of dysfunctional habits [50]. Along the same lines, institutional materials from the IAOM delineate the domain primarily through the characterization of OMDs and the description of OMT as the practice of the certified professional, so that the “field” is often presented more as a framework defined by the condition and the intervention than as a formal definition of a professional area [51].

Terminological variation, however, is not limited to the contrast between Orofacial Myology and Orofacial Motricity and is expressed across different countries and institutions. Although several countries develop equivalent practices, the nomenclature used is not always the same across professionals and organizations, with some being more specific at the level of the clinical condition, such as OMDs, as described in the Practice Portal of ASHA in the United States of America, in which the focus is placed on the competencies and responsibilities of the Speech–Language Pathologist (SLP) [52]; “Función Oral Faríngea” (Oral-Pharyngeal Function) in Colombia [53,54], as an institutional formulation of the object/focus and competence of the SLP; and others being broader, such as “Fonoestomatología” (Phonostomatology) in Argentina, where it is recognized as a specialty within SLP [55], as well as in Uruguay [56,57] and Paraguay [58,59], although the terminology Orofacial Motricity has also been adopted by some public and educational institutions [60,61,62,63,64] in these countries, which demonstrates the absence of consensus. In contrast, the nomenclature Orofacial Motricity has been used recurrently in different countries, such as Chile [9,10,11,12], Peru [13,14,15], and Portugal [16,17,18,19,20], and in a still limited way in education in Spain.

Additionally, several organizations in Latin American and European countries have taken positions in support of and endorsed the celebration of World Orofacial Motricity Day [65,66,67,68,69,70,71,72,73,74,75,76,77,78], established in 2015 by a group of specialists during a scientific event held in Peru [79]. Although the terminology Orofacial Motricity is present, terminological heterogeneity and variation in conceptual level, in formal recognition by regulatory and scientific bodies, and in the designation adopted for the field of practice are still observed. This scenario hinders data comparability, the production of scientific evidence, the development of clinical guidelines, the alignment of educational processes, and the consolidation of shared competencies. In a context of global expansion, the absence of institutional-level uniformity reduces the communicative coherence of the field, weakens its political and scientific strength, and compromises the development of integrated health care strategies.

To further qualify this discussion, it should be made explicit that, internationally, terms within the same lexical family have been used for distinct conceptual levels. The analysis of institutional documents/publications indicates that, in different countries, related terminological labels have been used to designate: (1) specialty/professional field (domain of knowledge and area of practice), (2) clinical condition (what will be identified/diagnosed), and (3) therapeutic intervention/approach (what will be performed). This misalignment may lead to imprecise interpretations when Orofacial Myology/Myofunctional Therapy/OMT are used interchangeably to refer to both the intervention and the discipline/field itself, because, although OMT is correctly described as a therapeutic modality, some institutional and regulatory sources use “Myofunctional Therapy” as the designation of the professional discipline itself or present Orofacial Myology/OMT interchangeably, thereby favoring overlap between the name of the treatment and the name of the field [50,80,81,82]. These divergences reinforce the need for conceptual and terminological standardization, since such debates tend to re-emerge as scope, education, and evidence evolve. Moreover, standardization is not limited to a nominal change: it involves the (re)definition and renegotiation of professional and institutional boundaries and, when implemented through policies/declarations, may be challenged by practice and by the emergence of new terms, with movements of (de)standardization [4,21].

Although divergence is more pronounced at the level of the designation of the field/area, a certain degree of international convergence can be observed at the levels of clinical condition and intervention, especially through the recurrent use of the labels OMDs and OMT in institutional documents and training materials. However, this convergence is predominantly nominal: the operational definitions, descriptive criteria, and scope attributed to OMDs and OMT vary across organizations, professions, and educational systems. These divergences reflect distinct regulatory arrangements and historical-institutional trajectories and, in part, the absence of a formal and shared definition of the “field” at the international level [7,51,52,82,83,84,85,86,87,88,89,90]. Thus, the most persistent comparative problem lies not only in residual differences in the conceptualization of condition and intervention, but above all in the oscillation of the designation used for the field/area. From this perspective, the standardization required should focus primarily on the conceptual delimitation of the field and on the explicit mapping of equivalences across levels (field–clinical condition–intervention), with a view to reducing inconsistent cross-readings and increasing scientific and educational comparability.

In order to understand these divergences, the authors analyzed institutional websites and documents from organizations in the field across several countries, examining whether distinctions are made among field of practice, clinical condition, and therapeutic intervention/approach. In the ASHA Practice Portal, the focus is essentially at the level of the clinical condition and its management by SLPs. ASHA describes OMDs as movement patterns of the oral and orofacial musculature that may result in improper tongue positioning at rest and during swallowing, breathing, and speech; they may occur throughout the lifespan, and the diagnosis of OMDs takes into account the impact of atypical movement patterns on structural changes and functional abilities [52,91,92,93]. In addition, ASHA itself explicitly states that orofacial myofunctional interventions are carried out by properly trained SLPs, within the context of interprofessional teams, and guides practice through normative documents such as the Code of Ethics, the Scope of Practice, and the Preferred Practice Patterns [94,95,96].

The historical organization in the field, the IAOM, uses the term Orofacial Myology to refer to the professional domain associated with practice involving OMDs, in alignment with the foundational assumptions of this field [97]. On its institutional website, the emphasis is placed primarily on the clinical condition and the intervention (OMDs/OMT). The IAOM defines OMDs as maladaptive functional patterns arising from structural and/or muscular deficits in the orofacial complex, resulting in compensations, undesirable habits, and/or additional impact on the orofacial structures. In addition, it describes OMDs as the “nexus between structure and function”: in some cases, a structural anomaly gives rise to functional challenges; in others, atypical oral habits and limited functional skills lead to undesirable structural changes. The organization also defines OMT as an individualized program designed to help the patient re-educate these maladaptive patterns of muscle function and to help create and maintain a healthy orofacial environment [51]. These authors did not identify a formal definition of Orofacial Myology as a field of practice on the institutional website or in the available materials.

In the Australian context, the Australian Association of Orofacial Myology defines Orofacial Myology as the study of the oral and facial muscles in relation to their movement patterns in daily life. Myofunctional Therapy is described as the application of training and exercise-based techniques that may be delivered by health professionals with a well-established knowledge of human biology and physiology, acting directly on the structures and functions of the head, face, mouth, and throat. Within this framework, inadequate movement patterns are collectively known as Myofunctional Disorders and may be identified through manifestations such as mouth breathing, speech, feeding, and/or swallowing difficulties, orofacial pain, orthodontic problems, and sleep-disordered breathing [90]. In a convergent manner, the Australian Academy of Orofacial Myology defines OMT as the treatment of disorders of the muscles of the face and mouth, including non-nutritive sucking habits, inadequate swallowing patterns, and incorrect postures and functions of the tongue, lips, jaw, and facial muscles. In addition, it states that these dysfunctions (OMDs) are often associated with speech alterations, such as articulatory difficulties, mandibular thrust during speech, frontal and/or lateral lisping, and hypernasality or hyponasality [89].

In the United Kingdom, the British Society of Myofunctional Therapy (BSMFT) characterizes OMT as the neuromuscular re-education/repatterning of the orofacial muscles and OMDs as alterations of the muscles and functions of the face and mouth, while also detailing professional eligibility and education/certification in Orofacial Myology across various professions [83]. However, while the BSMFT constitutes an institutional reference in the United Kingdom, its representativeness within the broader professional landscape appears to be limited in terms of professional representation and it should not be taken as fully representative of the UK context as a whole. In Italy, SMOF Italia characterizes Squilibrio Muscolare Orofacciale (Orofacial Muscular Imbalance; SMOF) as an alteration of one or more oral functions (swallowing, breathing, chewing, phonemic articulation, and resting posture) and defines OMT as a speech–language therapy pathway for the education and re-education of oral functions [84]. This should be interpreted alongside the fact that FLI (Federazione Logopedisti Italiani; Italian Federation of Speech–Language Therapists) had already recognized OMT as a discipline within Speech–Language Pathology prior to the creation of SMOF Italia. In the United States, the Academy of Orofacial Myofunctional Therapy (AOMT) defines OMDs as disorders of the muscles and functions of the face and mouth and describes OMT as a program aimed at correcting breathing/swallowing/chewing alterations, normalizing freeway space, stabilizing the bite, and eliminating harmful oral habits [85,86,87]. Similarly, the Academy of Applied Myofunctional Sciences (AAMS) defines OMDs in similar terms and describes OMT as an exercise-based program designed to eliminate many of the causes of swallowing abnormalities and inadequate tongue resting posture [88]. Overall, a recurring pattern can be observed in the clear description of the clinical condition and/or the intervention, despite variation across definitions, with less emphasis on the formal definition of the “field” as a discipline.

In contrast, in Brazil there is a normative and associative formalization that includes definitions provided by the regulatory body and scientific institutions. CFFa Resolution No. 320/2006 describes Orofacial Motricity as a field focused on the study, research, prevention, assessment, diagnosis, development, habilitation, improvement, and rehabilitation of structural and functional aspects of the orofacial and cervical regions, while also delineating the profile of the specialist [6]. Some documents issued by the Orofacial Motricity Department of the SBFa explicitly address the field of practice and terminological/vocabulary standardization and provide definitions of OMD (an alteration involving the oral, facial, and/or cervical musculature that interferes with the growth, development, or functioning of orofacial structures and functions) and OMT (a therapeutic action applied to the musculature through modification of orofacial function or functions) [7,98], while the ABRAMO specifies the specialist’s domains of expertise that encompass OMDs [99]. The Brazilian case is presented as an example of normative and conceptual formalization that operationally distinguishes the levels of field of practice, clinical condition, and therapeutic intervention/approach, as well as the terminology to be used in the area. Nevertheless, this standardization applies to the Brazilian national context since 1995 [48], without any intention of mandatory extrapolation to other countries or regulatory systems. Even so, in several Latin American and European countries, Brazilian references and regulations in Orofacial Motricity have been adopted as a basis for defining the field.

This expanded analysis has thus far made it possible to identify the existence of two main designations used to refer to the field of practice of professionals who intervene in OMDs and OMT across different countries. Orofacial Myology was found to remain more closely associated with English-speaking contexts, where it is often described as a field of study or discipline [49,82,83,90], and is practiced by different professional categories according to local educational and regulatory arrangements. Orofacial Motricity, in turn, is established in Brazil as a specialty within SLP, with a specific professional delimitation; moreover, in several Latin American and European countries, this same logic of linking the field to SLP/Speech and Language Therapists/Logopedics/Speech Therapy has also been observed [6,8,9,11,13,16,17,100,101,102,103,104,105].

From this terminological standpoint, Orofacial Myology and Orofacial Motricity do not operate as direct synonyms, since they tend to carry different institutional scopes and levels of coverage depending on the country and the professional-regulatory arrangement. In several institutional sources, greater emphasis is placed on the description of clinical conditions and interventions (e.g., OMDs/OMT) than on the formal definition of the “field” as a discipline. In contrast, in Brazil, and in some Latin American and European countries, it became clear that Orofacial Motricity is recognized primarily as a field/area. Thus, the purpose of this manuscript is not to replace consolidated traditions in other countries, nor to erase the historical and institutional trajectory of Orofacial Myology in contexts in which this nomenclature has structured education, certification, and clinical practice, but rather to promote greater uniformity in the term used to designate the field within SLPs, especially in contexts in which the nomenclature Orofacial Motricity is already present, undergoing consolidation, or being introduced, through formal consensus-building processes that present definitions and scope boundaries in a transparent and reproducible manner within the scope of international SLPs.

This terminological misalignment was also reflected in the exploratory database search. Greater retrieval was observed for studies using the designation Orofacial Motricity (n = 153) and its English and Spanish equivalents (Orofacial/Oral Motricity; Motricidad Orofacial) than for the designation Oral/Orofacial Myology (n = 20). In descriptive terms, the Orofacial Motricity family was 7.65 times higher in retrieved volume within the five-year period (n = 153 vs. n = 20), representing 88.4% of the combined total of records for both terminological families (153/173), whereas Oral/Orofacial Myology accounted for 11.6% (20/173). Additionally, in the main Ibero-Latin American databases consulted, the designation Oral/Orofacial Myology and its equivalent translations into Portuguese and Spanish (Miologia/Miología Oral/Orofacial) showed particularly limited retrieval within the same time frame (n = 4 across SciELO, Redalyc, and Dialnet combined), pointing to lower regional circulation of this terminological family in these databases.

Despite this, these findings should be interpreted only as descriptive indicators of record retrieval, according to the search strategies and filters applied by the authors in the databases consulted for this publication, and not as a bibliometric estimate of the field’s scientific production. This interpretation is warranted in light of the heterogeneity in platform coverage, the duplicate retrieval of records across databases, variation in the search fields/indexes consulted, and the possibility that relevant journals in the field (e.g., the International Journal of Orofacial Myology and Myofunctional Therapy [IJOM] and Revista CEFAC: Current Evidence on Feeding, Audiology, and Communication) may not be indexed uniformly across all databases. Based on this retrieval pattern, the overall set of findings is compatible with the hypothesis that there is greater homogeneity in the use of the lexicon Orofacial Motricity as the designation for the field of practice in Latin-language countries (Portuguese, Spanish, Italian) and within SLP, whereas in English-speaking countries (United States, United Kingdom, Australia), Orofacial Myology retains centrality, coexisting with designations anchored in the field and designations oriented toward condition and intervention (e.g., OMDs/OMT) within a multiprofessional arrangement. Even so, within the last five years, the retrieval of records associated with this terminological family (Orofacial Myology) proved to be low even in international databases with broader circulation in English-speaking contexts, which may reflect lexical dispersion across multiple labels, limitations in coverage and indexing, and possibly lower contemporary circulation or reduced centrality of this term in part of the literature. This pattern, however, does not in itself support a hierarchical reading of these terminological traditions, nor does it allow them to be treated as fully equivalent outside their contexts of use.

Beyond a semantic discussion, this divergence reflects distinct professional arrangements. In several contexts, competencies related to orofacial functions are organized as an area/field within the “speech professions,” with institutional structures and educational programs that explicitly designate Orofacial Motricity as a domain, for example, the Orofacial Motricity Department of SPTF and the Orofacial Motricity Department of SBFa, as well as postgraduate programs and complementary training initiatives that adopt Orofacial Motricity as a specialization area in some countries in Europe (Spain, Portugal, Italy) and Latin America (Chile, Peru, Colombia, Paraguay) [9,13,16,18,20,105,106,107,108,109,110,111,112]. In contrast, in part of the North American context and in related educational initiatives, the topic is often organized around OMDs/OMT, within an interprofessional framework in which different professional backgrounds participate in the provision of services and certifications [51,52,83,85,86,87,88,89,90]. This difference, however, should not be interpreted as a sign of lesser robustness in the tradition associated with Orofacial Myology, but rather as an expression of different ways of organizing the field, its professional boundaries, and its conceptual architecture. This dichotomy supports the need for conceptual and terminological standardization that distinguishes field–clinical condition–intervention, as well as for explicit terminological mapping to enable scientific comparability and the organization of this field within SLPs across different countries.

To understand the roots of this heterogeneity, it is necessary to recognize that the terminological diversity observed internationally arises from distinct educational traditions, the historical influence of different curricular frameworks, and the fragmented evolution of clinical practices over time. In operational terms, many of these labels “collapse” distinct levels (field–clinical condition–intervention) or privilege only one fraction of the domain, which helps explain the variability observed. Although the historical legitimacy and contribution of all these designations to the development of the area are acknowledged, none of them fully and integratively encompasses the anatomical, physiological, neuromuscular, functional, behavioral, and intersystemic complexity that characterizes the contemporary understanding of Orofacial Motricity. In this sense, the terminology adopted preferentially/by consensus to designate this area should be capable of conveying, accurately and integratively, the breadth of the structures and functions related to the orofacial and cervical regions, as well as their practical, scientific, and educational implications. A designation aligned with these principles has strategic political-institutional potential to enable international terminological unification, the consolidation of shared competencies, harmonized educational frameworks, and stronger professional representation before regulatory bodies, scientific associations, and health systems. The adoption of a standard term, therefore, has scientific relevance, direct clinical impact, and structural importance for the global positioning of this area.

Moreover, considering professional education and practice in SLP, the standardized adoption of terminology contributes to conceptual coherence and to a common language across education, regulation, and practice, thereby reducing ambiguities that affect communication and professional collaboration [113,114]. Empirical evidence in the field of Orofacial Motricity shows that, as the area expands and becomes institutionalized, education tends to be organized through diverse offerings, with descriptive variations in designations and scopes, which reinforces the value of stable terminological references for educational and professional comparability [115]. Terminological heterogeneity, in turn, tends to hinder the synthesis and generalization of evidence and interoperability across information systems, thereby affecting scientific comparability and the organization of care [116]. From a professional standpoint, the explicit presence of a standardized nomenclature in curricula, continuing education records, and competency certification tends to strengthen institutional recognition before regulatory bodies and health systems and to reduce uncertainty regarding boundaries of practice [117].

Likewise, the systematic use of terminology in scientific output, including articles, books, book chapters, clinical guidelines, protocols, technical materials, and institutional documents, is essential to ensure the traceability and visibility of knowledge production [118,119] in the field. The use of a term as a descriptor, keyword, and indexing category in national and international databases will make it possible for studies related to the field to be identified accurately [120], retrieved in bibliographic searches, and included in systematic reviews, meta-analyses, and evidence mappings [121]. The absence of such terminological uniformity fragments the literature, makes the identification of relevant studies and their systematic retrieval more difficult, and compromises evidence synthesis and the formulation of evidence-based recommendations. In this context, the field is at a decisive moment for moving in this direction through a globally standardized terminological structure with the potential to enhance scientific credibility and social impact. The adoption of a unified terminology may help raise levels of evidence, expand comparative analyses, strengthen knowledge production, and advance the scientific recognition of the field, with clearly established methods and conceptual foundations.

3.2. Proposal and Next Steps: Pathways Toward Convergence

This group proposes that progress toward international convergence in the field should be conducted through a periodic Virtual International Forum, conceived as a formal body for deliberation and governance of this work. It is recognized, however, that other institutions and groups may adopt alternative harmonization strategies, according to their regulatory contexts, educational priorities, and scientific traditions. In this direction, the convergence proposed here presupposes greater transparency in clarifying correspondences, limits of use, and conceptual levels among the nomenclatures currently in circulation. In the model proposed here, decisions would be made during the Forum’s virtual meetings, with explicit documentation of the proceedings (e.g., minutes/draft minutes, decision matrix, and timeline), and with the establishment of international working groups including representatives from different scientific societies, regulatory bodies, researchers, and academic/clinical professionals. The central objective will be to develop a minimum terminological framework that operationally specifies three conceptual levels: (i) field of practice/area (disciplinary domain and set of competencies), (ii) clinical condition (what is described/identified and, when applicable, diagnosed), and (iii) therapeutic intervention/approach (what is carried out in clinical practice). Such clarification may reduce ambiguities and overlaps, especially when historically consolidated designations come to be used interchangeably to refer simultaneously to the field and the treatment, or when they do not sufficiently encompass the current scope of practice.

At the operational level, this group proposes that the Virtual Forum deliberate on and coordinate four sequential stages. First, the Forum will define and approve the work plan and commission a scoping review specifically focused on terminology, covering: (a) designations for the field/area, (b) terms referring to clinical conditions, and (c) terms referring to therapeutic intervention/approach, with systematization of existing definitions, variations in use, conceptual gaps, and institutional frameworks. Second, based on the findings of this review, the Forum will deliberate on the design of the international consensus process, including its scope, participants, languages, item matrix, agreement criteria, transparency strategies, and dissemination plan. Third, the Forum will conduct the consensus process using structured methods carried out entirely in a virtual environment (e.g., modified Delphi, nominal group technique in synchronous sessions, and/or virtual consensus meetings with explicit documentation of decisions), with the aim of producing a consensus statement that operationally defines and delimits the three conceptual levels of the domain, including minimum criteria for terminological use, a multilevel glossary, and mapping of the designations used across different countries/languages. Fourth, after consolidation of the deliberations, the Forum will organize the publication and updating of the outputs, including a final version for submission to a scientific journal, public availability of supplementary materials (e.g., glossary and terminological tables), and periodic reviews to keep the framework aligned with scientific advances and the needs of health systems.

Subsequently, from the perspective advocated here, it is suggested that the consensus recommendations be gradually incorporated into educational curricula, continuing education programs, scope/competency documents, and clinical guidelines, so that standardization will not remain merely conceptual, but will also extend to education and care delivery. Finally, this process should remain dynamic, with cycles of reassessment defined by the Forum itself, thereby ensuring continuous updating and international applicability.

4. Conclusions

This position paper argues that international convergence will depend, first and foremost, on operationally clarifying the distinction among three conceptual levels—(i) field/area, (ii) clinical condition, and (iii) therapeutic intervention/approach—as well as on mapping equivalences among the designations used across different countries and institutional traditions. By reducing overlaps and cross-interpretations, this framework may increase communicative coherence, support more stable definitions of scope and competency, and provide a more robust basis for guidelines, education, and scientific comparability across educational and professional systems.

Given this context and the growing demands of the field, the future development of an international consensus aimed at standardizing terminology, scope of practice, and professional skills/competencies may bring substantial benefits to the field, with direct impact on educational and care quality as well as on interdisciplinary communication. The adoption of a unified nomenclature, articulated with global parameters for education and practice, will likely foster scientific production, expand international comparability across curricula, strengthen the development of public policies, and reinforce the professional identity of Orofacial Motricity.