Lab for Determining Who Needs Myofunctional Therapy

1. Lab for Determining Who Needs Myofunctional Therapy Screening each other All patient images are to be used for educational purposes and by the AOMT only; To protect the privacy of the people who are featured in the case studies during the course, Please do not distribute any images via email, online, or otherwise without written permission of the AOMT.

2. Were they bottle fed and was a pacifier used?

3. WHAT HABITS DO THEY HAVE?

4. Leaning Habits Other Leaning Habits

5. Bruxing/Grinding/Clenching Do they grind their teeth at night or during the day? Do they clench their teeth at night or during the day?

6. Allergies/Congestion Is there congestion? What % of the time? Are any nasal sprays, inhalators, or medications used? What types? How frequently? Are any allergies present? Previous testing? Shots? % of time effected? Visible allergic eye rings? Pushes nose? Sneezing? Asthma? Episodes?

7. Are they mouth breathing or snoring?

8. What is their sleep position? Sleeping positions..stomach, right side, left side, back? What % of the time?

9. How is the bedding? Is it protected from dust?

10. Watch them eat & drink

11. Do they chew on both sides? Does the jaw shift?Does the tongue come up to meet the cup? Bi-Lateral Chewing No tongue to meet the cup

12. Look at the way their teeth meet

13. Do they have an overbite, open bite, cross bite, under bite, wearing on edges, over jet?

14. Palpate the masseter muscles Are they over or under developed? Is there symmetry when they bite?

15. Does the mentalis muscle activate when they swallow or close their lips?

16. The Grimace Is there a swallowing grimace?

17. Are the lips flaccid and weak? Is there a lip seal?

18. Check out the Frenum attachments…Are there any restrictions? Lingual Labial

19. Frenum Evaluation 1. Look at the palate. If it is high and narrow, is it because the tongue rests down? 2. Have the patient put their tongue in their cheek. Does the chin follow? 3. Have the patient open their mouth and put their tongue up. Does the mouth close more than half? 4. When they close their mouth, do they feel the back of their tongue up? 5. Does the tongue pull to one side when the tip is up and they open? 5.

20. Frenum Evaluation 6. Does the tip of the tongue pull in or down when the patient sticks their tongue out? 7. Is there a dip or pull down in the center of the tongue? 8. Is there the classic "heart shape" at the tip of the tongue? 9. Can the patient "clean" their molars with their tongue?

21. Determining need for Lingual Frenotomy First measure distance from incisor edge to edge Then measure same distance with tongue up Should be greater than 60%

22. Treating the Restricted Frenum Be sure you have an orofacial myofunctional therapist do a few weeks of exercises before the surgery Then make sure the patient will do some exercises immediately following the surgery to prevent re-attachment.

23. Do they strain to close their lips?

24. Or are they more comfortable with their mouth open?

25. Speech Patterns • Has there been any previous speech therapy? Describe • Is the speech of any concern to the patient or parent? • Mumbling/garbled speech? • Facial or lip adaptation to achieve word sounds? • Visible tongue positions? Anterior? Lateral? Which sounds? • Any anterior lisp? Lateral lisp? • Any jaw shift? Anterior? Left? Right? • Any wetness? Bubbles? • Poor air projection? Difficult to hear? Talks too fast? • Stuttering history?

26. Speech Patterns….have them say “Sister Sally said something”. Note: tongue position and shift

27. Speech….Do you hear a frontal or lateral “s” lisp? Jaw Shift/Incorrect tongue placement/Asymmetry of lip use

28. Do they drool?

29. Is their tongue resting on the floor of their mouth, in between their teeth or up in the palate?

30. Does the tongue rest up in the roof of the mouth?Is the tongue resting out of the mouth?

31. Posture Do they carry the head forward? Shoulders Slumped?

32. What does their back posture look like? What is the posture? Back Lordosis?

33. Do they have any special needs, handicaps, or family patterns?

34. Also look at how trauma affects the muscles Have there been any accidents or traumas which may cause a problem and require therapy? Is there “neuro- imaging” or imitating from watching a loved one? Is there a genetic pre-disposition? What medications are they taking that may interfere with muscle functions? Are they in pain, which may cause a dysfunctional patterning issue?

35. Where do we go from here? How to refer 1. Informed consent…”If you don’t see an OMT you can expect…” 2. “It is the ideal time to see an OMT because of the window of time we have during their growth spurt…” 3. “I work with the bones (or teeth). The OMT works with the muscles. If we are all on the same page, the treatment will be much more successful!” 4. “The habits that your child has can be successfully treated by a specialist who will save you time, money, and embarrassment”. “Your child will learn how to eat comfortably and neatly and their digestion and posture will improve.” 5. “If it were my child, (or my problem) I would definitely see an OMT because they deal with the cause of your problem.” 6. “Please read this brochure and see a OMT as soon as possible.”

36. Thank you very much for making me part of your team!