Dental profile: Bridget O’Connor

In a new feature for Irish Dentistry, Siobhan Kelleher interviews members of the dental profession for insights and opinions into the world of dentistry. Here, Bridget O’Connor discusses the advantages of myofunctional therapy

How did you get involved with myofunctional therapy?

I learnt about myofunctional therapy in 2010, when my husband Tony and I became interested in determining the actual causes of crooked teeth. He has undertaken extensive postgraduate training all over the world to deepen his orthodontic understanding.

During our research, it became clear to us that nasal breathing, correct tongue resting posture, lip seal, and four to eight hours of teeth lightly touching a day were imperative for normal craniofacial growth and development. Myofunctional therapy became the perfect adjunct therapy for us.

Why is myofunctional therapy so important?

Myofunctional therapy is a treatment modality that recognises and addresses dysfunctional oral habits that lead to poor airway, inadequate craniofacial growth and crooked teeth. It has been widely practised, particularly in Brazil, where there are more than 30 universities doing PhD-level research.

It is now proven that from birth, the muscles of the lips and tongue are designed to exert repetitive inward and outward forces respectively on growing and developing facial bones. When the tongue resting posture is correct the apex should rest upon the incisive papilla or ‘spot’ while the tongue body adopts a broad, flat, horseshoe shape across the palate. This posture exerts a continuous, sagittal and bilateral pressure on the malleable maxilla, which, in the growing child, gently moulds and reflects it.

Myofunctional therapy became the perfect adjunct therapy for us

In adulthood, it continues to support the architecture. Normal growth pattern and tongue rest posture ensure that the upper jaw develops to fit comfortably over the lower jaw, similar to a lid sitting comfortably upon a box. Normal facial growth is forward and downward, and together with keeping the tongue in an elevated resting posture, it increases the oropharyngeal volume – thus enhancing airway patency.

If the orofacial muscles behave abnormally, however, airway may be negatively affected, bone alignment will be distorted, and emerging teeth crooked!

What are the causes of orofacial myofunctional dysfunction?

Some of the causes of orofacial myofunctional dysfunction are mouth breathing, incorrect tongue resting posture, poor lip seal, tongue thrusting, infantile swallowing, tethered oral tissues or frenums (TOTs), non-nutritive sucking habits (thumb, cheek, tongue, clothing etc), neurological and developmental abnormalities, and birth trauma.

What are the goals of myofunctional therapy?

•    Eliminate dysfunctional mouth breathing and restore nasal breathing
•    Establish correct tongue resting posture
•    Normalise the deviant tongue thrust swallow, which can create anterior and posterior open bites, as well as speech problems
•    Address snoring and sleep breathing disorders such as obstructive sleep apnea (OSA) by improving the tonicity of the oropharyngeal region. Exercises have proven invaluable for OSA and continuous positive airway pressure (CPAP) intolerant patients
•    Address TOTs as they restrict tongue and lip function
•    Correct dysfunctional habits such as bruxing and clenching
•    Encourage normal chewing habits
•    Create balance and harmony in the entire orofacial, respiratory and postural musculature.

What does treatment entail?

Treatment commences with habit elimination and/or jaw stabilisation exercises followed by an eight-week intensive phase, after which I see patients at two-, three-, and four-week intervals for general maintenance. Subsequent monthly appointments are designed to habituate positive orofacial patterns. Normalisation is achievable through accurate repetition of specific exercises, a little like taking the face to the gym, or facial physiotherapy!

What are the benefits of integrating myofunctional therapy into the practice?

Integrating myofunctional therapy into our practice has augmented the quality of treatment and care we offer our patients.

Orthodontic results are generally more stable, with improved outcomes for those presenting with airway, tempororomandibular joint disorders (TMJ) and sleeping problems. It has greatly deepened my appreciation of nasal breathing, airway, and muscle function to enhance the health and wellbeing of ourselves, and particularly our children.

Bridget O’Connor is Ireland’s first myofunctional therapist. She has been teaching myofunctional therapy for the last three years at her husband’s dental practice in Cork – O’Connor Dental Health – where she was practice manager for more than 14 years. Prior to this she taught biology and chemistry for 20 years to senior honours level.

Siobhan Kelleher RDH is the owner of Dentalhygienist.ie. She practices in Co Cork, Ireland and is a member of the Irish Dental Hygienists Association and continuing education officer on committee. She was awarded Best Dental Care Professional at the 2014 Irish Dentistry Awards and was highly commended at the 2015 Irish Dentistry Awards for Best Child Dental Health Initiative.