Oral myofunctional therapy

A philosophy of the treatment of tongue thrusting has been presented, along with a description of a therapy program. In geographic areas where such therapy has been provided over a number of years, it has been well accepted. Patients who do poorly in therapy coincide with those who have orthondtic relapse. Although tongue thrust may occasionally disappear spontaneously in patients receiving orthodontic treatment, the unpredictability of this outcome makes treatment a wise preventive procedure. Oral myotherapy may be administered by anyone who has the proper knowledge, training, and experience. Most therapists prefer to wait until the child is about 9 years old to begin treatment. Poor risks for treatment include patients with (1) long-standing nearnormal occlusions: (2) negative attitudes; (3) predominantly normal habit patterns; (4) mental or psychological disorders; and (5) uncooperative parents. A thorough orthodontic evaluation should precede treatment, and any conditions which mitigate against successful therapy should be remediated medically, surgically, or orthodontically before therapy begins. Usually, however, it is preferable to complete habit training before banding is begun. Eighty to 90 per cent of patients should complete treatment successfully and retain proper oral habits. The orthodontist should be wary of abbreviated training programs and should readily send the patient back to the therapist throughout treatment if any signs of relapse are detected. The role of the dentist in motivating the patient cannot be overemphasized. Whereas some patients are self-motivated, others need immediate reinforcement throughout therapy, such as behavioral-modification procedures offer. My approach to treatment entails a structured, yet flexible, program which uses learning theory principles. It requires a thorough diagnostic session plus at least nine weekly sessions, followed by recheck visits spaced gradually farther apart. Patients are seen periodically throughout orthodontic treatment. Follow-up studies have proved this to be an effective approach to the remediation of tongue thrust.