As a parent, you notice things. Maybe your child always seems to have their mouth open. Maybe their teacher says they are tired and unfocused in class. Maybe the orthodontist says the teeth keep shifting back after treatment, and no one can explain why.
These things can feel completely unrelated. Quite often, they are not.
Many of these signs point to a condition called an orofacial myofunctional disorder (OMD), a dysfunction of the muscles of the tongue, lips, and face that affects how a child breathes, swallows, speaks, and even grows. The good news is that these patterns are very treatable with a specialized exercise program called myofunctional therapy (OMT).
Below are 10 signs that parents most commonly overlook. You don’t need to recognise all 10; even two or three warrant a professional evaluation.
Sign #1: Mouth Breathing Even During the Day
What parents notice: The child’s mouth hangs open at rest. Lips are frequently dry and chapped. The jaw looks slack while watching TV or reading.
Why it matters: Nasal breathing filters, warms, and humidifies the air your child inhales. It also drives the tongue to rest on the roof of the mouth (the palate), creating the natural outward pressure that keeps the upper jaw wide. Chronic mouth breathing bypasses all of this and, over time, narrows the airway and reshapes developing facial bones.
The muscle connection: Mouth breathing is almost always linked to low tongue posture, the tongue rests on the floor of the mouth instead of the palate. Myofunctional therapy retrains the tongue to rest correctly and re-establishes nasal breathing as the default.
Look for: Lips that don’t close at rest, frequent chapped lips, open-mouth sleeping, and snoring.
Sign #2: Snoring or Noisy Breathing During Sleep
What parents notice: The child snores regularly, breathes loudly at night, or sounds like they are working hard to breathe while asleep.
Why it matters: Children should breathe quietly during sleep. Snoring in kids is not normal; it signals that the airway is narrowing or collapsing. Left untreated, this can develop into sleep-disordered breathing, leading to poor sleep quality and downstream effects on growth, mood, and attention.
The muscle connection: Weak tongue and throat muscles allow the airway to partially collapse during sleep. Myofunctional therapy strengthens these muscles and retrains the tongue to a position that keeps the airway open throughout the night.
Look for: Audible snoring, gasping or pausing during sleep, restless nights, waking up unrefreshed.
Sign #3: Tongue Thrusting When Swallowing
What parents notice: The child pushes their tongue forward against or between the teeth when swallowing food or saliva. The lips may pucker or strain visibly with every swallow.
Why it matters: A healthy swallow involves the tongue pressing upward against the roof of the mouth. Tongue thrust pushing forward instead places constant pressure on the front teeth, contributing to open bites, gaps, and orthodontic relapse (teeth drifting back after braces are removed).
The muscle connection: Retraining the swallow pattern is a core goal of myofunctional therapy. Correcting it removes the daily muscular force that undoes orthodontic work and keeps teeth in alignment long-term.
Look for: Front teeth that gap or flare, tongue visible between teeth during eating, orthodontist noting a persistent open bite.
Sign #4: A Persistent Lisp or Unclear Speech
What parents notice: The child substitutes a ‘th ‘ sound for ‘s’ (a frontal lisp), or speech is unclear and difficult to understand even after working with a speech therapist.
Why it matters: Many lisps have a structural or muscular root. The tongue is not positioned correctly for articulation because it lacks the resting posture or strength to do so reliably. Speech therapy trains the sound; myofunctional therapy treats the underlying muscle dysfunction that causes it.
The muscle connection: Tongue tip placement and strength directly affect the production of consonants like /s/, /z/, /l/, and /r/. OMT is commonly used alongside speech therapy for faster and more durable outcomes.
Look for: A lisp that has not resolved by age 7, speech that is hard to understand, tongue visible during speech sounds.
Sign #5: Prolonged Thumb Sucking or Pacifier Use Past Age 3-4
What parents notice: The child continues to suck their thumb or a pacifier well into preschool or kindergarten, often to self-soothe.
Why it matters: These habits exert sustained pressure on developing teeth and jaw bones. Beyond age 3-4, they can cause the upper front teeth to flare forward, create an open bite, and reinforce low tongue posture and mouth breathing habits.
The muscle connection: Myofunctional therapy helps extinguish the habit by addressing the underlying muscle pattern the tongue has not learned its correct resting posture and replacing the habit with functional alternatives.
Look for: Thumb sucking past kindergarten, visible changes to front tooth alignment, persistent need for oral stimulation.
Sign #6: Messy or Noisy Eating
What parents notice: The child chews with their mouth open, food frequently falls out, eating is noisy, or the child avoids certain textures and prefers only soft foods.
Why it matters: Efficient chewing requires coordinated lip closure, tongue movement, and jaw function working together. When these muscles are not functioning well, eating becomes messy and, in some cases, nutritionally limited if the child avoids harder or chewier foods.
The muscle connection: Lip seal and tongue coordination are foundational goals of OMT. Improved chewing function is often one of the first changes parents notice after their child begins myofunctional therapy.
Look for: Open-mouth chewing, food falling out frequently, strong texture aversions beyond typical picky eating.
Sign #7: Poor Posture, Especially a Head-Forward Position
What parents notice: The child holds their head forward with the chin jutting out, tends to slouch, or always seems to strain their neck.
Why it matters: This one surprises most parents. Mouth breathing causes children to tilt their head forward to open the airway, and over time, this becomes a habitual postural pattern that strains the neck, shoulders, and spine.
The muscle connection: Tongue resting posture, nasal breathing, and head position are functionally linked. Re-establishing nasal breathing and correcting tongue posture through OMT often improves head and neck posture as a natural downstream effect.
Look for: Head-forward stance during daily activities, frequent neck tension, and posture concerns raised by the child’s pediatrician.
Sign #8: Difficulty Concentrating or Chronic Tiredness
What parents notice: The child seems exhausted despite getting a full night of sleep, is flagged by teachers for attention or focus issues, or is consistently irritable and moody in the mornings.
Why it matters: Poor sleep quality from airway issues and mouth breathing reduces the amount of restorative sleep a child gets each night. The resulting symptoms, inattention, impulsivity, and hyperactivity, look almost identical to ADHD and are frequently misidentified.
The muscle connection: By improving airway muscle tone and restoring nasal breathing, myofunctional therapy can meaningfully improve sleep quality and, with it, daytime attention, behavior, and academic performance.
Look for: A child who is never rested, behavioral issues in the morning, and academic struggles despite obvious effort.
Sign #9: Narrow Dental Arch or Crowded Teeth
What parents notice: The orthodontist says the jaw is too narrow, there is not enough room for adult teeth to come in, or crowding is getting worse despite treatment.
Why it matters: The tongue resting on the palate creates gentle outward pressure that keeps the upper arch wide; it is nature’s palate expander. When the tongue rests low due to mouth breathing or poor posture, this pressure disappears, the arch narrows, and the result is crowding, crossbites, and the need for more intensive orthodontic intervention.
The muscle connection: Addressing tongue posture through OMT, ideally before or during orthodontic treatment, creates the muscular environment that allows teeth to align and stay aligned without constant retention.
Look for: an orthodontist recommending palate expanders or tooth extractions, progressively crowded teeth, and a narrow upper arch visible on dental X-rays.
Sign #10: Teeth That Keep Shifting After Orthodontic Treatment
What parents notice: The child completed braces or clear aligner treatment, but the teeth have started moving back. Retainers do not seem to be holding the result.
Why it matters: Orthodontic treatment moves teeth into position, but it does not change the muscle forces that act on them every day. If tongue thrust, mouth breathing, or low tongue posture has not been addressed, those forces continue to push teeth out of alignment even against a retainer.
The muscle connection: This is one of the most compelling cases for myofunctional therapy. OMT addresses the root cause of orthodontic relapse by retraining the muscles that determined where the teeth ended up in the first place. At Owl Dentistry, myofunctional therapy and orthodontic treatment are coordinated so results last.
Look for: Teeth shifting within months of completing orthodontic treatment, gaps reopening at the front, retainer no longer fitting properly.
What Happens If These Signs Are Left Untreated?
Orofacial myofunctional disorders do not typically resolve on their own. Without intervention, the following patterns tend to develop over time:
• Continued orthodontic relapse requiring retreatment at high additional cost
• Progressive narrowing of the airway, increasing the risk of obstructive sleep apnea in adolescence and adulthood
• Speech issues that become increasingly difficult to correct with age
• Facial development that diverges from the child’s genetic potential due to chronic muscle dysfunction
• Chronic fatigue affecting academic performance, mood, and quality of life
The encouraging news is that these patterns are highly treatable, especially when identified early. The earlier myofunctional therapy begins, the less impact these patterns have on your child’s long-term development.
What Myofunctional Therapy at Owl Dentistry Looks Like
At Owl Dentistry in Bloomingdale, myofunctional therapy is delivered as part of our integrated orthodontic and whole-body approach to care what we call the Take3ForMe philosophy.
• Each program is tailored to the child’s specific pattern of muscle dysfunction
• Sessions are engaging and age-appropriate, not clinical or intimidating for kids
• Most children complete therapy in 12 to 20 sessions, with home exercises practiced between visits
• When orthodontic treatment is also needed, the two are coordinated to work together
• Parents receive clear guidance on how to support their child’s progress at home
Myofunctional therapy is appropriate for children ages 4 and older. Adults with mouth breathing, tongue thrust, TMJ issues, or sleep-disordered breathing can also benefit significantly.
Is Your Child Showing These Signs?
You do not need a diagnosis to reach out; that is exactly what the evaluation is for. If you recognized your child in two or more of the signs above, we would love to talk.
Book a complimentary myofunctional screening at Owl Dentistry today.
Frequently Asked Questions (FAQs)
At what age can a child start myofunctional therapy?
Myofunctional therapy is generally recommended for children ages 4 and older. The ideal window is before or during orthodontic treatment, when the jaw and muscles are still developing. Adults can also benefit; it is never too late to retrain these patterns.
How long does myofunctional therapy take?
Most children complete therapy in 12 to 20 sessions spread over several months, with short home exercises practiced between visits. The timeline depends on the severity of the dysfunction and how consistently exercises are performed at home.
Will insurance cover myofunctional therapy?
Coverage varies by insurance plan. Some plans cover OMT when it is medically necessary and prescribed by a physician or dentist. The team at Owl Dentistry can help you review your benefits and explore available options during your initial consultation.
Can myofunctional therapy fix my child’s lisp without speech therapy?
OMT and speech therapy address related but different things. OMT treats the underlying muscle patterns that cause incorrect tongue placement, while speech therapy trains the production of specific sounds. For many children, both together produce the best and most lasting results.
Does myofunctional therapy hurt?
Not at all. Sessions involve guided exercises for the tongue, lips, and facial muscles. The exercises are gentle, and most children find them manageable and even enjoyable. Owl Dentistry’s approach is designed to be engaging and age-appropriate for kids.
Can adults benefit from myofunctional therapy?
Yes. While early intervention produces the fastest results, adults with mouth breathing, tongue thrust, TMJ issues, or sleep-disordered breathing can see significant improvement through myofunctional therapy at any age.
How is myofunctional therapy different from speech therapy?
Speech therapy focuses on the sounds a child produces and how to correct them. Myofunctional therapy focuses on the underlying muscle function of the tongue, lips, and face that determine resting posture, swallowing, and breathing patterns. Many children benefit from both simultaneously.