IN FOCUS
Oral Sensory Awareness Centric Orofacial Myofunctional Therapy
What is OSAcOMT?
It is a therapy modality proposed by an airway and sleep orthodontist and an orofacial Myofunctional Therapist.
It was borne under the concept that behaviors produced by the brain like mouth breathing, tongue thrusting, open mouth or low tongue posture, etc. are hardwired and learned behaviors out of necessity that is difficult to reverse without using the right stimulus or cortical input to retrain the lower part of the brain to react less defensively.
It is focused on the use of sensory receptors in the oropharyngeal complex to send safety cues to the various parts of the limbic system in the brain, leading to the appropriate adaptive behavior in the form of oral motor output even in the presence of dysfunction.
It follows the principles of neuroplasticity and is the multisensory approach.
What is NEUROPLASTICITY?
The Dark Side of Neuroplasticity
Orofacial Myofunctional Behavior (OMB)
It is a survival-oriented reflex produced by the brain in response to a stimulus from nasal obstruction, palatal constriction, tongue restriction, and jaw retrusion
Our brain is our third set of parents. It is always trying to keep us safe by assessing our internal and external environment for threats (Neuroprotection).
When the Limbic System (the Amygdala in particular) perceives a stimulus (reduction in the Nasal Airway for example), it will trigger a fight or flight response.
The default defensive response more often than not is mouthbreathing.
The brain remembers this because the hippocampus, together with the amygdala is part of the limbic system that is instrumental in regulating emotion, memory, and the autonomic nervous system.
Every time there is the perception of the reduced airway, even just wearing a face mask, the limbic system will remember to default to mouth breathing.
Through repetition and dysfunction, this becomes HARDWIRED.
This maladaptive behavior can be established enough to become habitual or default behaviors even in the absence of the original threat that started the automatic response.
This is the dark side of Neuroplasticity.
What do we do to overcome the HARDWIRED
default behaviors?
Retraining the limbic system to respond less defensively to past triggers is an important strategy to overcome hardwired behaviors.
In short, we need to change the way the brain’s default defensive responds to perceived threat or danger by creating new wiring to prune away the old wiring created by the fight or flight response (Amygdala Hijack).
Before you read on, we thought you might like to download our 4 Isometric Activities for the Sleep Bruxer Patients for FREE. Isometric activities place a strain on specific muscles without moving the encompassing joints. By applying steady strain to the muscles, isometric activities can be valuable for working on physical endurance and posture by reinforcing and balancing out the muscles. This will give you the tools to enhance the well-being of your clients, students, and yourself.
From Oral Sensation To Brain Perception To Oromotor Function
The brain does NOT generate its own information.
It relies on sensory neurons found on receptors (sensation) to provide itself with information to process.
This information is sent to the brain for processing (perception).
The brain then recruits the appropriate muscles and glands to perform and coordinate functions.
By stimulating the right sensory receptors, we can send safety cues to the brain to adapt an appropriate behavior in the form of motor output (new wiring).
Doing this will keep the brain from automatically and habitually maladapting in the presence of dysfunction.
Introducing...
Oral Sensory
Awareness
Centric
Orofacial
Myofunctional
Therapy
A system based therapy focused on the use of sensory receptors in the Oropharyngeal Complex to command the muscles to perform a particular function or group of functions while protecting the upper airway.
Orofacial Myofunctional Therapy
-----Practice Makes Perfect
It follows the principle of neuroplasticity which states that with increased biological activity, both function and structure involved in the behavior can be enhanced.
Disorders from survival-oriented reflex (learned behavior out of necessity) result in compensations.
Due to these compensations, some muscles will be behaviorally hyperactive and biologically inactive.
Muscle development is one of the most important steps in this therapy in developing oral motor skills.
The main focus of the therapy is to provide sufficient excitation (changes in tone and length) that can be detected by special sensory neurons called proprioceptors whose job is to inform the brain about any kind of muscular activity.
Proprioceptive information feeds back to the brain where it influences the firing of the motor neuron as it makes its way up to the cerebral cortex where it gives you the perception of muscle position and fine-tunes its strength to speed up oral-motor integration.
Oral Sensory Awareness
-----Practice Makes Permanent
Oropharyngeal muscles operate in a sequential, coordinated, and synchronized motor activity (rhythmicity).
Orofacial Myofunctional Disorders (OMD) disrupt the coordination of chew, breathe and swallow in kids and adults, and suck, swallow, and breathe in newborns and infants.
The treatment modality is about introducing a new flow of information (rewiring) from the oropharyngeal receptors via the sensory neurons to the motor system via the brain in order to produce a function in the presence of dysfunction (hardwiring).
It takes advantage of oral sensory awareness in order for the brain and muscles to develop and work together (sensorimotor integration).
It consists of sequential activation of different sensory receptors in the mouth to generate specific muscle movements involved in the coordination of functions.
The brain learns best when it is learning what it needs to survive through repetition, repetition, and repetition (Neuroplasticity).
The MyoCEO Mentors
Jennifer Tuazon,
BSDH
Jennifer is a passionate Airway-Centric Dental Hygienist who advocates for the essential role of Orofacial Myofunctional Therapist in the management of both pediatric and adult sleep-disordered breathing. For her, the airway, the mode of breathing, and craniofacial formation are interrelated during growth and development. A crooked airway is known to be a contributing factor to deviant facial growth patterns and she believes that early intervention and control of airway obstruction through Oral Sensory Awareness Centric Orofacial Myofunctional Therapy |OSAcOMT which she is a proponent of, will enhance the lives of children. A philosophy she has taught with fellow enlightened ENTs, Pulmonologists, Sleep Doctors, Airway Centric Orthodontists and Dentists, SLPs, and fellow dental hygienists, nationally and internationally. She also sees and co-manages patients suffering from SDB here and abroad.
Alissa Mcfall, MS, CCC-SLP
She is a licensed-language pathologist (CCC-SLP), a certified Orofacial Mycologist (COM), and is studying for Certification in Lactation. I specialize in connection as it relates to the fundamental core skills of breathing, eating, and speaking functionally. I have a passion to support professionals, parents, children, and family members to thrive in the world we live in.
Ranilo Tuazon, DDS, certOrtho, D.ABDSM
Dr. T is a prolific advocate of Airway Orthodontics and Dental Sleep Medicine who helps kids develop beautiful faces that produce healthy smiles and straight teeth that can breathe well, eat well, and sleep well. For the past 31 years in private practice and 3 years in academic Orthodontics, he has helped educate as many patients, parents, and professionals about the benefits of Airway Focused Dentistry/Orthodontics.
An open and functioning airway is his top priority in the well-being of children, teens, and adults. He practices a philosophy that integrates airway into all TMJ, orthopedic, orthodontic, and periodontic diagnoses and treatments. He has taught this method to other dentists orthodontists, and medical doctors through seminars, workshops, and mini-residencies nationally and internationally.
Margaret Crawford, M.S., CCC-SLP
She is a licensed and certified speech-language pathologist (SLP) with specialized experience in orofacial myology. Her team works to support children and families with skills to yield optimal functional development and strive to create an improved neural network for communication, speech production, feeding and swallowing disorders.
Mouth Breathing
Facts
” nasal obstruction that forces mouth is a potential risk factor for sleep-disordered breathing “
-Sleep Disordered Breathing
(Young T, Finn L, Kim H, 1997)
“mouth breathing due to nasal obstruction decrease masticatory efficiency “
-Weak Chewing Muscles
(Nagaiwan M, Gunjigake K, Yamaguchi K., 2016)
” mouth breathing is related to abnormal swallowing “
-Atypical Swallow
(Zhonghua Kou, Qlang YI, Xue Za Zhi., 2013)
Malocclusion
Facts
” malocclusion is a swallowing and respiratory pattern disorder phenomenon due to malfunction and maladaptive tongue “
-Crooked Airway
Crooked Teeth
(Knosel M, Et Al., 2012)
” malocclusion is an expression of atypical swallow due to an altered tongue position & movement “
-Crooked Swallow Crooked Teeth
(Rogers JH 1961)
Goals
” in principle, to influence behavior, either modify the existing circuits (rewire) or generate new circuits “
-Rewire
(Kolb, B., Gibb R., & Robinson, T. E., 2003)
” place the survival-oriented reflex under conscious control through sensory cues “
-Rewire
(Shananhan Et Al, 1993)
” …willful or conscious control through oral sensory awareness aimed at modification of a patterned response “
-Rewire
(Rosenbek Et Al., 1996)
Pathways
optimizing pathways to nasal breathing
optimizing pathways to integration of senses with Oropharyngeal actions
optimizing pathways to coordination of chew breathe and swallow
optimizing pathways to keep the autonomic nervous system out of prolonged state of defense
optimizing pathways to promote breathing pauses during swallowing
optimizing pathways to prevent aspiration and pulmonary complications
The most rapid period of brain growth and its period of highest plasticity is in the last trimester of pregnancy and the first two years of life.
Before OSAcOMT
Tongue thrust swallow.
Uncoordinated breathe
and swallow.
After OSAcOMT
Correct tongue swallow.
Coordonated breathe
and swallow.