Frequently Asked Questions

What can be achieved with Orofacial Myofunctional treatment?

The goals of orofacial myofunctional therapy are to eliminate habits (such as thumb/finger sucking, tongue thrusts etc), and establish:

• An optimal resting tongue position
• Adequate lip seal at rest
• A typical pattern of swallowing
• Bilateral chewing and correct drinking habits
• Nasal breathing, with lips together
• Good neck and head posture

Elimination of habits and use of healthy oral behaviors can also decrease periodontal disease, and reduce the risk of orthodontic relapse (your teeth moving after the removal of dental appliances)

Strengthened muscles and correct tongue placement also has a positive effect on your facial appearance.

Orofacial myofunctional has also been proven to be successful as an adjunct in treating snoring, mild to moderate OSA (Obstructive Sleep Apnea), SDB (Sleep Disordered Breathing) as well as some TMD (Temporomandibular joint disorders)

What are Orofacial Myofunctional Disorders (OMD)?

OMD are disorders that include at least one of the following:

• Incorrect placement of the tongue at rest (tongue may rest between front teeth, or on floor of the mouth)
• An open mouth rest posture (lips are not closed together at rest)
• Any sucking habit, such as thumb sucking, finger, lip or tongue sucking

Why be concerned about OMDs?

OMDs can cause:

• Dental malocclusions (teeth not closing properly)
• Atypical pattern of swallowing (tongue thrust swallowing pattern with saliva, liquids and solids)
• Difficulty chewing food (“sloppy eaters”)
• Mispronunciation of sounds (i.e. lisp)
• Improper facial growth patterns (development of a long face, retruded chin)
• Jaw joint pain
• Weak lips

In children, OMDs are linked to a disruption of the dental development.

What is a typical tongue placement?

As you read this brochure, it is expected that your tongue should rest comfortably against the roof of your mouth and the tip of your tongue should be right behind your front teeth. Importantly, your upper and lower teeth should not touch, allowing a resting dental freeway space. Your lips are closed, you are breathing comfortably through your nose with your hands away from your face.

Any changes to those typical tongue and lip resting postures, caused either by an airway issue blocking continuous nasal breathing, prolonged sucking habit of thumb/finger/pacifier, nail biting habit, or leaning your face on your hand, can disrupt the dental freeway space. Research has shown that only a few hours of increased resting dental freeway space a day can result in unwanted, permanent changes of dental development.

Can’t orthodontic treatment alone restore the placement of my teeth?

Orthodontists or dentists can realign your teeth and restore your smile, but they do not retrain your tongue to rest in the right spot, switch to nasal breathing or eliminate habits. Over time, it is likely that the habits or behaviors that have initially disrupted your dental development will continue to do so.

How are OMDs treated?

Exercises are customized for every patient’s needs. Breaking habits is a difficult task, and success in therapy depends greatly on individual motivation and commitment to the therapy program.

Testimonials

Nicky was so wonderful helping my daughter with exercises to support her before and after frenectomy. She is extremely knowledgeable, gentle, kind, and funny. My 13-year-old daughter felt very comfortable with her and her instructions were clear and concise. We got the results we were looking for and are so grateful for her support! Highly recommend.

As a parent of a 16 year old daughter who required myotherapy treatment, I could not have asked for a more professional, compassionate, "cheerleader" than Nicky. After 2 applications of full-mouth braces, it was finally recommended that we seek out this therapy from the "best in the business," Nicky. She was truly a Godsend! Nicky's approach was always encouraging and supportive which truly helped my teen to stick with the program (not an easy task for many teenagers!). During every visit, we learned something new about this very complicated process and the diligence needed to be successful. After several weeks of treatment there was a measurable improvement in her bite and her chewing abilities! I truly wish that Nicky had become involved with my daughter's care prior to her second set of braces. The "pain" both to my daughter (and my wallet!) might've been completely avoided! Thank you, Nicky! You are the best!

I have nothing but great things to say about my daughter’s experience with Nicolette Enhörning-Picton. My daughter not only is tongue tied but also had tongue thrusting issues, because of this both her dentist and her orthodontist recommended we see Nicky for help. From the first meeting, I could tell this was someone who cares deeply about her work and also her patients. We talked through reasons why I did not feel like at this time my daughter could get a frenotomy and laid out the best plan for the best results despite that hiccup. She met with my daughter weekly, at each meeting measuring success from the week prior and giving homework to effect change for the coming week. Nicky was not only supportive and enthusiastic about the work my daughter was putting in to make changes but she also passed that enthusiasm along to my husband and me so we could be better cheerleaders for our daughter. I am happy to say that our daughter is now in the maintenance phase with her tongue work. With the knowledge, Nicky was able to impart and the work our daughter put in they were able to effect real, long-term change in her oral health. I would wholeheartedly recommend Nicky to anyone looking to make similar changes. I have to admit I got really used to seeing her weekly and miss her upbeat and cheerful personality, it has been a pleasure working with her.

It was a lucky day when a dentist gave me Nicolette's card. I had spent years in largely fruitless efforts to cure my sleep apnea. Tried CPAP, various drugs, all kinds of "sleep hygiene," and even learned to play the didgeridoo. Everything helped somewhat, but not enough. I was still sleeping only 2-3 hours at a stretch, the night a tortured patchwork of tossing about in bed or up and wandering the house. Nicolette is astonishingly knowledgeable about all the muscles, structures and processes of the mouth, cheeks, lips, tongue, palate, etc. With an array of simple but sometimes challenging exercises, she led me into new habits and strengths. It was been some months of on-again, off-again exercise on my part, met by steady, cheerful expertise and encouragement on her part. And it "took." There seems to be a substantial and lasting benefit. At this point, my uninterrupted sleep has more than doubled in length, and I am much more rested during the day. My wife says I sleep like a kitten, without snoring. A zillion thanks to you, Nicolette!