The International journal of orofacial myology: official publication of the International Association of Orofacial Myology

Publications in this journal

• Article: A one-page orofacial myofunctional assessment form: a proposal.

  Licia Coceani Paskay
  [show abstract] [hide abstract]
  ABSTRACT: The author presents her own proposal of a one-page orofacial myofunctional assessment and for each item on the list a brief rationale is provided. The protocol is an easy but comprehensive form that can be faxed or emailed to referral sources as needed. As science provides more objective assessment and evaluation tools, this one-page form can be easily modified.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2012; 38:27-37.
• Article: Research and clinical findings--a wholistic view.

  Marvin L Hanson
  [show abstract] [hide abstract]
  ABSTRACT: Valuable information is available to clinicians both from research articles, and reports from clinicians. Both sources have limitations. Research, with the exception of longitudinal studies, tends to isolate a variable or two from the whole, limiting its usefulness. Clinical techniques reported are sometimes biased, and perform well for certain therapists in certain settings, and not so well for others. Interrelationships are important among variables such as dentition, anatomy, physiology, oral muscle functions, oral rest postures, eating, and speech. Each affects the others. Equally important are interrelationships among all the specialists who treat patients with orofacial myofunctional disorders. A wholistic approach to the evaluation and treatment of orofacial disorders is advocated.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2012; 38:4-7.
• Article: The "Interdisciplinary Orofacial Examination Protocol for Children and Adolescents": a resource for the interdisciplinary assessment of the stomatognatic system.

  Diana Grandi
  [show abstract] [hide abstract]
  ABSTRACT: The Interdisciplinary Orofacial Examination Protocol for Children and Adolescents (Protocolo de exploración interdisciplinaria orofacial para niños y adolescents, Barcelona, 2008) is very useful in providing a fast, initial, expedient detection of possible morphological and functional disorders, and to guide the patient toward the appropriate professionals. With this tool it is possible to detect the risk factors which can negatively affect morphological and functional harmony and guide patients toward the necessary treatment as early as possible. This Protocol, developed by 4 orthodontists, 1 ENT and 3 speech language therapists, also contributes to the unification of concepts and nomenclature used by distinct specialists, thus making professional understanding easier and more dynamic.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2012; 38:15-26.
• Article: MBGR protocol of orofacial myofunctional evaluation with scores.

  Irene Queiroz Marchesan, Giédre Berretin-Félix, Kátia Flores Genaro
  [show abstract] [hide abstract]
  ABSTRACT: The MBGR Protocol with scores was first published in 2009. This protocol was widely administered by speech-language pathologists experienced in orofacial myology in different states from Brazil for four months. From the comments and suggestions of these professionals, the protocol was reviewed and modified. A consistent visual training materials program was prepared, and speech-language pathologists, experienced in orofacial myology from different states of Brazil, Venezuela, Peru, and Colombia were trained with the provided materials. These speech-language pathologists administered the protocol for two years. From the data collected by the speech-language pathologists, modifications were made, and a final version was designed. This final version was administered for two-months by the same speech-language pathologists from Brazil, Venezuela, Peru, and Colombia in order to re-test the final version of MBGR protocol. The aim of this study was to demonstrate the efficiency and effectiveness of the protocol to assess orofacial myofunctional alterations. The final version of the MBGR protocol with scores has proven to be efficient and effective in the identification of individuals experiencing orofacial myofunctional disorders.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2012; 38:38-77.
• Article: Basic dental information needed for the OFM initial occlusal evaluation.

  Marjorie L Snow
  [show abstract] [hide abstract]
  ABSTRACT: It is incumbent upon the orofacial myologist to evaluate the presenting client's occlusion and detect any behaviors which may be influencing the alignment of the dentition or interfering with the treatment plan of the referral source. In order to accomplish these tasks, it is necessary to share some common terminology and to effectively communicate between all the participants involved in the treatment plan. The purpose of this article is to assist in accomplishing these goals.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2012; 38:8-14.
• Article: Lingual frenulum protocol with scores for infants.

  Roberta Lopes de Castro Martinelli, Irene Queiroz Marchesan, Giédre Berretin-Felix
  [show abstract] [hide abstract]
  ABSTRACT: An experimental protocol model for frenulum evaluation was first designed, and administered to ten infants in 2010. After obtaining the data and statistical analysis, the protocol was re-designed and administered to 100 infants. The aim of this study is to present an efficient and effective lingual frenulum protocol with scores for infants. From the experimental protocol model, a new protocol was designed. One speech-language pathologist, and specialist in orofacial myology, administered the new protocol to 100 full-term infants. All steps of the protocol were recorded and photographed. The data collected was sent to two specialists in the area, who evaluated the cases based on the recordings and photographs. The data from the three evaluations were compared. A two-part protocol was designed to evaluate the lingual frenulum in infants. The first part consists of clinical history with specific questions about family history and breastfeeding. The second part consists of clinical examination: anatomo-functional, non-nutritive and nutritive sucking evaluations. A new lingual frenulum protocol with scores for infants was designed, and has proved to be an effective tool for health professionals to assess and diagnose anatomical alterations of the lingual frenulum, and its possible interference with breastfeeding.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2012; 38:104-12.
• Article: Lingual frenulum protocol.

  Irene Queiroz Marchesan
  [show abstract] [hide abstract]
  ABSTRACT: An efficient lingual frenulum protocol with scores is presented. From a specific lingual frenulum evaluation used until 2004, a new protocol was designed. Ten speech language pathologists experienced in orofacial myology used the new protocol with different groups of subjects. 1235 subjects were evaluated during 3 years. From the experience of these ten speech language pathologists, the protocol was re-structured, and a scoring system was added. Absence of alteration (normal tongue and frenulum) was scored zero. The alterations observed were scored in ascending order. Four additional speech language pathologists experienced in orofacial myology were trained by the researcher to administer the final version of the protocol. The protocol was administered in 2008 and 2009 to 239 subjects: 160 children between 7 years and 2 months old and 11 years and 7 months old; and to 79 adults from 16 years and 8 months or older. From the results of administration of the protocol, a new lingual frenulum protocol with scores was designed. According to the scores, the frenulum can be considered altered or normal. When the sum of general tests is equal or higher than 3, the frenulum may be altered. The interference of the lingual frenulum in the oral functions may be considered when the sum of the functional tests is equal or higher than 25. This new lingual frenulum protocol with scores was designed and has been an efficient tool to diagnose an altered lingual frenulum.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2012; 38:89-103.
• Article: Sample of a client intake information protocol: a synopsis and rationale.

  Shari Green
  [show abstract] [hide abstract]
  ABSTRACT: The utilization of standardized comprehensive forms in the field of orofacial myology is crucial as this profession continues to grow and establish assessment and treatment protocols. This article formally presents a comprehensive health history intake form currently in use, and highlights the rationale for each particular question within this form in an effort to explore the evidence-based theory behind each question utilized. Highlighting the importance of obtaining a thorough health history as it pertains to our profession, personally allows the clinician to ultimately best plan a therapeutic strategy and assess the individual criteria necessary for successful orofacial myofunctional habituation.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2012; 38:78-88.
• Article: Feeding therapy for children with food refusal.

  Fumiyo Tamura, Takeshi Kikutani, Reiko Machida, Noriaki Takahashi, Keiko Nishiwaki, Ken Yaegaki
  [show abstract] [hide abstract]
  ABSTRACT: Disabled children suffer not only from their primary disease, but also from other complications, including food refusal. The purpose of this study was to elucidate the relationship between these conditions and food refusal in disabled children. The effectiveness of feeding therapy in treating food refusal was also examined. The study subjects were 67 disabled children (35 boys and 32 girls; mean age at initial examination: 6.5 years, SD: 6.0 years) who attended the Nippon Dental University Hospital between April 2004 and August 2008. Of them, the 13 subjects who were diagnosed as those who refused food received feeding therapy combined with desensitization therapy for hypersensitivity. Approximately 20% of the subjects showed food refusal symptoms. Primary disease, respiratory impairment and gastroesophageal reflux were not causes of food refusal in this population. There was a significant relationship between food refusal and hypersensitivity (p = 0.021). After receiving feeding therapy, six of the seven subjects with hypersensitivity but without dysphagia at initial examination recovered from food refusal. Food refusal did not significantly correlate with tube feeding. Hypersensitivity and/or tube feeding may induce food refusal. For subjects with these conditions, feeding therapy combined with desensitization therapy is effective in achieving recovery from food refusal.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2011; 37:57-68.
• Article: International Association of Orofacial Myology History: origin - background - contributors.

  Christine Stevens Mills
  [show abstract] [hide abstract]
  ABSTRACT: These milestones of the history of the International Association of Orofacial Myology (IAOM), its founders and many of the major contributors are presented in this article. Personal reflections are provided by individuals who were instrumental in the formation of IAOM.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2011; 37:5-25.
• Article: Myths that persist about orofacial myology.

  Robert M Mason
  [show abstract] [hide abstract]
  ABSTRACT: This article addresses many myths that have persisted over the years in dentistry and orofacial myology regarding the nature of orofacial myofunctional disorders (OMD's). Myths include 1) the concept that the term "tongue thrusting" includes the rest posture; 2) that there is an excessive amount of pressure exerted against the anterior teeth in swallows, that swallowing pressures add up, and the frequency of swallowing has an impact on the dentition; 3) the idea that the tongue is the strongest muscle in the body; 4) the view that a muscle will be the winner in any tug of war between muscle and bone; 5) the claim that a tongue thrust can cause an open bite malocclusion; 6) the claim that a tongue thrust can cause a Class II malocclusion; 7) the claim that the tongue molds the palatal vault; 8) the notion that a low tongue tip posture at rest presents a problem; and 9) the claim that OMD's represent a muscle imbalance that can be brought into balance with therapy. Each of these false claims or "myths" is discussed and corrected, with the positive acknowledgement that clinicians are abandoning the incorrect notion of muscle balance and imbalance as had been claimed previously.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2011; 37:26-38.
• Article: IJOM celebrates the 40th anniversary of the International Association of Orofacial Myology (IAOM).

  Patricia Taylor
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2011; 37:3-4.
• Article: Influence of mandibular morphology on the hyoid bone in atypical deglutition: a correlational study.

  Almiro J Machado, Agrício N Crespo
  [show abstract] [hide abstract]
  ABSTRACT: evaluate the possible correlation with the radiographic position of the hyoid bone and mandibular angle in lateral radiographs of children with atypical deglutition. This was an observational study using cephalometric analysis of lateral teleradiographs for the distances of H-MP (hyoid to mandibular plane). Spearman's correlation analysis was performed with MA (mandibular angle) in two groups: the experimental group with atypical deglutition and the control group normal deglutition. Both groups included subjects in mixed dentition stage. there was a significant moderate negative correlation between MA (mandibular angle) and hyoid bone (H-MP) in the normal group (R = -0.406, p = 0.021). However, there was no significant correlation between the MA and H-MP (R = 0.029, p = 0.83) in the group with atypical deglutition. there is a moderate negative correlation between the position of the hyoid bone and mandibular angle in the group of normal swallowing and there is no correlation between variables H-MP and MA in the group of atypical swallowing.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2011; 37:39-46.
• Article: Horns, whistles, bite blocks, and straws: a review of tools/objects used in articulation therapy by Van Riper and other traditional therapists.

  Pam Marshalla
  [show abstract] [hide abstract]
  ABSTRACT: The use of tools and other objects in articulation therapy has been bundled into new groups of activities called "nonspeech oral motor exercises" (NSOME) and 'nonspeech oral motor treatments' (NSOMT) by some authors. The purveyors of these new terms suggest that there is no proof that such objects aid speech learning, and they have cautioned students and professionals about their use. Speech-language pathologists are trying to reconcile these cautions with basic Van Riper type therapy routines. The purpose of this literature review was to summarize the ways in which tools/objects were used by Van Riper and other speech professionals between 1939 and 1968. Fourteen textbooks were selected for review. Van Riper and other developers of traditional articulation therapy regularly used a wide variety of tools/objects in articulation therapy. Tools/objects were used when other auditory, linguistic, and cognitive means failed to stimulate correct phoneme productions. To call these activities "non-speech" methods seems to misrepresent the historic purpose objects have served in articulation therapy. More empirical research is required in this area.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2011; 37:69-96.
• Article: Standardization of the registration and analysis of mastication: proposal for clinical application.

  Silvia Fernandes Hitos, Dirceu Solé, Maria Cecília Periotto, Maria Lúcia T N Fernandes, Luc L M Weckx, Zelita C F Guedes
  [show abstract] [hide abstract]
  ABSTRACT: The purpose of this study was to verify the inter-rater agreement level as a means of obtaining an efficiency measure of a standard mastication evaluation through video recordings. The studied population included oral breathing children and teenagers with maxillary atresia. The chewing aspects studied were mode of chewing and preferential chewing side. A white tag was placed on half the subjects' chins while the recordings were made. Two expert evaluators analyzed 54 video recordings at regular viewing speed. The lead author analyzed the same video recordings both at reduced speed and at reduced speed linked through graphical computing techniques. The analysis was conducted on chewing cycles with the viewing angle of the frontal plane. Findings indicated that when comparing the data for the three manners of watching the video recordings, the agreement level was higher for videos with the tag on the chin watched at reduced speed. It was also determined that alternating and bilateral mastication modes were prevalent (64.7%) in this sample.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2011; 37:47-56.
• Article: Quantitative evaluation of tongue protrusion force.

  Renata Maria Moreira Moraes Furlan, Amanda Freitas Valenti, Tatiana Vargas de Castro Perilo, Cláudio Gomes da Costa, Márcio Falcão Santos Barroso, Estevam Barbosa de Las Casas, Andréa Rodrigues Motta
  [show abstract] [hide abstract]
  ABSTRACT: The tongue plays an important role in the functions of speech, mastication, swallowing, and breathing. The tongue helps in the maintenance of proper dental alignment and arch stability. Adequate strength is essential for the tongue to perform these tasks. Recently the Biomechanical Engineering Group from Universidade Federal de Minas Gerais, Brazil, developed a device to improve tongue strength evaluation. The purpose of this study is to describe and compare the main results obtained in tongue protrusion force measurements in different age groups using this new device. Fifteen healthy subjects were given a qualitative evaluation and determined to have normal tongue strength. They were separated by age in three groups: children, adults and elderly. They were then given a quantitative evaluation. Maximum and average forces were analyzed. The time taken to reach maximum force was also assessed. Higher values of maximum and average tongue force were obtained in the adult group, followed by the elderly group and the group of children. Older subjects had greater tongue force when compared to children. However, there were statistically significant differences in the average force and in the maximum force only between children and adults. Time taken to reach maximal isometric force was longer in the elderly group and shorter in the group of children than in the group of adults although no statistically significant difference was found between groups.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2010; 36:33-43.
• Article: Submental muscle tissue compliance during relaxation, contraction, and after tone-modification interventions.

  Heather M Clark, Nancy Pearl Solomon
  [show abstract] [hide abstract]
  ABSTRACT: Deviations in muscle tone are presumed to accompany speech motor control deficits in select forms of dysarthria, although there is little confirmation of these associations. For patients experiencing neuromuscular impairments, therapeutic interventions and/or principles have been devised to alleviate tone deviations where they occur and to prevent the development or exacerbation of tone deviations. Potentially therapeutic effects of these interventions on muscle tone in the speech musculature have not been studied empirically. One reason for the paucity of research is that tools for assessing muscle tone in the speech musculature are not generally available. This pilot study explored the feasibility of a commercially available, handheld instrument for measuring submental muscle compliance during relaxed and active conditions in 16 women with normal speech and swallowing. Additionally, the study examined changes in muscle compliance when interventions presumed to impact muscle tone were applied to the submental region. The Myotonometer was sensitive to changes in tissue compliance related to active contraction of the submental musculature. Applying ice or vibration to the submental region resulted in no systematic changes in submental tissue compliance in the relaxed or contracted state. Additional research is needed to validate the use of this instrument to reliably assess muscle tone and other contributors to tissue compliance. If successful, studies should examine the sensitivity of the Myotonometer to assess intervention-induced tissue compliance changes in patient groups with suspected muscle tone impairments. Further study of intervention effects across muscle groups and dosage levels can help inform clinical decisions about the potential usefulness of tone-altering interventions for the orofacial musculature.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2010; 36:6-15.
• Article: A lateral cephalometric x-ray study of selected vertical dimensions in children with atypical deglutition.

  Almiro J Machado, Agrício N Crespo
  [show abstract] [hide abstract]
  ABSTRACT: Atypical deglutition (tongue thrust swallowing) has been thought by some to be an etiological factor related to dental malocclusion, especially changes related to excessive increase in vertical facial growth. The purpose of this study was to investigate this possible relationship between atypical deglutition and vertical facial growth by documenting the lower, middle and upper facial areas of children with atypical deglutition. 55 lateral cephalometric radiographs were analyzed and measured in each of two groups of subjects according to standardized facial plane angles between the (I) palatal plane and mandibular plane, (II) palatal plane and occlusal plane, (III) mandibular plane and occlusal plane, (IV) skull base and Frankfurt plane, and (V) mandibular angle. The experimental group was comprised of 55 subjects with atypical deglutition, while 55 subjects with normal swallowing were used as a control group. The linear/angular measurements were subjected to Mann-Whitney statistical test with a significance level of 5%. Results: The average angle of the variables I, II, III and IV are, respectively: 29, 14, 14 and 9 degrees in both groups. There were no significant differences in the variables studied in the normal and atypical swallowing groups. However, for variable V there were 3 degrees of difference between the groups, which was statistically significant. The results of this study suggest that the problem of atypical swallowing may be of functional origin and not associated with anatomical changes seen in vertical growth patterns.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2010; 36:17-26.
• Article: Speech-language pathology findings in patients with mouth breathing: multidisciplinary diagnosis according to etiology.

  Patrícia Junqueira, Irene Queiroz Marchesan, Luciana Regina de Oliveira, Emílio Ciccone, Leonardo Haddad, Maria Cândida Rizzo
  [show abstract] [hide abstract]
  ABSTRACT: The purpose of this study was to identify and compare the results of the findings from speech-language pathology evaluations for orofacial function including tongue and lip rest postures, tonus, articulation and speech, voice and language, chewing, and deglutition in children who had a history of mouth breathing. The diagnoses for mouth breathing included: allergic rhinitis, adenoidal hypertrophy, allergic rhinitis with adenoidal hypertrophy; and/or functional mouth breathing. This study was conducted with on 414 subjects of both genders, from 2 to 16-years old. A team consisting of 3 speech-language pathologists, 1 pediatrician, 1 allergist, and 1 otolaryngologist, evaluated the patients. Multidisciplinary clinical examinations were carried out (complete blood counting, X-rays, nasofibroscopy, audiometry). The two most commonly found etiologies were allergic rhinitis, followed by functional mouth breathing. Of the 414 patients in the study, 346 received a speech-language pathology evaluation. The most prevalent finding in this group of 346 subjects was the presence of orofacial myofunctional disorders. The most frequently orofacial myofunctional disorder identified in these subjects who also presented mouth breathing included: habitual open lips rest posture, low and forward tongue rest posture and lack of adequate muscle tone. There were also no statistically significant relationships identified between etiology and speech-language diagnosis. Therefore, the specific type of etiology of mouth breathing does not appear to contribute to the presence, type, or number of speech-language findings which may result from mouth breathing behavior.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2010; 36:27-32.
• Article: Confirmational study: a positive-based thumb and finger sucking elimination program.

  Shari E Green
  [show abstract] [hide abstract]
  ABSTRACT: This article emphasizes the critical need for information specifically regarding the topic of retained sucking behaviors. The study aimed to confirm results provided by Van Norman of 723 subjects in 1997. Parent surveys were collected on 441 subjects who received an orofacial myofunctional treatment program provided by one certified orofacial myologist. Results of this study do confirm that retained digit sucking behavior may be addressed successfully and expediently by a program based on positive behavior modification techniques.
  The International journal of orofacial myology: official publication of the International Association of Orofacial Myology 11/2010; 36:44-59.