How OMT and Orthodontic Treatment Work Together

If your orthodontist has recommended orofacial myofunctional therapy alongside your child's braces or other orthodontic treatment, you may wonder how these two treatments connect. The relationship between OMT and orthodontics is significant, and combining both approaches often produces better, more stable results.

The Role of Muscles in Tooth Position

Teeth are not fixed in solid bone. They sit within the jawbone surrounded by periodontal ligament, which allows them to shift position in response to consistent pressure. Orthodontic appliances like braces and aligners use controlled pressure to move teeth into better positions.

However, the muscles of the tongue, lips, and cheeks also exert pressure on teeth throughout the day and night. The tongue alone exerts approximately four pounds of pressure each time we swallow, which happens over 2,000 times per day. When these muscles function improperly, they can counteract orthodontic treatment or cause teeth to shift back after treatment ends.

This is why addressing the muscle function through OMT is so important for orthodontic success. The muscles and the appliances need to work together, not against each other.

How Tongue Thrust Affects Orthodontic Treatment

Tongue thrust occurs when the tongue pushes forward against or between the teeth during swallowing. This repeated forward pressure can push front teeth forward, create gaps between teeth, or prevent proper bite alignment.

For children in braces, tongue thrust creates an ongoing battle. The braces apply pressure to move teeth into proper position, while the tongue applies pressure in the opposite direction. This can slow treatment progress and extend the time needed in braces.

Even more concerning is what happens after braces are removed. Without addressing the tongue thrust pattern, the tongue continues pushing against the teeth. Retainers help, but they cannot fully counteract thousands of tongue thrusts daily. This is a primary cause of orthodontic relapse, where teeth shift back toward their original positions.

Why Open Bite Is Particularly Challenging

Open bite occurs when the front teeth do not meet when the back teeth are together, leaving a gap between the upper and lower front teeth. This condition is often directly related to tongue thrust and low tongue posture.

Orthodontically correcting an open bite without addressing the underlying tongue position has a high relapse rate. The tongue sitting between the teeth or thrusting forward maintains the pattern that created the open bite in the first place.

OMT teaches proper tongue resting position on the roof of the mouth and correct swallowing patterns. This removes the force that created and maintained the open bite, allowing orthodontic correction to hold stable.

Timing of OMT and Orthodontic Treatment

The ideal timing for OMT varies depending on the individual situation. Some orthodontists prefer to complete OMT before beginning orthodontic treatment so that proper muscle function is established from the start. This approach can make the orthodontic treatment more efficient.

Other cases call for OMT during orthodontic treatment. The therapist and orthodontist work together, with OMT addressing the muscle patterns while braces or aligners move the teeth. This coordinated approach ensures the muscles support rather than fight the tooth movement.

OMT after orthodontic treatment is sometimes necessary when muscle dysfunction was not identified earlier. Even after braces are removed, retraining the muscles can help maintain the orthodontic results and prevent relapse.

The Mouth Breathing Connection

Chronic mouth breathing affects more than just breathing patterns. It influences facial development, tongue posture, and swallowing patterns, all of which impact orthodontic treatment.

Children who mouth breathe typically have a low tongue posture because the tongue drops to allow air to flow through the mouth. This low position fails to provide the natural palatal expansion that comes from the tongue resting on the roof of the mouth.

OMT addresses mouth breathing by establishing nasal breathing habits and proper tongue resting position. This supports orthodontic goals by encouraging proper jaw development and maintaining palatal width.

What to Expect from Combined Treatment

When OMT and orthodontic treatment work together, you will have two providers coordinating care. The orthodontist manages the appliances and monitors tooth movement. The orofacial myofunctional therapist teaches exercises to retrain muscle patterns.

Communication between providers is important. The OMT therapist may need to know about orthodontic progress, and the orthodontist may adjust treatment based on improvements in muscle function.

Home practice is essential for OMT success. Your child will have daily exercises to complete between therapy sessions. These exercises gradually become habits, replacing the problematic patterns with proper function.

Measuring Success

Success in combined treatment looks like several things happening together. Teeth move into proper position with orthodontic treatment. Your child learns to keep their tongue on the roof of the mouth at rest. Swallowing occurs with the tongue pressing up rather than forward. Nasal breathing becomes the default pattern.

The long-term measure of success is stability. When both the teeth and the muscles are in proper position and function, the results of treatment should remain stable over time. This is the goal of combining OMT with orthodontic care.

Questions to Ask Your Orthodontist

If your child is beginning orthodontic treatment, ask whether orofacial myofunctional issues might affect their case. Specifically, ask about tongue thrust, tongue posture, mouth breathing, and any habits like thumb sucking.

If your orthodontist recommends OMT, ask about the recommended timing and how the two providers will communicate. Understanding the treatment plan helps you support your child through both therapies.

For children who have already completed orthodontic treatment, OMT can still help if teeth are beginning to shift or if tongue thrust and other patterns persist. It is never too late to address muscle function, though earlier intervention typically produces easier and faster results.