For the tongue thruster, the therapy program aims to establish a normal dental freeway space through habituating appropriate tongue- and lips-together resting postures (oral rest postures). While these important oral rest postures are being established, the patient is taught the mechanics of a correct swallow. This new swallowing muscle pattern is trained and habituated with saliva, liquid & solid swallows.
This is achieved by:
- Creating an awareness of selected musculature
- Reshaping/toning appropriate musculature
- Developing normal neuromuscular functions
- Establishing a routine to achieve habituation
The program is made up of eight structured therapy sessions. During each session, home-based exercises are taught in the office and given to the patient to be executed at home. The exercises are designed to be sequential and hierarchical, can be completed quickly and many of the exercises can be folded into one's daily routines.
Initially, the therapy sessions are scheduled every two weeks to allow the patient to absorb & understand the concepts, do the work and allow muscle memory to develop. Once the patient demonstrates consistent appropriate oral rest postures and a proper saliva swallow, therapy can then be scheduled weekly to move the patient through the program if the more frequent schedule is desired.
As the patient moves through the program, the saliva swallow is transferred to liquids then to solids. Constant communication between the patient and the therapist is maintained to help with clarification, maintain focus and ensure successful completion of the program.
After the completion of the eight intensive therapy sessions, the patient is placed on a maintenance program to ensure habituation of the tongue & lip resting postures, consistent use of the correct swallowing pattern for saliva / liquids / solids and stabilization of the oral cavity. This is highly important to ensure that 'ortho relapse' doesn't occur - opening up of the bite. The maintenance therapy sessions are scheduled one month, three months then five months out from the eighth therapy session. Research has demonstrated it takes a year to a year and a half for muscle, ligament and tendon memory to habituate and stabilize.
Not only oral rest postures are adjusted in therapy but body posture is also addressed. Proper body posture with the head in correct alignment supports and maintains the desired tongue resting posture within the oral cavity.
For the digit sucker, the therapy program is the development and implementation of a behavior modification program between the child and the parent(s) with the clinician guiding the process. Scheduled rewards are given throughout the program for non-intentional sucking with longer periods between reinforcers. This program is carried out at home and into other environments the child engages in.
The Sucking Elimination Program will only work if the child is emotionally ready to give up the finger, thumb, tongue or pacifier sucking habit. This can be as early as three; it is best to eliminate the habit by the age of five.
Parental involvement and supervision is key to ensure that their child carries out their individualized therapy program. Parents also are instrumental in helping their child maintain a positive attitude and dedication to achieve their goals.
For both the tongue thruster and the digit sucker, establishing a normal dental freeway space is the overall goal. This ensures that appropriate dental-facial development will be achieved and maintained, especially with the young patient.
Scientific studies have shown that treatment for Orofacial Myofunctional Disorders can be 80-90% effective in achieving appropriate tongue and lip resting postures and habituating a correct swallowing pattern. These conditions are stable and are retained years after completing therapy (source: IAOM).
For the child, teenager or adult patient, compliance and dedication to either of the programs is key. The treatment is non-invasive, inexpensive and directly treats the problems -not the symptoms. It's easy, affordable and life changing!