By Sandra R Coulson, MS, ST, Ed, COM

Orofacial Myology (OM), or Orofacial Myofunctional Therapy (OMT), is the treatment of an orofacial muscle imbalance, incorrect swallowing pattern, TMJ muscle dysfunction and/or the elimination of bruxing, clenching or noxious oral habits like thumb sucking, nail biting or hair pulling. The main muscles of concern to the Orofacial Myologist include the temporalis, masseter, internal and external pterygoid, buccinator, orbicularis oris
and the mentalis. OMT involves exercises and stimulation designed to inhibit inappropriate oral behaviors and/or strengthen appropriate muscle function. Therapy is non-invasive, uses no drugs and has proven results.
Length of therapy depends on the severity and nature of the disorder. In most cases, therapy is a short-term process with the active stage of weekly treatments for three to six months with quarterly appointments over six to 12 months.

OMT may be necessary when there are indications that dental treatment or orthodontic intervention alone may not bring about the desired changes in oral behaviors. Adverse oral behaviors can often interfere with dental or orthodontic treatment and stability. Resting postures of the tongue, jaw and lips are very important in normal oral growth. When the tongue rests between the posterior teeth, they may not fully erupt, resulting in an anterior open bite. If the tongue rests against the anterior teeth, especially if the upper lip is short or weak, the teeth may protrude. When the lips are not closed, growth and development of the mouth can be adversely affected. One of the most common disorders, tongue thrust, is a pattern of swallowing where the tongue pushes forward and/or sideways against or between the teeth during swallowing. Swallowing occurs
hundreds of times each day with little to no conscious thought. When the tongue presses against or between the teeth during swallowing, the pressure can have adverse effects on the position of the teeth, bone growth, soft-tissue condition and muscle function.

Symptoms include:

  • Aerophagia,
  • Difficulty swallowing pills or firm foods,
  • Residual effect on the hard palate from a digital habit,
  • Chronic mouth breathing,
  • Continued nasal stuffiness,
  • Orofacial muscle strain and imbalance,
  • Chronic headaches or facial spasms or pain


Long-term non-nutritive sucking habits can also mal-form the oral structure. Sometimes poor speech patterns may indicate neurological or other physical deficits. OM therapists have received specialized training to evaluate and treat orofacial muscle disorders. Many clinicians have additional professional training in the areas of speech language pathology, dental hygiene, dentistry or other health-related fields. The IAOM regulates how course material is constructed and delivered, and oversees the certification process that assigns the credential of Certified Orofacial Myologist (COM).

Sandra Coulson has been practicing OM for over 40 years, and has been training others through the Coulson Institute under approval of the IAOM since 2003. The training that is being offered in Sydney, June 20-22, 2014, is recommended for Dentists, Orthodontists, RDH’s, and SLP’s. For more information and details about the upcoming course, contact the Coulson Institute at +1 (303) 759-2760, email or website at