Orthodontic treatment, whether with braces or clear aligners, is incredibly effective at moving teeth into their ideal positions to create a straight, beautiful smile. For many, this marks the end of their journey. However, for some, the celebration is short-lived as teeth begin to shift back towards their original places, a frustrating phenomenon known as orthodontic relapse. But what if the cause of crooked teeth isn’t just the teeth themselves, but the muscles surrounding them?

This is where myofunctional therapy comes in. It’s a specialised field that acts as a crucial partner to orthodontics, addressing the underlying muscular habits and dysfunctions that can compromise treatment. By correcting the function of the tongue, lips, and facial muscles, this therapy helps ensure that orthodontic results are not only achieved but also remain stable for a lifetime.

The Unseen Forces: Why Teeth Move in the First Place

Teeth are not rigidly fixed in the jawbone. They are held in place by ligaments and are constantly subjected to forces from the surrounding muscles. The tongue, lips, and cheeks are in a perpetual state of balance. When these muscles function correctly, they exert gentle, harmonious pressures that help maintain proper dental alignment.

However, when there is an imbalance—an orofacial myofunctional disorder (OMD)—these forces can work against the teeth. Common OMDs include:

• Incorrect Tongue Posture: A low-resting tongue that sits on the floor of the mouth instead of the palate.
• Tongue Thrust: The habit of pushing the tongue against the front teeth during swallowing.
• Mouth Breathing: Chronic breathing through the mouth instead of the nose, which affects facial development and tongue position.
• Improper Chewing and Swallowing: Dysfunctional patterns that place undue stress on the teeth and jaw.

These habits can be powerful enough to push teeth out of alignment. An orthodontist can straighten the teeth, but if these underlying muscle patterns are not corrected, it is like fixing a crooked fence without addressing the soil erosion that caused it to lean. The problem is likely to return.

The Role of Myofunctional Therapy as a Supportive Partner

Myofunctional therapy works in tandem with orthodontic treatment to address these root causes. It can be implemented before, during, or after orthodontic work to enhance the outcome and ensure long-term stability.

1. Creating a Stable Environment Before Treatment

For some patients, particularly children, undergoing myofunctional therapy before getting braces can be highly beneficial. By correcting issues like a tongue thrust or promoting nasal breathing early on, the therapy helps to guide facial growth in a more favourable direction.

This pre-orthodontic work can sometimes simplify the subsequent orthodontic treatment, potentially reducing the time a patient needs to wear braces. It clears the path by removing the negative forces that would otherwise be working against the orthodontist’s efforts.

2. Assisting Progress During Orthodontic Treatment

When performed during orthodontic treatment, Myofunctional Therapy acts as a powerful ally. While the braces or aligners are busy moving the teeth, the therapy is retraining the muscles to support this new alignment.

• Correcting Tongue Thrust: If a patient has a tongue thrust, they are pushing against their front teeth thousands of times a day with every swallow. This constant pressure can slow down orthodontic progress or even prevent the teeth from moving into the correct position. Myofunctional exercises teach a proper swallowing pattern, where the tongue pushes up against the palate, removing this counterproductive force.
• Establishing Nasal Breathing: Mouth breathing leads to a low tongue posture, which fails to provide the internal support needed for the upper arch. This can result in a narrow palate and crowding. Myofunctional therapy helps patients establish a consistent lip seal and breathe through their nose, allowing the tongue to rest on the palate and support the arch width created by the orthodontist.

By harmonising muscle function with the mechanical forces of orthodontics, treatment becomes more efficient and predictable.

3. The Key to Long-Term Stability: Preventing Relapse

Perhaps the most critical role of myofunctional therapy is in preventing orthodontic relapse. After braces are removed, patients are given retainers to hold the teeth in their new positions. Retainers are excellent at resisting movement, but they are a passive solution. They contain the teeth but do not fix the underlying problem.

If a patient still has a strong tongue thrust or a low tongue posture, their muscles will continue to wage a subtle war against the retainer. Over time, if retainer wear becomes less consistent, the muscular forces can win, causing teeth to shift and crowd again.

Myofunctional therapy provides an active solution. By retraining the muscles of the mouth and face to function correctly, a balanced oral environment is created, where natural forces support the new alignment. The tongue, resting on the palate, acts as a natural, internal retainer for the upper arch, while sealed lips provide gentle, guiding pressure from the outside. When the muscles are working for you instead of against you, the chances of long-term stability increase dramatically.

A Holistic Approach for Comprehensive Health

The benefits of combining myofunctional therapy with orthodontics extend beyond just straight teeth. This integrated approach contributes to overall health and well-being.

• Improved Airway and Breathing: Promoting nasal breathing and maintaining proper tongue posture helps to keep the airway open, which can reduce the risk of snoring and sleep-disordered breathing.
• Better Jaw Function: Correcting muscle imbalances can alleviate strain on the temporomandibular joint (TMJ), thereby reducing symptoms such as jaw pain, clicking, and headaches.
• Enhanced Facial Aesthetics: Proper muscle function supports balanced facial development, contributing to a more harmonious facial profile.

Is Myofunctional Therapy Right for You?

If you or your child are considering orthodontic treatment, it is worth exploring whether an orofacial myofunctional disorder might be present. Signs to look for include:

• Habitual mouth breathing, especially during the day.
• An open-mouth posture at rest.
• Visible tongue pushing between the teeth when swallowing or speaking.
• A history of orthodontic treatment followed by relapse.
• Difficulty with chewing or messy eating habits.

Consulting with an orthodontist who works with myofunctional therapists can provide a comprehensive evaluation. They can determine if addressing muscle function is a necessary component of your treatment plan.

Building a Smile That Lasts

Orthodontics is a remarkable tool for creating beautiful, functional smiles. However, for that smile to last a lifetime, it needs to exist in a balanced and harmonious environment. Myofunctional therapy provides the foundation for that balance by addressing the powerful but often-overlooked influence of our oral muscles.

By pairing the mechanical science of orthodontics with the neuromuscular re-education of myofunctional therapy, patients receive a truly comprehensive solution. This partnership approach not only straightens teeth more efficiently but also empowers patients with the tools to maintain their results naturally, paving the way for a stable, healthy smile that stands the test of time.