Unveiling the Impact of Myofunctional Therapy: Sleep, Swallowing, and Oral Health

Embark on an enlightening journey with oral myologist Renata and myself, Dr. Rachel Carver, as we delve into the transformative world of myofunctional therapy. If you've ever wondered about the intricate connections between oral health and overall well-being, prepare to have your curiosity satisfied. Renata, transitioning from her career as a dental hygienist to a pioneering specialist in myofunctional therapy, introduces us to her innovative program myomove, which is revolutionizing patient care on a global scale. Together, we uncover the foundational exercises that strengthen oral facial muscles, crucial for everyday activities like chewing and breathing. This episode promises not just a discussion but a revelation of how myofunctional therapy confronts common health issues, including sleep apnea and dental relapse, enhancing lives one breath at a time.

This episode takes a deep look at the complex relationship between tongue ties, body work, and swallowing patterns. Renata sheds light on the nuanced nature of oral restrictions and how they affect normal function, guiding us through the conservative treatment options that prioritize function over aesthetics. We also explore the collaborative power of combining therapies such as osteopathy and craniosacral therapy, proving that when it comes to health, it truly takes a village. Listen as we address the far-reaching impacts of surgery for tongue ties, noting the essential role myofunctional therapy plays in preemptive and follow-up care, and how it can improve outcomes for those with hypermobility facing post-operative challenges.

Wrapping up our session, we spotlight the substantial benefits of myofunctional therapy, with a special emphasis on sleep-related difficulties. For many, this therapy offers a beacon of hope, paving the way to improved sleep quality through muscle strengthening and a focus on nasal breathing. It's an honor to have shared this space with Renata, who generously imparted her wisdom and broadened our understanding of this often-overlooked field. For anyone grappling with sleep issues or curious about the power of a holistic dental approach, this episode is an invaluable resource that could unlock the door to a better quality of life.

To follow Renata and get more information on her services find her on Instagram:

www.instagram.com/myomoves/

For more training and weekly educational webinars go to:

www.instagram.com/airwaycircle/

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To learn more about holistic dentistry, check out Dr. Carver's website:

http://carverfamilydentistry.com

To contact Dr. Carver directly, email her at drcarver@carverfamilydentistry.com. 

Want to talk with someone at Dr. Carver's office?  Call her practice: 413-663-7372

Disclaimer: This podcast is for educational purposes only. Information discussed is not intended for diagnosis, curing, or prevention of any disease and is not intended to replace advice given by a licensed healthcare practitioner. Before using any products mentioned or attempting methods discussed, please speak with a licensed healthcare provider. This podcast disclaims responsibility from any possible adverse reactions associated with products or methods discussed. Opinions from guests are their own, and this podcast does not condone or endorse opinions made by guests. We do not provide guarantees about the guests' qualifications or credibility. This podcast and its guests may have direct or indirect financial interests associated with products mentioned.

Transcript

Speaker 1: 0:00

Hello everyone and welcome back to another episode of the Root of the Matter. I'm your host, dr Rachel Carver. Today we are bringing on a wonderful oral myologist to discuss myofunctional therapy. So we've talked about this a little bit on the podcast before, why it's important, but we've never had somebody talk on exactly what it is. So thank you so much, renata, for coming on. Why don't you introduce yourself? Tell us a little bit how you got into this field and we'll go from there, of course.

Speaker 2: 0:33

So first of all, thank you so much for having me. I'm so excited to be here. So I am, by trade, a dental hygienist. I've been a dental hygienist since 2010. And my offunctional therapy kind of just fell in my lap when I was attending one of the dental conferences, and this was in 2016. Immediately, when I realized that there was so much more I could do for my patients, I was sold and I started studying oral facial myofunctional therapy. And I did not stop, and today I run myomove. It's an online myofunctional therapy program and we see patients all over the world.

Speaker 1: 1:18

I think that's really exciting because because it's a maybe newer type of therapy, a newer therapist that you're not going to have everyone in your backyard like you have a dental hygienist. So the fact that this is so amenable to online is incredible, so that you can reach everyone all over the globe, which is really exciting. So let's just dive into myofunctional therapy. How do you define that? What is myofunctional therapy?

Speaker 2: 1:46

So myofunctional therapy is a treatment modality for dental hygienists and speech pathologists. It is not a profession by itself per se. It's something that we learn outside of school. It is not taught in universities, so you have to seek on your own different courses and they are exercises that we give the patients for the oral facial muscles. So we're looking at cheeks, lips, tongue, oral pharynx all of the muscles of the head and neck to see how they can function better. So what are some functions that you do with these muscles? Chewing, swallowing, breathing all of these things are things that myofunctional therapists are going to address.

Speaker 1: 2:34

Excellent. So as we kind of progress in the world today and have more kind of holistic modalities, those of us dentists, hygienists we're seeing that we're not doing enough for our patients. Especially if you have adult patients, we see, hey, this patient spent how many years in braces and now they have relapse and they're still having problems. They've got sleep apnea. We're missing something. So now when you become aware of all these things, unfortunately as dentists and hygienists we're trained to look at teeth and gums, teeth and gums and not much else beyond that.

Speaker 1: 3:11

We don't even really get any education in sinus, certainly not very much sleep. Maybe today I've been out 20 years now but maybe they're learning a little bit more about sleep because we know how vital that is. But even today, as dentists, we are not able to diagnose sleep apnea. I mean this is right in our wheelhouse, right, but technically that is not a diagnosis that a dentist can give. Hopefully that will change again as more and more dentists and myofunctional therapists are understanding that the importance of everything works together. So when we're looking and we really want to take a holistic view with our patients, we really want to create overall health, we need to look at the tongue and the cheeks and the airway and the nasal passages, because that is what we want to achieve so oftentimes. Why are the teeth crooked in the first place? Right?

Speaker 2: 4:01

It's not just always genetic.

Speaker 1: 4:03

My teeth looked like that. Well, sure, sure, genes can play a partial role here. But what is problem? They're not breathing properly Right. They're mouth breathers. They are swallowing in properly Right. The tongue is not being placed properly Right. So the reason why the teeth become crowded is because we're not growing to our full potential Right.

Speaker 1: 4:26

And then some people have like an open bite, meaning the top teeth and the bottom teeth aren't closed, so there's like a little opening of space. And if you ask somebody who has that kind of condition to swallow, you'll see that the tongue pushes right out Right. Tongue is the strongest muscle in the body. So if you're not swallowing properly and your tongue is pushing on those upper teeth every single time you swallow, then the result is an open bite. So we can put braces on there and try to close that bite, but if we never fix why the bite was open in the first place, you're never going to fully be able to close that Right. So let's say we're looking at a child. What are the things, the obvious signs that somebody could need biofunctional therapy.

Speaker 2: 5:13

Number one are lips apart. So if your lips are apart at rest, lips should always be closed. Tongue should always be up. We should be breathing in and out through our nose. If somebody needs to open their mouth to breathe it's because there's something wrong with their nasal breathing. So we need to address breathing first. Breath is life. It's the first thing you do when you're born and it's the last thing you do before you die. It's take that breath. So our bodies are always trying to find how do we take the next breath and sometimes we go to extreme measures.

Speaker 2: 5:53

If you see some of these kids with sleep apnea and the body position during sleep which would open their airways so they can breathe, it's just insane. So first things first, always address nasal breathing. If your child is constantly having upper airway infections or has always a runny nose, we've got to find out. Why. Address allergies there's so much that we can do just at home eliminating dust and things from the bedroom that could be collecting dust, hypoallergenic sheets, getting an air purifier All of those things are going to improve the air quality and breathing during sleep, therefore improving sleep.

Speaker 2: 6:32

Most of these issues are not necessarily sleep issues. They're breathing issues. So if somebody has their lips open. That's the first thing I look for, besides that, whenever they are chewing. So if a child is eating and you're constantly reminding them to close their mouth, or food is coming out of the mouth as they're chewing, that's another red flag. Most kids that are not able to breathe well through their nose are going to eat very noisily and getting food all over their face because they cannot breathe and eat at the same time. So even though you keep telling them to close their mouth, they just can't do it because they have to be able to breathe. So again, we've got to just breathe. It always goes back to breathing. Violet, those are some of the things that we're looking at to start myofunctional therapy.

Speaker 1: 7:27

Fantastic. And also, what about lip ties, things like that? Is that something? Lip ties, lip ties? There's a lot of controversy. Do we cut it, do we not? And what I've come to believe is there are certain situations right, yes, that we need to remove them. If the baby isn't feeding, well, obviously we want them to feed. Breastfeeding is also important for developing that right nasal breathing right, because, as they're eating, the only way they can breathe is through the nose. So that's one of the other reasons why breastfeeding is so important. And also, by opening the mouth, is why to get on that breast? Right? We're also creating the right function. We're creating proper tongue function, right? So some of these people who have the tongue thrust or these tongue problems, if they were bottle fed, the tongue never really learned where it was supposed to be. So why is the tongue supposed to be resting on the roof of the mouth? Is there a physiological reason for that?

Speaker 2: 8:21

Yes. So the tongue is kind of like the foundation of your orificial structure. So think about a building with support beings. The tongue is your support beam. It's going to apply light pressure to the palate, which is your upper jawbone. It's called the maxilla. So by applying gentle pressure to the maxilla all day and all night, we're going to promote oral facial growth.

Speaker 2: 8:49

If you think about the way the orthodontist move teeth, it is slight but constant pressure. It is not just a big push like it is a swallow. So if it's light, constant pressure, that's actually worse if it's done incorrectly. So that's the significance of having your tongue up there. Also, if you suction your tongue to the roof of your mouth and you can try this at home try to take a breath into your mouth. You just can't because your tongue creates a vacuum seal with your palate and it does not allow any air to go through. So it makes you a nasal breather. And the more you keep your tongue up there, the more likely you are to breathe well through your nose and for your nose to work well, because if you don't use your nose you lose your nose. I just made that up. If you don't use your nose you're going to get a lot of dryness and then the tissues in there are going to swell up and then it's harder to breathe through your nose.

Speaker 1: 9:46

And I think that's one of the biggest problems we see today is that our maxilla, or upper jaw, is not growing forward enough. So ideally, the tongue we kind of call it, the spot, the little ridges that you can feel up on your palate, behind your front teeth, that is where the tip of the tongue ideally should rest and then the base of your tongue should be on the palate. That constant, slight pressure there is what helps. Again, this tongue is a strong muscle in the body that helps grow the maxilla.

Speaker 1: 10:13

So most of us are really deficient in the maxilla and if our upper jaw only grows so far, then the lower jaw can only go as far as the upper jaw allows it. It stops it, and so if it hasn't grown forward enough, the upper jaw, then the lower jaw is too far back, which means we're putting pressure on our joints. So it can lead to over time, tmj issues, people with the lower jaw too far back as adults end up with sleep apnea. So the point of this functional therapy and the younger that we can get the kids, the better we prevent the habits, because habits are kind of hard to get out of. So we want to create that proper structure, the proper position for the tongue and everything, in order to grow everything so that as adults, and again, when we grow the proper structures, we get rid of these negative habits. Then the teeth happens to come in straight. Imagine that right.

Speaker 2: 11:06

It is this snowball effect, to the positive or to the negative. And if somebody, if an adult, is diagnosed with sleep apnea, it did not just start. Somebody has heart disease, it did not just start. If somebody has type 2 diabetes or high blood pressure, it did not just start. These are ears and ears of dysfunction and of your body working extra hard to be able to get you to breathe well, and when it's overworked, it's just going to start breaking down earlier. So it's very important for us to catch these kids as early as we can to guide them in the right direction as far as growth and development in function.

Speaker 1: 11:49

Absolutely so. Number one is nasal breathing. We got to make sure everybody is breathing through the nose. So number two we have to swallow properly, right? So what? We talked a little bit about that tongue thrust. What? What caused that? Again, when you're swallowing and you're pushing the tongue forward between your teeth, why do some people have that habit?

Speaker 2: 12:09

So I actually have a different view on tongue thrust. Perfect, don't believe and this is taught everywhere that a tongue thrust causes an open bite. I believe that there are other things that cause the open bite, because there are some people with a tongue thrust without an open bite and, for example, if somebody has a pacifier or is a thumb sucker, not every single one of them is going to have an open bite. Some will, some won't. So I feel like there's predispositions in the algos. Back to nasal breathing airway, airway, airway Always got to check the airway first. So the tongue is kind of like cake batter it always fills in the spaces that it has. That's why a lot of times we see the scalloping on the sides of the tongue. If somebody has a very narrow bite, your tongue is fitting into those spaces. That's why we need to expand these kids that are so narrow to have more room for the tongue. So the tongue can't lightly suction without touching the teeth up there and do its function. Some people will develop a tongue thrust, or actually they are born with an infantile swallow. Everybody's born with an infantile swallow, where your tongue goes back and forth. When you swallow At around age six months, that's when that starts changing and they start swallowing with a very static movement. Everything in life, developmental wise, there is a reason. There's a reason why we have to learn how to roll before we can crawl. There's a reason why we have to crawl before we learn how to walk. And the same thing, developmentally, there's a reason when we have to drink out of a bottle or out of a breast before we're able to eat food. So all of that is in preparation for the next step and it is not seen that way. Unfortunately, it's all about nutrition. We're just going to feed these kids, but no, there is a mechanical and a physical reason why you have to go through these steps. It's so important.

Speaker 2: 14:18

So we have this infantile swallow and you guys can remember when you first started feeding your babies and I remember this with my own child she was about five or six months and I was like okay, let's try some, whatever it was, and I put it in her mouth and she spit right out and was first time. Parents were like, oh my gosh, she doesn't like it. She spit it out. No, that's the infantile swallow that tangles out. It's normal for that to happen. Guess what? She was not ready for me to start introducing food.

Speaker 2: 14:48

Yet there are certain things that we have to look at before they're ready for that step. But if certain things don't happen, if they don't practice it enough, if they have a restriction underneath their tongue, if their structure is too small, there are so many different reasons that they do not mature into that normal peristaltic movement of a swallow. And then, of course, if they are already dysfunction, the dysfunction is just going to get worse as they grow. So I don't know if there's like one exact reason exactly why somebody would have a tongue thrust, but there are several reasons why they stay and we have to approach this in a multidisciplinary manner. So it's not just my functional therapy that's going to fix a tongue thrust swallow. It can't just force somebody to swallow a certain way if their structure doesn't allow them to do that. So we do have to work with an aeroidentus or an orthodontist for them to grow the structure properly. So the tongue does have a place to go.

Speaker 1: 15:51

Interesting. So let's talk a little bit more about tongue ties and the problem with tongue ties. There's all different kinds of grades of tongue ties and again, do you release it, do you not release it, and what's your opinion on that?

Speaker 2: 16:05

I am very conservative when it comes to ties. Lip ties First. I feel like a lot of moms have insane pain while breastfeeding, more because of the lip tie than the tongue tie. If the lip is restricted and that baby cannot create a complete seal. Whenever they are grabbing the breast they tend to chew, and whenever they chew they chew the breast and that hurts like crazy. And I can say this because I had both of my kids so much pain in nobody saw the lip ties. So I am way more inclined to release a lip tie first and see what that will do.

Speaker 2: 16:46

Also, in the dental field we see a lot of decay on the upper teeth of these small kids. Nine out of 10 times you look and they have a lip tie. So it's not necessarily the diet, it's not necessarily because they're breastfeeding at night, it's not necessarily because they didn't clean well enough. It's a lot of times because they have the lip tie and then it's harder to clean. It's more likely that things are going to get caught in there. So I do see many benefits of releasing a upper lip tie. That's obviously causing issues.

Speaker 2: 17:21

The tongue yes, there are several different types. Since the variety is all restriction, we have to look at function. In school, all we learn is full ankle aglossia, which is whenever the phrenum, that little tissue under the tongue, attaches to the tip of the tongue. So if a patient cannot stick their tongue out past their lower teeth, that's when we know, okay, they have a tongue tie. Well, we see many patients with this insane tongue ties and they kind of look like they developed okay, they kind of look like they don't have any issues. They are nasal breathers.

Speaker 2: 17:54

So you have to address function. It's not just about the way it looks. Let's get it released and hope that something gets better. Now we always have to look at symptoms. What are the patient's issues? Is the patient ready for a release? That's another huge one. You have to have enough malfunctional therapy. You have to have enough body work. You have to address everything else to make sure that that patient is not going to reattach or they are going to get the real benefits of a really good release. Also, there are several people out there that are not fully trained, or trained well, into how to do a proper functional phrenoplasma.

Speaker 2: 18:32

That was developed by Dr Zaghi and it's a way of releasing tongue ties that addresses function. Not just about the way it looks, but making sure that the tongue can elevate and it can suction, and all of these things. They're necessary for proper function. With that being said, I always do my own functional therapy for a long time before I recommend a tongue tie release, unless that patient has the full ankle aglossia and it is causing a functional issues and they do need a release before they can even do my own functional therapy. So we work on certain areas of breathing and certain things like that before we send them in. But oh my goodness, there are so many symptoms that can come from all the different grades of tongue tie. So after eight sessions, 12 sessions of my own functional therapy, and after expansion, some of the symptoms may subside After osteopathic treatment or quinoa sacral therapy, some body work, physical therapy. After addressing all these things, sometimes they don't need a release. So yes, I'm very concerned about when it comes to those.

Speaker 1: 19:39

I think that's important because there are people out there just now, with the advent of lasers, right, we're like, oh, it's so easy, we just zip it in 30 seconds. But especially as the patient is there, they're 10, 11, 12 years old. They've had that many years of this tied tongue. Now suddenly it's loose. If you don't train where it's supposed to go, that can lead to other problems, right? So I really think when we see that tongue tie I know my own daughter. She's right on that border.

Speaker 1: 20:10

So we're doing myofunctional therapy. She's in the mild brace. All these exercises to see, because I'd rather not if I don't have to do a surgery and create a scar, thinking about energetic medicine Anytime we have scars, that can be a challenge to the body's energetic system too. So can we stretch and retrain that muscle without having to cut? And again, depends on the person, depends on the severity of it, but myofunctional therapy, in my opinion, should always be the number one tool we go to first to see if we can get that proper. Now you talk about, like this, body work, and what does that have to do with the tongue? Why would we need body work?

Speaker 2: 20:48

Well, just like we are all connected, it's not just about the teeth. So a body worker of course I'm not trained in any body work, but it can be a massage therapist, it can be chiropractic care, it can be this craniosacral therapy that's practiced usually by either massage therapists or occupational therapists. There's different professionals that would do craniosacral and they all have different modalities, but they are looking at how the body is interacting with itself and other parts of your body and they try to make sure that the cerebral spinal fluid is flowing correctly and it's flowing well and it don't have too much tension on one side of the body versus the other. So you have to release tension. There is so much involved. But let's talk about the frontline fascia. So all of our muscles are covered by this white, very thin material called fascia, and fascia is so interesting. There's a lot of research coming out right now about fascia. Fascia holds a lot of emotion, emotional pain and a lot of times when they release the tongue. It's actually the only place in your whole body that you can cut fascia and a lot of people will just burst out crying after they release the fascia. But this fascia holds a lot of tension and body workers can address this tension. That's how it's connected to the tongue. But the issue is that as you start healing, that fascia is gonna start getting tight again. So if you don't have a professional that's addressing the rest of your body's tension, it's very likely that you're gonna get the tension back. So they're not gonna get that full release.

Speaker 2: 22:32

I always tell my patients as soon as they release your tongue that's 100% the release you're gonna get. If they do it super well, you're going to lose about 30% of that. It's expected. But you may lose way more if things are not done properly. People forget the reattachment is healing. Everybody's going to heal. Everybody's going to reattach. Now to which degree? Hypermobile patients are way likely to reattach even more.

Speaker 2: 23:01

So we have to have even a different way of looking at these patients. And now I can tell if a patient is slightly hypermobile just by looking at their tongue. I have something that I look at it. There's three things that I look for. As soon as I see their tongue, I'm like there's slightly hypermobile. So I already know that it's going to be a more difficult release. I'm actually less likely to release a hypermobile patient. They are those patients. They look at their tongue and you can't tell. You don't know if they're really tight or not. Because they have so much range of motion they can reach their tongue out Like they can stick their tongue out so far they can almost touch their nose. A lot of times they can't touch their nose, they're way on the bottom of their chin, but whenever they suction and their symptoms like, they look like they're tied. So hypermobile patients are very interesting.

Speaker 1: 23:53

If they're hypermobile, if they have a tongue tie release, what would happen?

Speaker 2: 24:00

Yes, so the joints are hypermobile. Of course that doesn't necessarily affect the tongue whenever you're talking about joints on some way you could but they are just more likely to be attached. So yeah, if they're hypermobile we have to be extra careful. So I already know that I'm going to have talk to the provider about having seropeptase in our other hand to make sure that we can use that in case we see signs of reattachment. There's also some catalog injections now that they can do to release the scar tissue a little bit more. So I just know that that patient is going to need a little bit more hands on post-op care to make sure that we get the most benefits of that release.

Speaker 1: 24:41

So you mentioned the seropeptase, which is an enzyme, and how is that helpful?

Speaker 2: 24:46

So that powder is put on the scar tissue and it helps break up the scar tissue, A lot of people will take the pills. You're not supposed to take the pills. You're supposed to open up the powder and put it on the scar tissue underneath the phrenum. That let the whitish area where the scar was created and that usually releases it.

Speaker 1: 25:08

Oh, that's interesting. Yeah, we typically use that like proteolytic enzymes to break up biofilm and to help kind of work as I always describe it, as like a pac-man when you take it on an empty stomach it goes through the system and choose up all the inflammatory proteins and stuff. I use a lot of proteolytics. We use it a lot in periodontal disease to help break things up and there's a lot when we have a lot of inflammation that we use those, the proteolytic enzymes, to help with that. So interesting, I didn't know you could use it to not describe that. So good to know. This is why we do this podcast, so we can all get informed, not just the audience but myself as well. So tell us. What else should we know about myofunctional therapy?

Speaker 2: 25:50

That myofunctional therapy. There are so many areas of interest. It's not just mouth breathing, it's not just tongue ties, it's just. It's not just sleep. There are many myofunctional therapies that are trained for pre-op and post-op oral facial surgery, sleep surgery, orthodontic surgery. Anything that's done to the oral facial muscles we need to judge, just like physical therapy. If you're gonna have knee surgery, you want to send that patient to a physical therapist afterwards so they can learn how to optimize their muscles again.

Speaker 2: 26:25

We have so much training and, because we love it, people that decide to go into this field love to learn. You have to have the love for learning. It's not a university program that you go through that and you graduate and you're done. In this field you're never done. You're always learning. You're always looking for new courses and new research and we love collaborating.

Speaker 2: 26:50

And I feel like we have to know a little bit of every other specialty that we work with, because in order for me to refer to an occupational therapist, I need to understand a little bit more about what they do. If I'm going to refer to an orthodontist or to a sleep physician, I need to understand when it's the best time for me to refer to that other professional and how to collaborate. I feel like we are the glue of the interdisciplinary team. We gather everybody, the whole team, together to be able to treat this patient in a way that is not a professional patient in a multidisciplinary manner. All of the other professionals don't necessarily refer to us. So if a patient goes to an EMT first because they have a deviated septum, they're going to correct the septum and send them home. They're not looking at all these other things that we're looking at. So if you guys find a myofunctional therapist out there, just know that they are so invested not only into learning more, they really, really care.

Speaker 1: 27:55

Yeah, that's fantastic. So talking about for surgeons even, let's say you're just having a filling right, but your mouth's been open for an hour plus. That causes a lot of stress. Some people already have stressed musculature. They've got the tight shoulders, very tight neck, which then it's all connected right by this fascia. So are there even exercises? Let's say your mouth has been open a long time. Or say someone you don't know that you've had all this, but your mouth, maybe your jaw locks every once in a while.

Speaker 1: 28:25

Are there simple exercises patients can do to help kind of soften and release some of those tight muscles?

Speaker 2: 28:32

Yes, 100%, you can do. So it depends on what the issue is, and I don't want to recommend any specific exercise because it's going to depend on what the patient looks like. So you're gonna have two or three different types of patients that are gonna stay with your mouth wide open and might give different exercises for each. So if somebody has bruxism, if they clench and grind a lot, the type I'm going to give them more stretch things and massage is sort of masseter muscle. The masseter is so strong it's the amount of force that you can do with the masseter is just unheard of. So to release that muscle and the massage has to be done the right way because otherwise it can make it worse. So definitely there's things that my functional therapist can give you that will help.

Speaker 2: 29:21

After a long dental appointment, even your bite, your bite will change, doesn't matter how incredible the dentist is. Whenever you bite. Afterwards it's gonna be slightly different, and we all know that the small little change to our occlusion, people can feel it. Whenever we get feelings, even though they're only inside the grooves, you can still kind of feel it sometimes, and there are studies showing that every time you change your occlusion, your hips can change. We're all connected. So definitely there is a lot that we can do. But if you just want to, if you wake up with a headache, I'll say this if you normally wake up with a headache, if you have TMJ issues, open your mouth for about 18 seconds at a time. It will help release the masseter muscle.

Speaker 1: 30:07

So just stretching, yeah, so what other conditions? So let's see if you've got proxiesm that you want to stretch, if you have somebody, maybe who had a lock jaw all the time, what kind of muscle do you think is involved with that?

Speaker 2: 30:20

Well, it depends. It could be the pteragoids also involved in those. Those are super painful and super hard to release. You need somebody that really knows TMJ and manual therapy. That's strained in manual therapy. Tmj doc is a great one that you guys can look her up. She's wonderful.

Speaker 2: 30:40

But usually if somebody has those types of issues of getting lock jaw, first of all I look at a tongue restriction. A lot of people that have TMJ issues are tongue tied because your tongue is supposed to move all by itself. Your jaw is not supposed to move with it and whenever you have a restriction, every time you move your tongue you move your jaw with it. So you are overworking the TMJ how it's not supposed to be worked. Think about if you stepped with the wrong side of your foot all day long. Eventually, years after, you're going to need a new replacement surgery because you're putting tension and pressure on that joint. That is incorrect. That's what happens when you have a tongue tie and you're constantly moving your jaw.

Speaker 2: 31:28

Every time you have to move your tongue and we use our tongue a lot. We're chewing, we're talking, we're singing, we're kissing all of these things we have to use. Our tongue is functioning constantly. So first thing I look for is a tongue restriction. Second thing I look for is upper and lower jaw development. So most of these people also are underdeveloped. So either their jaws are too narrow or they're too far back, like you were mentioning earlier. We call that AP deficient, so we have to look at both. Those are, yes, the muscles can help, but usually there are some other issues that are bigger than you should be addressed in order for them to get full relief.

Speaker 1: 32:13

That makes a lot of sense. You're teaching me lots of good stuff, stuff to really think about. Because, again, we don't get any of this training in dental school and most of the time we're trained oh you have a TMJ, we'll just throw a splint in there and we just hope for the best. We don't really understand anything about the tongue. I don't think I can't think of anything that I learned about the tongue. Maybe I've just forgotten, but it certainly wasn't prominent in my education of how that can. So sometimes, when we're just throwing a splint in again, we're treating a symptom. We're not getting at the root of the problem. So that's what I really like about the myofunctional therapy is we're getting at the root of these issues. When you can create harmony, muscle harmony, and it's so true. I mean I tell my patients all the time A fraction of a millimeter of your bite off throws everything off. So until people don't think, you're going to just bite it down and it'll be fine over time, because you are creating massive effects throughout your entire skeletal system. So it's important. We know we're starting at the top of the head. When the jaw is off, it can affect all the way Our knees, our ankles, our toes. So it's really important that we get. And so what I love about what you said is that collaboration, and I think we really need more and more of that in today's world because, especially in medicine, we've become all these super specialists, right, and they're just folk, which is important, like it's great. We need to have this expertise, but we have to be working together because we all have different areas of expertise. If we want to treat a person holistically WHO we need to consider how the body works as a whole and when, in this super specialized society we have now, we forget how it all works together. So we start just, unfortunately, treating the symptoms instead of what is the underlying problem.

Speaker 1: 34:03

So again, I think and when you have myofunctional therapy, it's another way that you get proper retention, right? So many people are like oh, I didn't wear my retainers and that's why my teeth are crooked now, even though I was embraced for four years. Well, no, we never really corrected the problems, right? We didn't usually didn't grow the jaws to their proper dimension, right, so the teeth were like when you artificially moved them to this spot to make them look good, they didn't feel good to the body, right, so the body adapted to adjust and reach a better kind of state of balance there, right? So when we create the right structure, we get the tongue and the and breathing properly, then we're going to have much more success.

Speaker 1: 34:48

And when we can recognize these in kids under six, oh my gosh, you're setting those kids up for amazing health. And it's much easier and less expensive when you start at a young age, because I think the worst thing for a parent, right? You spend $10,000 on braces and then they're in their 20s and their teeth are all crooked. It's like, oh my gosh, was that just a waste of money? So again, we always you know the whole idea of this podcast is looking at the root. What is the root issue there? And also you know again that collaboration, looking at how the whole body works together. So a very, very important concept and it's nice I like how you said that you're, you know, kind of the manager, basically right Is bringing all these different modalities together. So that's exciting because you have an insight into what all these different people will do so with your patients. What is the best therapy? Who is the best person to take you in the next phase of your treatment? So that's so exciting.

Speaker 2: 35:48

And that's why we created ARI Circle, because we needed to learn from other professionals. We needed to have a safe place that we can all talk. It's not a stupid question. I just want to know about something that another specialist is like how do you not know that? I mean, their field is so normal. But for me, like as a mother, I had no idea that crawling with one knee was an issue. Both of my kids crawled in one knee and I saw the cutest thing ever. We asked an occupational therapist and they're like are you crazy? So I wanted to have this environment that we are open to learning from others and we're open to sharing.

Speaker 2: 36:27

I feel like in our society we are such fans of our universities, of our professors and, yes, they're incredible people but many of us leave school thinking of these people as their idols, like they would never be wrong. They know everything there is to know and they taught me everything I needed to know, and I feel like that's the biggest mistake that we can make. We need to come out and understand that there is another world out there and it's science. Things are changing constantly and we have to keep challenging our own beliefs. We have to be more of little kids asking constantly but why? Why is that happening?

Speaker 2: 37:08

We were learned in school that a geographic tongue, it's common and it's just a variation Like there's. We don't know what causes it. Well, really there is a reason. Why do some people have it and some others don't? So it's just one of those things that we have to come out and we, you know, I feel like people that go into a field because of the love of it, they are way more likely to grow and want to learn more. People that go into a field because of the money they just go in and they do the job and they leave and they don't want to do anything else, they don't really care and they just stay in that mentality. So, in order for us to grow into better, help our patients, because that's the whole key, the whole reason why we're doing what we're doing is to talk to each other and collaborate and be open to learning and sharing.

Speaker 1: 38:03

And I think that's so, so important because, like you said, we don't know everything. Even our professors don't know everything, and the whole idea of science is we're constantly involving in constant learning. So what I?

Speaker 1: 38:15

know right now it's going to be very different than what I know next year or the year after that. I mean my entire education, everything that I do has evolved as I learned, because I always ask that question why, why, why? Why I did a whole curriculum, the Dawson curriculum, because I, after being in my own practice for five years, I'd say, oh, why have that tooth cracked? I did a crown on the other side a few years ago. Did that impact that? Did that bite change cause that problem? And I didn't really know enough about occlusion. So I was like I want to know why, because I want to prevent my patients from meeting all this extensive work. I don't want them to have cracked teeth and stuff like that. So that is how we learn and so and again, we're always evolving.

Speaker 1: 39:01

So it's important that we do collaborate this so that we can bring this information to our patients or audience so that people start asking right, because too much in society we just we believe and go with whatever our doctor says, because they're the ones with the knowledge. But maybe that's not the case. And I think in my podcast I just did before this one we were talking about intuition and especially as a mom right, do not discount a mother's intuition and what she she says, no matter what your education and your experience is. A mother knows her child right, and so it is so important to really listen to these moms because, again, they know their kid better than anyone and if you understand that and you are listening and you're resonating, they're going to do the recommended treatment because they feel that you are hearing them and that's so important.

Speaker 1: 39:56

I mean, we're both moms. We would do anything for our kids, we want the best for them and so we just want to have that information. We just and we want to be listened to. We want to be heard when we're having concerns and not just written off like we're crazy because we don't want fluoride or something like that. So so very important, all right. Well, as we're wrapping up, what else, anything else important we need to know about my function? Please let us know how we can learn more about how to reach you and and get this therapy if we need it.

Speaker 2: 40:30

Of course. So I think the most important thing for people to understand about my functional therapy is that my functional therapy is not a program. There is not a beginning and end. There is a beginning and there are several steps and there are referrals and there are breaks, because the patient is always evolving, the child is always growing and we have to keep checking their function as they are growing. So you know, don't think that it's a 12 week program and you're done forever. You don't ever have to go back to it.

Speaker 2: 41:10

There are so many things involved in my own functional therapy that some people might need a few fewer sessions and some people might be in therapy a lot longer. So just trust your therapist. Even though a lot of my patients I'll start therapy and then I'll pause for us to do expansion or something like that, or else into a different professional, and sometimes several symptoms go away and then they get expansion. They're even better and then they don't think they need to come back for therapy. But every single time you change the structure, there's change to the muscle also, and muscle always wins. The muscle is always gonna pull that structure back. So stay in contact with your myofunctional therapist. Make sure that you're checking back in, following up every so often to make sure there are not any new issues or other things that need to be addressed.

Speaker 1: 42:01

Good point. How do we find you, Renata?

Speaker 2: 42:05

All right, I am all over social media. So if you guys have Instagram, go to at MyoMovez on Instagram, that's on Myofunctional Therapy practice. I share a lot of information over there with parents about all of this airway stuff. And then, if you're a professional, find me on Airway Circle. We're also Instagram. We have a Facebook group and we have lectures every Thursday night and it's free for everybody to watch live, and then we have a membership if you'd like to have access to our recorded lectures.

Speaker 1: 42:41

That's fabulous. And just one other quick point. We talk a lot about kids, but any adults who have these sleep issues or crowding teeth if any of them they come in they want a busy line and I'm like, oh time out. First of all, why are you crowded? And so now I have, as I learn now, my patients all are going through myofunctional therapy while we're doing this expansion. It has to be part of it, especially because now, as you're adult, you've had decades of habits we may need to unwind. So myofunctional therapy is for adults and kids alike.

Speaker 1: 43:13

So check out everything we're not going to talk about on her social media We'll post that in the notes If you didn't catch it or if you're driving and definitely check it out. It's really, really important and, especially with more and more of us being aware of all of our sleep issues, myofunctional therapy is really helpful for that too. Especially, there's a lot of us who can't tolerate CPAP. There's even mandibular advancement devices. It looks better, but it still has some problems too. So making sure we get the muscles and the nasal breathing all as part of myofunctional therapy and can benefit everyone. So thank you so much, renata, for taking your time to come out and educate everyone, and me too. I learned some new things, so I appreciate that. So thank you so much and we'll see you next time. Everybody, thank you for having me.