Myofunctional Therapy and Orthodontics: Why Correcting Teeth Isn't Always Enough

Sometimes orthodontic treatment goes perfectly. The teeth move as planned, and the final result is beautiful. And yet, a few years later, the teeth start to shift again. Not because the treatment was done poorly, but because the underlying cause was never addressed.

This condition is often caused by myofunctional dysfunction. And that is precisely why Transforme Orthodontie includes myofunctional therapy in its clinical services, provided by a dedicated therapist who is separate from the orthodontic team.

What is myofunctional therapy?

Orofacial myofunctional therapy is a paramedical discipline that focuses on the muscles of the mouth, face, and throat, as well as how these muscles function at rest, during swallowing, breathing, and speech.

When these muscles function improperly or are out of balance, they exert constant forces on the teeth and bone structures. These forces, which are applied for hours each day, have a direct impact on the position of the teeth and can compromise the stability of orthodontic treatment.

Myofunctional therapy aims to retrain these muscles so that they can function properly again. It is not an orthodontic treatment in itself. It is a complementary approach that addresses the mechanical causes that aligners alone cannot correct.

The most common signs of myofunctional dysfunction

Among the children and adolescents we see in our clinic, the most commonly observed habits and dysfunctions are:

Tongue thrust: The tongue pushes against or between the teeth during swallowing or at rest. This repeated pressure, occurring thousands of times a day, can push the front teeth apart, create an open bite (a gap between the upper and lower teeth), and make it very difficult to stabilize the orthodontic result.

Mouth breathing: Breathing primarily through the mouth rather than the nose alters the position of the tongue and the tone of the facial muscles, and can affect the development of the dental arches. In growing children, this can have a significant impact on facial shape and jaw alignment.

Atypical swallowing: a swallowing pattern characterized by improper contraction of the facial muscles or incorrect tongue positioning.

Persistent oral habits: thumb-sucking or pacifier use beyond the appropriate age, biting the lips or cheeks.

These habits often go unnoticed during a routine dental visit. Our team systematically assesses them, especially in younger patients.

At what point is myofunctional therapy introduced at Transforme?

This is one of the most common questions parents ask during consultations. The honest answer: it depends entirely on the individual case.

Our myofunctional therapist can be involved at any stage of the process.

Before starting orthodontic treatment: in cases where a dysfunction has been clearly identified and correcting it beforehand will lead to a more stable orthodontic outcome. Starting aligner treatment without first addressing active lingual protrusion, for example, is like building on unstable foundations.

During treatment: when a problem is identified during treatment, or when certain tooth movements are progressing more slowly than expected due to opposing muscle forces.

After treatment, during the maintenance phase: to consolidate the results and reduce the risk of recurrence in patients whose muscle patterns have not yet been fully retrained.

There is no single protocol. Myofunctional assessment is part of our team’s comprehensive approach, and the decision to involve our therapist is made on a case-by-case basis, in consultation with the patient and their family.

Why have a dedicated therapist instead of the orthodontists themselves?

Myofunctional therapy is a discipline in its own right. It requires specialized training, in-depth knowledge of orofacial muscle patterns, and rehabilitation techniques that are acquired through targeted practice, distinct from orthodontic training.

At Transforme, we have chosen to employ a dedicated myofunctional therapist rather than delegate these evaluations to the orthodontic team. This decision reflects our belief that every aspect of treatment should be handled by the person best qualified to do so.

For the patient, this means more comprehensive care. Two distinct areas of expertise work together toward the same goal.

What Myofunctional Therapy Is Not

It is important to be clear about what this therapy can and cannot do.

Myofunctional therapy is not a substitute for orthodontic treatment. It does not align teeth or correct malocclusions. Its purpose is to create the muscular conditions that allow orthodontic treatment to be more stable over time.

It is not suitable for all patients. Our team does not routinely recommend a myofunctional evaluation for every patient. It is offered when a dysfunction is identified and our team determines that it may affect treatment or its stability.

And it requires active participation from the patient, or from the parents in the case of children. Muscle rehabilitation exercises must be done regularly between sessions to be effective.

If this article resonates with you

Whether it’s for your child or for yourself, if you recognize any of the signs described, or if you’ve previously undergone orthodontic treatment and the results have shifted over time, a consultation at Transforme can help determine whether a myofunctional component is involved.

The myofunctional evaluation is available at our clinic for $175. Our team can let you know about upcoming availability when you schedule your appointment. 

Make an appointment: drtransforme.ca · (514) 819-0995

Clinics in Montreal (Côte-des-Neiges, 5845 Côte-des-Neiges Road, #225) and St-Hubert (7171 Cousineau Boulevard)

Dr. Mostafa Altalibi, DMD, MSc, D.Ortho, FRCD(C)