In toddlers, preschoolers and school age children, OMD red flags can look like children who:
- Mouth breathe when asleep and/or during the day
- Chronically are "fussy" and have tantrums more than the average toddler/preschooler
- Push out their tongue when they talk (lisp), drink, or eat. This is called tongue thrusting/anterior swallow pattern (immature swallow) or interdental/lateral lisp
- Have speech delay and/or unintelligible speech
- Are picky eating beyond typical pickiness; eats less that 15 different food items
- Didn’t transition to solids well by 12 months
- Show overt and frequent signs of coughing, gagging, choking when eating and drinking
- Snore or grind teeth excessively
- Display excessive drooling; can soak a shirt easily
- Have poor posture, slouched, head forward
- “W” sit and who may qualify for PT or OT based on delayed motor skills
- Does not easily fall asleep, is up during the night frequently, and is chronically tired in the morning; “cranky behaviors” upon waking up
- Has ADHD or Sensory Processing Disorder (SPD) type symptoms
- Has chronic ear infections
- Needs palatal expansion for teeth fit
- Needs orthodontics/braces
- Has a gummy smile
- Needs tonsils and/or adenoids removed
- May have crowded teeth; shark teeth
- May suck thumb, suck pacifier, or have anoher oral habit that lasts beyond 2 years of age
- May still use a bottle or sippy cup after 18 months and cannot transition to other cups
Why Does Screening for OMDs Matter?
OMDs are important to identify because they can interfere with normal growth and development of the muscles and bones of the face and mouth. The bones of the face and cranium are around 70-80% done growing by 8 years old and 98+% done growing by 12 years of age. OMDs can also interfere with how the muscles of the face and mouth are used for eating, drinking and talking. Did you know that the tongue is a muscle that grows and expands the palate so their adult teeth have room to come in? That means that muscle builds bone.
Who Can Treat OMDs?
Now that we know more about symptoms, that brings us to therapy. Who can treat OMDs, how can OMDs be treated and when is the best time for treatment to be most preventative? A highly skilled Orofacial Myologist (COM certification) or Speech Language Pathologist (SLP) with Orofacial Myology Training can conduct an evaluation and make medical recommendations and referrals and create an individualized treatment plan for their patient to address the disorder. COM certified individuals are certified through the International Association of Orofacial Myology (IAOM) and they can be dental hygienists, orthodontists, speech therapists, ENTs, etc.
How can OMDs be treated? That completely depends on your child’s age and specific OMDs. There is not a one size fits all or most model to therapy. Evaluation should consider multiple areas of function and therapy should be highly individualized to meet the specific individual’s needs. No two patients with similar OMDs should have the same exact treatment plan.
When is the best time to be getting evaluated and treated? In my opinion, as soon as possible. As soon as there are red flags for oral motor delay in infants and OMDs in older children, evaluation can happen and a treatment plan can be made. It is never too early to start early intervention.
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