When parents think about orthodontic treatment, they usually focus on what they can see. A child may have crowded teeth, an uneven bite, or teeth that are coming in crooked.
Braces, aligners, expanders, and other orthodontic appliances can help correct many of these concerns. However, the position of the teeth is only one part of the picture.
The tongue, lips, cheeks, breathing pattern, and swallowing habits also affect how the mouth functions each day. In some children, these patterns may place repeated pressure on the teeth or make it harder to maintain healthy oral posture.
This is where myofunctional therapy may help.
Orthodontics and myofunctional therapy do different jobs. Orthodontics focuses on the position of the teeth and the relationship between the jaws. Myofunctional therapy focuses on how the muscles of the mouth and face rest and move.
Some children need orthodontic care without myofunctional therapy. Others may benefit from functional support before, during, or after orthodontic treatment.
The goal is not to choose one approach over the other. The goal is to help structure and function work together.
What Is the Difference Between Orthodontics and Myofunctional Therapy?
Orthodontic treatment is designed to guide or move the teeth. Depending on the child’s needs, an orthodontist may use braces, clear aligners, expanders, retainers, or other appliances.
Myofunctional therapy does not move teeth in the same way.
Instead, it focuses on oral muscle patterns. These patterns may include tongue posture, lip closure, swallowing, chewing, and breathing.
The American Speech-Language-Hearing Association’s overview of orofacial myofunctional disorders explains that these disorders involve patterns of the mouth and facial muscles. They may affect tongue position during rest, swallowing, breathing, or speech.
At MyoWay Centers for Kids, we often explain the difference this way:
Orthodontics addresses the position of the teeth and jaws. Myofunctional therapy addresses the way the muscles around those structures function.
Neither approach automatically replaces the other.
Why Does Oral Muscle Function Matter During Orthodontic Care?
The teeth do not sit in isolation.
The tongue rests inside the dental arches. Meanwhile, the lips and cheeks apply pressure from the outside. Children also swallow many times each day.
These forces are usually gentle. However, they happen repeatedly.
For example, a child may rest the tongue low in the mouth or push it forward during swallowing. Another child may keep the lips apart and breathe through the mouth for much of the day.
These patterns do not explain every orthodontic problem. Genetics, tooth size, jaw size, growth, airway anatomy, and oral habits may also play a role.
Still, oral function may be important when planning care for some children.
It is also important to avoid exaggerated claims. Changing tongue posture alone cannot correct every bite problem or remove the need for orthodontics. The American Association of Orthodontists notes that tongue positioning by itself is not enough to reshape the jaw or correct misaligned teeth.
A more balanced approach looks at both structure and function.
What Does Pediatric Myofunctional Therapy Address?
Myofunctional therapy is more than a list of tongue exercises.
A structured program considers the child’s age, anatomy, breathing ability, oral habits, coordination, and treatment goals. Parents can learn more in Pediatric Myofunctional Therapy: More Than Just Mouth Exercises.
The areas addressed may include the following.
Tongue-Resting Posture
A provider may look at where the tongue rests when a child is not eating or speaking.
Some children rest the tongue low in the mouth. Others place it against or between the front teeth.
Therapy may help a child improve tongue awareness, coordination, and resting posture. However, the recommended position should be comfortable and appropriate for the child’s anatomy.
Lip Closure
Some children keep their lips apart while reading, watching television, playing, or sleeping.
Open-mouth posture can be related to habit. It can also occur when nasal breathing is difficult.
For that reason, a child should not simply be told to keep the mouth closed. First, the care team should consider whether the child can breathe comfortably through the nose.
Swallowing Patterns
A child may move the tongue forward or between the teeth during swallowing. This is often called a tongue-thrust pattern.
In some cases, this pattern may place pressure near the front teeth. In other cases, it may be an adaptation to an existing bite or limited space in the mouth.
An evaluation can help determine whether the swallowing pattern is clinically important.
Nasal Breathing
Some children breathe through the mouth because the nose feels blocked. Others continue mouth breathing after the original blockage has improved.
Possible factors include allergies, congestion, enlarged tonsils or adenoids, airway anatomy, oral posture, and habit.
The article What Is Really Behind Pediatric Mouth Breathing? explains why mouth breathing may be a form of compensation rather than a behavior problem.
Myofunctional therapy may encourage nasal breathing when it is safe and comfortable. However, therapy cannot remove a physical blockage inside the nose or throat.
Chewing and Oral Coordination
Chewing requires the tongue, jaw, lips, and cheeks to work together.
Some children chew mainly on one side. Others keep the mouth open, avoid certain textures, or have difficulty moving food.
These patterns may not always affect orthodontic treatment. Still, they can provide useful information about overall oral function.
When May Myofunctional Therapy Help Before Orthodontics?
The period before braces or aligners may be a useful time to evaluate oral habits and muscle function.
That does not mean a child should delay orthodontic care. Bite problems, crossbites, crowding, eruption concerns, and jaw relationships may need timely assessment.
The American Academy of Pediatric Dentistry’s guidance on developing teeth and bite relationships emphasizes careful diagnosis, treatment planning, and appropriate timing. It also notes that oral habits, growth, cooperation, and other factors may affect treatment.
An orthodontic evaluation may consider:
- Tooth position and eruption
- Available space
- Crowding or spacing
- Crossbites and open bites
- Jaw relationships
- Dental arch development
- The appropriate timing for treatment
A myofunctional evaluation may consider:
- Tongue-resting posture
- Lip closure
- Mouth breathing
- Nasal breathing ability
- Swallowing patterns
- Oral habits
- Muscle coordination
Therapy before orthodontics may be considered when a child has persistent open-mouth posture, mouth breathing, a forward swallow, low tongue posture, or an oral habit that may affect the developing bite.
However, the timing should be individualized.
Can Myofunctional Therapy Be Used During Braces or Expansion?
In some cases, myofunctional therapy can take place while a child is receiving orthodontic treatment.
The therapy plan should account for the appliance in the child’s mouth. It should also support the orthodontist’s goals rather than interfere with them.
During orthodontic care, therapy may help a child:
- Improve tongue awareness
- Reduce forward tongue pressure
- Practice a more comfortable resting posture
- Improve lip closure when appropriate
- Strengthen nasal breathing habits
- Adjust swallowing patterns
- Maintain oral coordination as the dental arches change
Children may need time to adapt to braces, aligners, or an expander. Exercises may also need to change as treatment progresses.
Communication between providers is important.
The orthodontist should know what the myofunctional provider is addressing. Likewise, the myofunctional provider should understand the orthodontic treatment plan.
MyoWay does not provide orthodontic treatment. Instead, its pediatric programs and therapy options are designed to complement appropriate dental, orthodontic, and medical care.
What Happens After Braces Come Off?
After braces, the teeth need time to settle into their new positions.
Retainers are an essential part of orthodontic care. Children should wear them exactly as directed by their orthodontist.
Myofunctional therapy does not replace retainers.
However, therapy may be considered when oral muscle patterns continue to place pressure on the teeth. Examples may include a tongue that rests between the teeth, a forward swallow, open-mouth posture, or ongoing mouth breathing.
Research on myofunctional therapy and long-term orthodontic stability is still developing. Some evidence suggests that therapy may improve tongue posture, swallowing, and oral habits in selected patients. However, the available evidence does not support promising that therapy will prevent relapse in every child.
Teeth can shift for many reasons, including:
- Growth
- The original bite problem
- Bone and tissue changes
- Inconsistent retainer wear
- Treatment mechanics
- Individual biology
- Ongoing oral habits
Parents can read more about these factors in Why Do Teeth Shift After Braces?.
If a child’s teeth begin moving, parents should contact the orthodontist promptly.
Which Signs May Suggest a Functional Evaluation?
Crowded teeth alone do not prove that a child needs myofunctional therapy.
Likewise, mouth breathing or a tongue thrust can have several possible causes.
Still, an evaluation may be helpful when orthodontic concerns occur alongside signs such as:
- Frequent mouth breathing
- Lips that stay apart at rest
- Snoring or noisy breathing
- Difficulty breathing through the nose
- A tongue that rests between the teeth
- Forward tongue pressure during swallowing
- An open bite
- Continued thumb or finger sucking
- Difficulty chewing
- Speech concerns related to tongue placement
- Teeth shifting after orthodontic treatment
The Conditions We Treat page provides more information about breathing, sleep, dental, and oral muscle concerns that may lead families to seek an evaluation.
These signs are not a diagnosis. They simply show that a closer look may be useful.
Why Is Collaborative Care Important?
A child’s teeth, tongue, airway, sleep, and facial development are connected.
However, no single provider manages every part of that system.
An orthodontist may identify a bite or dental arch concern. A pediatric dentist may notice crowding, oral habits, or changes in tooth eruption. A myofunctional provider may observe low tongue posture or poor lip closure.
Other children may need support from a pediatrician, allergist, ear, nose, and throat physician, sleep physician, or speech-language pathologist.
The order of care can vary.
For example, one child may need medical treatment for chronic nasal obstruction before beginning breathing exercises. Another child may need orthodontic expansion before the tongue has enough room to rest comfortably.
A third child may begin habit training before or during braces.
The purpose of collaboration is not to add unnecessary treatment. Instead, it helps each provider understand the child’s needs and treatment sequence.
What Should Parents Expect During an Evaluation?
A thoughtful evaluation should begin with questions.
The provider may ask about:
- Daytime and nighttime breathing
- Snoring or restless sleep
- Allergies and congestion
- Previous tonsil or adenoid treatment
- Feeding and chewing
- Pacifier or thumb habits
- Speech concerns
- Current or past orthodontic care
- Retainer use
The provider may also examine tongue movement, oral posture, lip closure, swallowing, and breathing patterns.
In addition, the provider should explain the limits of myofunctional therapy.
Myofunctional therapy cannot diagnose a sleep disorder. It cannot remove an airway blockage. It also cannot replace orthodontic treatment when a child needs tooth movement or correction of a bite relationship.
A clear treatment plan should explain the goals of therapy, how progress will be measured, and when other providers should become involved.
Can Parents Use Exercises Found Online?
Parents can find many tongue, breathing, and jaw exercises online.
However, the same exercise is not appropriate for every child.
For example, a child who cannot breathe comfortably through the nose should not be instructed to keep the mouth closed without further evaluation.
Likewise, an exercise that helps one swallowing pattern may not be useful for another.
Incorrect practice can also create tension or reinforce the wrong movement.
Professional guidance helps determine:
- Whether therapy is appropriate
- Which patterns need attention
- Which exercise is suitable
- How often the child should practice
- Whether another referral should come first
Not every child needs a long therapy program. An evaluation simply helps the family understand what may be contributing to the concern.
Is It Braces or Myofunctional Therapy?
Parents are sometimes asked to think of orthodontics and myofunctional therapy as competing choices.
That is usually not helpful.
Orthodontic treatment addresses tooth position and dental or jaw relationships. Myofunctional therapy addresses oral muscle function and habits.
A child may need one, both, or neither at a particular stage.
Instead of asking which approach is better, parents can ask:
- Is the concern structural, functional, or both?
- Can my child breathe comfortably through the nose?
- Are oral habits affecting the bite?
- Does my child need medical care first?
- Are the providers communicating?
- What is the goal of each recommendation?
These questions help parents make informed decisions without expecting one form of care to do everything.
Learn Whether an Evaluation May Help
Parents do not need to decide on their own when myofunctional therapy should begin.
A professional evaluation can help identify whether the concern involves oral function, breathing, orthodontic development, or several connected factors.
Families can schedule a free MyoWay consultation to discuss their child’s breathing, oral posture, sleep, jaw development, and orthodontic history.
The purpose of the consultation is to help parents understand what they are seeing and determine whether additional evaluation or collaborative care may be appropriate.
Frequently Asked Questions
Can myofunctional therapy replace braces?
No. Myofunctional therapy focuses on muscle function, tongue posture, swallowing, and breathing habits. Braces and aligners move teeth and address orthodontic relationships. Some children may benefit from both.
Should my child begin myofunctional therapy before braces?
It depends on the child’s needs. Some children may benefit from addressing oral habits or breathing patterns first. Others may begin orthodontics and therapy at the same time.
Can a child receive myofunctional therapy while wearing braces?
Yes, in some cases. Exercises may be adjusted to account for braces, aligners, or expanders. The therapy plan should support the orthodontist’s treatment goals.
Can myofunctional therapy prevent teeth from shifting?
It cannot guarantee that teeth will remain in place. Therapy may support healthier oral function in selected children, but retainers and regular orthodontic follow-up remain essential.
Does tongue thrust always cause an open bite?
No. A tongue-thrust pattern may contribute to dental changes, or it may develop because an open bite is already present. An evaluation can help clarify the relationship.
Can orthodontic treatment stop mouth breathing?
Orthodontic treatment is not designed to retrain breathing habits. Some treatment may change available oral space or dental arch relationships. However, ongoing mouth breathing may require medical and functional evaluation.
What age is best for myofunctional therapy?
There is no single ideal age. Readiness depends on the child’s development, needs, ability to follow instructions, and treatment goals.
Who should evaluate my child first?
That depends on the main concern. Dental crowding or bite problems may require an orthodontic evaluation. Chronic congestion, snoring, or breathing pauses should be discussed with a medical provider. A myofunctional evaluation can assess oral function and help coordinate referrals.
