History of Myofunctional Therapy

OMT originated within the field of orthodontics as early as the turn of the twentieth century. Early orthodontists, such as Edward Angle and Alfred Rogers, were documenting observations about parafunctional habits, muscle function, and dental occlusion.1 Angle’s 1907 publication, Malocclusion of the Teeth, emphasized that the resting position of the tongue may affect orthodontic outcomes (Figure 1). Approximately a decade later, Rogers was developing orofacial exercises in an attempt to correct muscle functioning and correct malocclusion.2 Many subsequent theories were developed regarding swallowing and orofacial muscular function. Then, in the 1950’s, orthodontic researcher W.J. Tulley had a notable development in the field. He used electromyography (EMG) and cinefluorography technology to study OMDs like abnormal swallowing. This was the first time these techniques were used for this purpose. Through his research, Tulley was able to find a possible association between open mouth posture during swallowing and dental malocclusion.2

In the late 1950s, Walter Straub, an orthodontist, was continuing his research on abnormal swallowing by partnering with speech pathologists. Through these partnerships, he provided treatment to hundreds of patients, and eventually those partnerships led to Straub teaching more dentists and speech therapists about abnormal swallowing. In the early 1970s, a team of therapists, including those who had been trained under Straub, founded what is now known as the International Association of Orofacial Myology (IAOM).1,3 This association still exists today, and provides patient education, as well as professional training opportunities and membership.3 Also in the early 1970s, Marjorie Snow, a dental hygienist, began teaching at Kalamazoo Valley Community College in Michigan. She developed and implemented an orofacial myology program into the college’s dental hygiene curriculum. The orofacial myology course continues today, and remains one of the only of its kind.

Figure 1. Summary of the history of OMT.2

Timeline showing the summary of the history of OMT.

In 1975, the Joint Commission on Dentistry and Speech Pathology-Audiology published a statement calling for additional research on the tongue thrust phenomena and questioning the efficacy of current treatment modalities.4,5 This statement was also accepted as an official position statement of the American Association of Orthodontists (AAO). Instead of bringing advancements to the field, this statement essentially halted new research on OMDs and OMT, and the number of new therapists decreased dramatically. In 1990, the American Speech-Language-Hearing Association (ASHA) issued a new position statement which acknowledged the clinician’s need to receive additional training to provide treatments for patients with OMDs. Shortly after, ASHA also created guidelines on education, knowledge, and experience needed to provide appropriate care for patients with OMDs.

Today, OMT is once again gaining recognition as a valid specialty area. In 2015, the Academy of Applied Myofunctional Sciences (AAMS) held its first congress in Los Angeles, California. The congress was attended by multiple professional disciplines from various countries worldwide. The AAMS, along with its partner organization, the Academy of Orofacial Myofunctional Therapy (AOMT), as well as the long-standing IAOM, are currently leading the push for education, research, and awareness of OMDs and OMT.