Orofacial Myofunctional Therapy is an interdisciplinary practice that works with the muscles of the lips, tongue, cheeks and face and their related functions (such as breathing, sucking, chewing, swallowing, and some aspects of speech). It acts in the prevention, evaluation, diagnosis and treatment of people who may have these functions compromised or altered. It can also act in improving facial aesthetics. In this area, the Specialist in Orofacial Myofunctional Therapy can work in partnership with other professionals such as dentists, doctors, physical therapists, occupational therapists, nutritionists, nurses and psychologists. As an emerging field, questions are quite common when we talk about Orofacial Myofunctional Therapy. Below are some answers of frequently asked questions.

ON THE FOLLOWING PAGES, WE HAVE COMPILED THE MOST IMPORTANT QUESTIONS AND ANSWERS THAT PEOPLE ASK ABOUT OROFACIAL MYOFUNCTIONAL THERAPY > WHAT IS OROFACIAL MYOFUNCTIONAL THERAPY (OMT)? Orofacial Myofunctional Therapy is neuro- logical re-education exercises to assist the normalization of the developing, or devel- oped, craniofacial structures and function. It is related to the study, research, preven- tion, evaluation, diagnosis and treatment of functional and structural alterations in the region of the mouth (oro), face (facial) and regions of the neck (oropharyngeal area). WHAT IS THE LINK BETWEEN FEEDING AND WHAT ARE THE MAIN PROBLEMS RELATED SPEECH? TO OROFACIAL MYOFUNCTIONAL DISOR- Feeding a child stimulates the orofacial DERS (OMDS)? muscles and this promotes the growth of The main problems related to OMDs are the face. In the same way, proper suction alterations in breathing, sucking, chewing, and chewing prevents dental alterations swallowing and speech, as well the position and difficulties when structures such as the of the lips, tongue (including what is known lips and tongue are moving. This is funda- as oral rest posture), and cheeks. mental in the production of speech sounds. WHY SOME INFANTS HAVE DIFFICULTY SUCKING? WHAT ARE THE ADVANTAGES OF BREAST- Difficulties of sucking in infants may FEEDING? occur due to: lack of sucking reflexes Besides all the nutritional and immunolog- which decrease the suction force, frenulum ical benefits, the practice of breastfeeding restriction, lack of coordination between stimulates the proper functioning of the the actions of sucking, swallowing and structures of the mouth and face. Breast breathing; improper positioning of the feeding strengthens the orofacial muscles mother and /or the baby; absence of sealing of the infant, reducing risk of future prob- (closing) of the lips around the breast nip- lems in important functions such as breath- ple, and inadequate movement of tongue ing, chewing, swallowing and speaking. and jaw during breast feeding. WHAT TO DO WHEN BREASTFEEDING IS NOT POSSIBLE? Failing to breastfeed the infant directly at the maternal breast, milk may be collected HOW TO FEED A BABY WITH CLEFT LIP AND from the mother’s breast, or other milk may PALATE? be recommended by a pediatrician, which For breastfeeding infants with a cleft lip, also may be offered by a bottle, a spoon or the guidelines are the same as given to a small cup. The evaluation of a specialist infants without clefts. Many babies with a in Orofacial Myofunctional Therapy, with cleft lip may breastfeed with no alterations. advanced training in this area, must be However, in cases with a cleft palate, many individualized in each case, and may assist children may fail to have an adequate milk in indicating the most appropriate way to intake with breastfeeding alone. In these breastfeed the infant, along with a lacta- cases, the milk can be offered using special tion consultant. feeding bottles. HOW CAN FINGER SUCKING AND PACIFIER USE HARM A CHILD? Depending on the child’s facial features, functions, chewing, swallowing, and may the intensity, frequency and the duration also lead to slurred speech, such as an of these oral habits may cause changes in anterior lisp (placing the tongue between facial growth, alteration of tooth position the teeth). The pacifier soothes the baby, (anterior open bite), problems in the because it satisfies the need to suck, but its orofacial muscles, impairment of breathing use can be eliminated as soon as possible. WHY DO SOME YOUNG CHILDREN LOVE TO EAT VERY SOFT FOOD? The preference for soft foods may be HOW CAN ONE SUPPRESS HABITS, SUCH AS related to the reduction of the strength of FINGER SUCKING AND PACIFIER OVERUSE? the muscles of mastication (chewing) and The first step is to understand how these also because of enlarged tonsils. Some chil- habits began and why are they still occur- dren prefer foods with such consistency, as ring. The child must be understood and they would not need to chew much or at not ridiculed. Awareness is crucial to gain all. Feeding early on with different consis- the cooperation of the child. Depending tencies may stimulate the strength of the on the case, the Orofacial Myofunctional orofacial muscles and enhance harmonious Therapy Specialist may indicate exercises development of the face. for strengthening the orofacial muscles (especially the lips and tongue), and the WHAT IS A LISP? balance of the stomatognathic functions A lisp is a distortion of speech, character- (breathing, chewing and swallowing). An ized by placing the tongue between the occupational therapist may also be indi- front teeth during the production of the cated for consultation. sounds /s/ and /z/. CAN CHEWING ON ONE SIDE ONLY BE HARMFUL? Yes it is. By chewing only on one side, only the muscles of one side of the face are emphasized. This can cause a facial asym- metry over time. In addition, the bite can be altered and the temporomandibular joint SHOULD OROFACIAL MYOFUNCTIONAL

(TMJ, the joint that connects the jaw to the THERAPY OCCUR BEFORE OR AFTER skull and allows the mouth to open and ORTHODONTIC TREATMENT? close) on the opposite side of mastication, Orthodontic and Orofacial Myofunctional may suffer an overload. Therapy can be closely related with each directly impacting the other. Each case must WHAT CAN CAUSE AN OPEN BITE? be analyzed and discussed by the professionals An open bite corresponds to a problem involved. Treatment may be indicated before, of occlusion caused by multiple factors. during, and or after orthodontics. Orofacial Harmful habits (such as finger sucking Myofunctional Therapy specialists promote a or pacifier use) as well as the presence balance of the muscle and orofacial functions, of functional disorders (such as mouth improving the oral rest posture of the tongue breathing and inadequate pressure for and thus the stability of these cases treated by an optimal position of the tongue during orthodontists by helping diminish orthodontic swallowing and /or speech). relapse after the removal of braces. WHAT CAUSES TMD? TMD may be related to various factors such as dental changes (loss or wear of the teeth, poorly fitting dentures), unilateral chewing, mouth breathing, lesions due to trauma or degener- ation of the TMJ, muscle strains caused by psychological factors (stress and anxiety) and poor habits (nail biting, biting objects or food too hard, resting a hand on the chin, grinding or clenching teeth during sleep).

WHAT ARE THE MAIN SIGNS AND SYMP- TOMS OF TMD? Pain may be present around the TMJ (it WHAT IS TEMPOROMANDIBULAR JOINT may radiate to the head and neck), along DYSFUNCTION? with earache, tinnitus, ear fullness, sounds The term temporomandibular dysfunction when opening or closing the mouth (pop- (TMD) is used to define some problems ping or other noises in the TMJ), pain or that can affect the temporomandibular joint difficulties when opening the mouth, and (TMJ), as well as muscles and structures pain when moving the jaw and the muscles involved in chewing. involved in chewing. WHO CAN PROVIDE OROFACIAL MYOFUNC- HOW IS OROFACIAL MYOFUNCTIONAL TIONAL THERAPY? THERAPY CARRIED OUT FOR PATIENTS The stomatognathic system is supported by WITH TMD? an interdisciplinary team including speech Most cases of TMD should be treated by language pathologists, otolaryngologists, a team of allied health professionals such orthodontists, dentists, dental hygienists, as an Orofacial Myofunctional Therapy physical therapists, occupational therapists, Specialist, dentist, psychologist, physical kinesiotherapists and others. Each country’s therapist, neurologist and otolaryngologist. healthcare system is different, with one spe- The Orofacial Myofunctional Therapy Spe- cialty having differing degrees of leadership cialist, after conducting a thorough assess- roles. In some countries speech patholo- ment, working in an allied approach, may gists may take a leading role where in others apply techniques to rebalance the muscles another profession such as physical therapy of the mouth, face and neck, and restore the or dental hygiene may have a more promi- functions of breathing, chewing, and swal- nent role. It’s a truly interdisciplinary ther- lowing. With this, there may be attenuation apy, with several professions contributing, and/or elimination of the signs and symp- each according to their own scope of prac- toms of TMD. The patient should be made tice. It is incumbent upon the professional aware about any harmful oral habits and to complete additional training in orofacial oriented to contribute to the evolution of its myofunctional therapy and to abide to local clinical case. laws in the country in which they reside. HOW MAY AN OROFACIAL MYOFUNC- WHAT CAUSES FACIAL PARALYSIS? TIONAL SPECIALIST WORK WITH PATIENTS There are two types of facial paralysis: WHO HAVE FACIAL PARALYSIS? Peripheral Facial Paralysis, that affects the A specialist in Orofacial Myofunctional facial nerve (lesion outside the brain) and Therapy may work, with advanced training can be caused by trauma, tumors, infec- and according to their particular specialty’s tions or unknown factors, and Central (brain scope of practice, on the underlying mus- injury) caused by cerebral vascular accident cles that may be involved. This work should (stroke), head injuries and brain tumors. be performed in conjunction with otolar- yngologists and neurosurgeons. The main HOW ARE THE TWO KINDS OF FACIAL objective of the Orofacial Myofunctional PARALYSIS DIFFERENTIATED? Therapist is to rehabilitate the functions In Peripheral Facial Paralysis, only one side of chewing, swallowing, sucking and facial of the face or the whole face is affected. expression (essential to human communi- In Central Facial Paralysis, only the lower cation). The muscles of the face are manip- region of the face (around the mouth and ulated so that they can “relearn” the func- nose) is paralyzed. In the presence of a tions performed by them before the injury. facial palsy or any facial paralysis, it is crit- The Orofacial Myofunctional intervention ical to seek medical advice, seeking a diag- should be initiated as early as possible, in nosis and appropriate treatment. order to prevent muscle atrophy. HOW ARE WRINKLES PRODUCED? Wrinkles may be the result of inadequate postures, habits and repetitive movements, when chewing, swallowing, breathing and in speech. Furthermore, the wrinkles may be influenced by the exaggerated strain of the facial muscles.

HOW MAY THE OROFACIAL MYOFUNC- TIONAL SPECIALIST WORK WITH FACIAL AESTHETICS? WHAT IS THE RELATIONSHIP BETWEEN The Specialist in Orofacial Myofunc- OROFACIAL MYOFUNCTIONAL THERAPY tional Therapy works with the functions AND FACIAL AESTHETICS? of chewing, swallowing, and breathing. Wrinkles and marks caused by facial When these functions are working ade- expressions and habits that are directly quately and habits are eliminated, with the linked to the function of the muscles of the manipulation of the facial muscles, one face, which should be quite familiar to the may achieve a significant improvement in specialist who works in Orofacial Myofunc- facial aesthetics with facial rejuvenation tional Therapy. and smoothing of wrinkles. DOES SNORING CONTRIBUTE TO THE EMER- GENCE OF OBSTRUCTIVE SLEEP APNEA? Yes, due to constant vibration, the muscles of the mouth and throat become larger, and may bring about changes in size, width and thickness. This may contribute to the appearance of total or partial obstruction of breathing during sleep. WHAT IS SNORING? Snoring is defined as partial obstruction WHAT IS OBSTRUCTIVE SLEEP APNEA? of the upper airways causing noise and Obstructive Sleep Apnea Syndrome is vibration produced by some muscles of the defined as an obstruction of the airflow mouth and throat during sleep. channel during sleep. HOW COULD OROFACIAL MYOFUNC- TIONAL THERAPY BE RELATED TO CASES OF SNORING? Whoever snores and presents Obstructive Sleep Apnea should be treated by a multidisciplinary team including a sleep WHAT ARE POSSIBLE ISSUES AFFECTING specialist. In this team, the Orofacial PEOPLE WHO’VE SUFFERED BURNS ON THE Myofunctional Specialist may help by FACE AND NECK? directing and performing specific exercises Burns that affect the face and neck can to strengthen the muscles of the mouth trouble breathing, the act of opening and and throat and exercises that may help, if closing the mouth, chewing and swallowing. indicated, in improving oral rest posture. The aesthetics of the face is also affected. AFTER BURNING THE FACE, WHEN SHOULD A PERSON SEEK OROFACIAL MYOFUNC- TIONAL THERAPY? After being evaluated and treated by a HOW MAY OROFACIAL MYOFUNCTIONAL medical team and finding that the patient THERAPY HELP PATIENTS WHO HAVE SUF- is clinically stable, they may now be evalu- FERED BURNS IN THE FACE AND NECK? ated by an Orofacial Myofunctional Ther- A burned patient must be treated by a apy Specialist, with advanced training in multidisciplinary team. Within this team, this area, in order to help prevent the emer- advanced specialists in Orofacial Myofunc- gence of sequelae. tional Therapy may help patients with third degree burns. In an initial period, the ther- WHAT IS A FACIAL TRAUMA? WHAT ARE apy aims to prevent scarring sequelae. In THEIR CAUSES? later periods, it seeks to improve the func- The traumas and fractures caused on the tions of breathing, chewing, speech, voice face are called facial trauma. Traffic acci- and swallowing, as well as reducing tissue dents, falls, assaults, accidents with fire- retraction affected by burning (to promote arms, among others, could cause trauma balanced muscles of the face and neck and and fractures in various parts of the body, improve the aesthetics of the face). including the face. WHAT ARE THE POSSIBLE DIFFICULTIES HOW MAY OROFACIAL MYOFUNCTIONAL PRESENTED BY PEOPLE WHO HAVE SUF- THERAPY HELP PATIENTS WHO HAVE SUF- FERED FACIAL TRAUMA? FERED FACIAL TRAUMA? Chewing and swallowing are the functions Treatment of a patient who has suffered a more impaired, because facial trauma is facial trauma is multidisciplinary and spe- mainly comprised of damage to the facial cialized. The goal of the specialist in Oro- muscles, teeth and bones of the maxilla and facial Myofunctional Therapy is to promote mandible. Thus, a change occurs in speech the balance of the muscles of the face which articulation and also in the opening and may help to relieve pain, decrease swelling, closing of the mouth during speech and improve chewing, speech, and the appear- chewing. The TMJ and the aesthetics of the ance of scars and facial aesthetics. Patients face may also be impaired. Speech is in the may also benefit from re-education of chew- domain of a Speech-Language Pathologist. ing, swallowing, and breathing patterns. WHAT IS MOUTH BREATHING? Mouth breathing refers to breathing per- formed predominantly by the mouth. In this way of breathing, the individual does not use, or uses very little, the nose to inhale and exhale the air.

CAN MOUTH BREATHING CAUSE DAMAGE? Yes in several aspects, such as the mouth’s and face’s structures and their function, MOUTH BREATHING > including sleep, feeding, learning, hearing and speech. IS THERE A DIFFERENCE BETWEEN NASAL AND ORAL/MOUTH BREATHING? HOW CAN ONE IDENTIFY A PERSON WHO Yes, when breathing is done through the BREATHES THROUGH THE MOUTH? nose, the air is filtered (cleaned), warmed The person may have one or more of the and humidified, and thus it reaches the following characteristics: nasal congestion, lungs with less impurities that are in the air. open mouth at rest; parched lips, lip color When you breathe through your mouth the change, appearance of a large tongue that air does not go through this process and may be recessed and projected forward; reaches the lungs full of impurities. The long face syndrome; forward head posture; oral rest posture of the tongue and the man- dark circles under the eyes, sagging cheeks, dible when mouth breathing may also alter wheezing, and snoring. In such cases it is mandibular posture, palate width, and other recommended that an otolaryngologist craniofacial growth patterns as well as pos- (ENT) and/or allergist be consulted. ture of the head, neck, and upper body. HOW CAN MOUTH BREATHING CAUSE CHANGES TO THE STRUCTURE OF THE MOUTH AND THE FACE? Keeping an open mouth posture can cause: WHAT CAN CAUSE MOUTH BREATHING? dry and chapped lips, short and fast breath- The most common causes of mouth breath- ing; diminished strength of the muscles of ing are: allergic rhinitis, sinusitis, bronchi- the lips, cheeks, jaw and tongue; a lowered tis, enlarged adenoids; enlarged tonsils; and more anterior oral rest posture of the weakness or low tone of facial muscles that tongue, leading to changes in aesthetics may lead to open mouth rest posture, hab- and position of teeth/occlusion (improper its such as thumb sucking, tumors in the fit of the teeth); elongated face, retruded region of the nose, enlarged turbinates, and mandible, and palate (“roof of the mouth”) nose fractures, amongst others. becoming more narrow and /or deep. HOW CAN MOUTH BREATHING AFFECT FUNCTIONS RELATED TO THE MOUTH AND FACE? Mouth breathing leads to chewing food with lips apart, which becomes faster, nois- process of swallowing, one may also notice ier and less efficient than with lips closed. changes such as: anterior projection of the This can lead to greater digestive problems tongue, noise, contraction of muscles that and potential for choking due to the poor wrap around the mouth and movements of coordination between breathing, chewing, the head. There may also be excessive pro- and an increase in the swallowing of air. It’s duction of saliva and an anterior lisp: which hard to breathe through the mouth when the is a distortion of speech characterized by mouth is full, thus an individual will need to placing the tongue between the front teeth choose whether to chew or to breathe. In the during sound production of /s/ and /z/. WHAT ARE DISADVANTAGES THAT MOUTH BREATHING MAY CONTRIBUTE WITH REGARDS TO FEEDING AND BODY WEIGHT? Mouth breathers may have poor appetite, lower strength for chewing and swallow- WHAT ARE KEY ISSUES THAT MAY BE ing difficulties. Thus they may prefer softer CAUSED BY MOUTH BREATHING DURING foods and the use of liquid to assist feeding. SLEEP? The feeding of mouth breathers may also When sleeping with the mouth open, a per- be impaired because of decreased olfac- son may have some of these characteristics: tion (smell) and taste (taste). As a result of restless sleep, snoring, headaches, drooling changes in chewing, smell, and taste, the on the pillow, thirst when waking up, morn- individual may have decreased appetite, ing sleepiness, sleep apnea (breathing gastric changes, constant thirst, gagging, interruptions during sleep), and decreased pallor, anorexia, and weight loss with less oxygen saturation in the blood. physical improving or, conversely, obesity. WHAT ARE THE MAIN DISADVANTAGES TO HEARING AND SPEECH CAUSED BY MOUTH BREATHING? It is common in mouth breathing chil- dren to have more colds, infections in the nose, throat and chronic ear infections. Ear infection may lead to hearing loss, speech problems, language delays and vestibular issues. It is important to pay close atten- WHAT ARE THE MAIN DISADVANTAGES TO tion to children in such cases: listen well LEARNING CAUSED BY MOUTH BREATHING? to determine if they have difficulty hearing Sleep disturbances that have been previ- in the presence of noise; if they are unable ously explained can generate agitation, anx- to answer questions or follow direction, or iety, impatience, decreased levels of alert- could be considered inattentive. Most com- ness, impulsiveness and discouragement. mon changes are hoarseness in voice. This All of these changes can cause difficulties is because of the constantly open mouth with attention, concentration, memory leading to a drying out of all the structures problems, and subsequent learning difficul- that produce the voice and because the ties in children. During the critical periods muscles are contracted for a long time, they of a child’s development, mouth breathing may also appear to frequently have a cold can be more detrimental to learning. and a runny nose. WHICH KIND OF SPECIALIST IN OROFA- CIAL MYOFUNCTIONAL THERAPY SHOULD A MOUTH BREATHER SEEK? WHAT ARE THE MAIN DISADVANTAGES An individual who breathes through the OF MOUTH BREATHING REGARDING BODY mouth can seek an Orofacial Myofunc- POSTURE? tional Therapy Specialist to assist in the One major alteration is a change in the treatment of mouth breathing, as any gen- head’s postural position. The head will go eral Myofunctional Therapist is trained to forward seeking a larger space to breathe deal with these cases, but some seek addi- better, as often the tongue is resting in the tional training in respiratory education floor of the mouth. We can also find other techniques that may be helpful in treat- changes in the body caused by mouth ment. Orofacial Myofunctional Therapy is breathing, as the abdominal muscles are commenced only after evaluation of the weakened and stretched; dark circles with cause. It is advisable to also work within asymmetric positioning of the eyes, tired an allied team, with an otholaryngologyst/ eyes, and shoulders that may come forward ENT, a breathing specialist and /or an aller- and compresses the abdomen. gist as well. WHAT IS TONGUE-TIE? Tongue-tie is a popular term used to charac- terize a common condition that often goes undetected. It occurs during pregnancy when a small portion of tissue that should disappear during the infant’s develop- ment remains at the bottom of the tongue, restricting its movement. When an infant is born with tongue-tie, it is important to LINGUAL FRENULUM > research other family members, since this change has a genetic influence. WHO CAN DETECT THE PRESENCE OF TONGUE-TIE? A specialist in Orofacial Myofunciotnal Therapy should be well suited to detect a tongue-tie since they should know about the lingual frenulum and also the normal way the newborn sucks. In the case of infants, a pediatrician and a lactation con- sultant may also be involved. HOW AND WHEN SHOULD TONGUE-TIE BE TREATED? MAY THE TONGUE AND FRENULUM BE When the tongue cannot perform all the INSPECTED AS SOON AS THE BABY IS BORN? necessary movements and thus jeopardizes Yes, but there are varying degrees of the way of sucking, swallowing, chewing or tongue-tie, so the importance of having a talking, a small surgery or frenotomy in the test or validated protocol that evaluates the tongue is indicated. The “cut” of the frenum tongue and the “trickle” under the tongue in infants is a simple procedure done with (lingual frenulum) is crucial, as well as the scissors, scalpel, or laser and anesthetic way the infant sucks. This will ensure an gel, which lasts about five minutes. In older accurate diagnosis, and indicate whether children and adults the most common pro- or not the need to do a frenotomy (or small cedure is the frenectomy (partial removal of “cut” under the tongue) is recommended. the lingual frenulum). WHEN IS A SURGICAL PROCEDURE INDI- CATED TO RELEASE THE LINGUAL FRENU- LUM? WHAT CAN HAPPEN WITH AN INFANT IF In infants, surgery is usually indicated NOT TREATED? when the lingual frenulum restricts the Many people with tongue-tie suffer the con- tongue’s movement and compromises sequences without knowing the cause. There breastfeeding. In older children and adults, are infants who have changes in the feeding the indication is made when the tongue is cycle, causing stress for the infant and for visibly restricted, is unable to adequately the mother; there are also children with dif- reach the palate, or when possible distor- ficulties in chewing, children and adults with tions in speech are caused by limitation of speech problems affecting communication, the elevation of the tongue tip (especially social relationships and professional devel- in producing the sound of the “L” and “R”) opment. With the chronic oral rest posture that could not be corrected in speech ther- of the tongue in the floor of the mouth, many apy. A lactation consultant may also be of the Orofacial Myofunctional Disorders indicated for consultation. (OMDs) enumerated above may result. This project, FREQUENTLY ASKED REVISION COMMITTEE QUESTIONS AND ANSWERS IN THE 2012-2013 AREA OF OROFACIAL MYOFUNC- Ana Paula Dassie Leite TIONAL THERAPY, is coordinated by Ana Cristina Gama the Academy of Orofacial Myofunctional Aline Wolf e Lia Duarte Therapy (AOMT), a USA based post grad- uate training institution that specialises TRANSLATION AND SBFa LEADERSHIP 2012-2013 in training allied health professionals in COPY UPDATES 2014 Orofacial Myofunctional Therapy. This BOARD OF DIRECTORS ACADEMY OF ORO- pamphlet has been created with the Irene Queiroz Marchesan_President FACIAL MYOFUNC- support of the Brazilian Speech Pathol- Ana Cristina Cortês Gama_Vice President TIONAL THERAPY Marc Richard Moeller ogy Society (Sociedade Brasileira de Lia Inês Marino Duarte_Secretary Fonaudiologia/SBFa) and their Orofa- Licia Coceani-Paskay Aline Epiphanio Wolf_Deputy Secretary cial Myofunctional Therapy Committee, Nicole Archembault Besson Ana Elisa Moreira-Ferreira_Treasurer upon whose original work, “Repostas Para Samantha Danielle Weaver Perguntas Frequentes Na Area De Motri- Adriana Tessitore_Deputy Treasurer cidade Orofacial,” originally published in Marileda Cattelan Tomé_Scientific Director ILLUSTRATIONS 2011, with a second edition in 2012. Brazil Hilton Justino_Deputy Scientific Director Luisa Furman is the world’s leader in research, protocols, DESIGN and standards in Orofacial Myofunctional DEPARTMENT OF OROFACIAL Lia Assumpçao (Brazil) Therapy and the SBFa has consistently MYOFUNCTIONAL THERAPY Patrick Grandaw (USA) been at the forefront. This project is also Adriana Rahal_Coordinator supported by the Academy of Applied © AOMT. All Rights Reserved. Reproduc- Andrea Motta_Deputy Coordinator tion requires the permission of the AOMT. Myofunctional Sciences (AAMS), an inter- This is intended for information purposes national, non-profit NGO and membership OROFACIAL MYOFUNCTIONAL only and should not be used to diagnose association engaged in advancing THERAPY COMMITTEE or treat. Any person seeking care should consult with their doctor prior to any research, standards, education, and public Daniele Andrade da Cunha_Coordinator form of treatment. AOMT disclaims any health initiatives in the area of Orofacial Carmen das Graças Fernandes_Deputy and all liability for the accuracy of the information presented and for any use of Myofunctional Therapy worldwide. Coordinator the information for any purpose.