Frequently Asked Questions

Orofacial myofunctional disorders (OMDs) are atypical movements and rest postures of the face, mouth, tongue lips and jaw. They may negatively impact dentofacial skeletal growth, healthy nasal breathing patterns, sleep (sleep disorder breathing or obstructive sleep apnea), temporomandibular joint movement and development of orofacial pain, chewing patterns, bolus collection in preparation for the swallow, overall oral hygiene, and compromise progression of and maintenance of long-term stability in orthodontic care.

Ankyloglossia (tongue tie) is often inadvertently correlated as the etiology of  all orofacial myofunctional disorders. While ankyloglossia is a structural condition present at birth, functional deficits associated with ankyloglossia can sometimes be contributory to development of an orofacial myofunctional disorder. Orofacial myofunctional disorders are not feeding disorders and subsequently should not be treated as such. be treated differently and in the right time frame. 

Orofacial myofunctional disorders can and do occur over the lifespan. Healthy babies can often slide into dysfunction during growth years. Healthy teens or adults can later experience them secondary to other injuries, poor orthodontic treatment or health issues. The geriatric population is prone to developing many signs and symptoms with the advent of decreased coordination, muscle tone, trauma, or tooth loss. 

Orofacial myofunctional disorders is a highly specialized area of practice for certain healthcare professionals, especially in the field of speech pathology. Their work puts them in close collaboration with other specialists in healthcare including: pediatricians, otolaryngologists, gastroenterologist, allergist, sleep medicine specialist, dental specialists, physical therapists and chiropractors.

There remains a lot of generalized misperceptions about “myofunctional disorders” by most healthcare practitioners and dental health specialists and the general public.  The idea that it is just a simple practice or exercise regimens and handouts (See YouTube, Facebook groups, etc), further research has revealed that these disorders are much more complex and layered than previously thought.

Therefore, to understand orofacial myofunctional therapy, practitioners need to first understand what they are.   Orofacial myofunctional disorders (OMDs) are patterns involving oral and orofacial musculature that interfere with normal growth, development, or function of orofacial structures, or call attention to themselves.   OMDs can be found in people of all ages from infancy through the geriatric population.  OMD’s can and do co-occur with a variety of speech and swallowing disorders. OMD often develop via the interplay of learned behaviors, physical/structural variables, genetic and environmental factors.  

The interplay of learned behaviors alongside structural development and other factors is what makes the needs for consistent differential diagnosis so important to therapeutic success.  It is also underscores why written step by step manuals for “therapy” are generally unsuccessful because a single plan cannot possibly accommodate virtually all the subtle differences in symptoms that emerge.  Unfortunately, there just are no “cookbook” methodologies that make this a simple practice approach.  While a simple practice approach of printed handouts, stretches, and recommendation were broadly used in the earliest years of the field, more recent research has found them to be largely unsuccessful in habituating changes in patient patterns.

After years of our own clinical practicum and assessment, the team at Function Focus Academy, have developed a comprehensive clinical diagnostic method for course participants.  This diagnostic methodology subsequently guides course participants on how to apply varied therapeutic techniques to the specific individual needs of the client rather than provide a one size fits all program approach. Not all people are the same. Not all bodies are the same.  Not all responses are the same.  Not all disorders are the same.

The fundamental physiological processes of breathing and swallowing underlie the healthy structural development of the entire orofacial complex.  Dentists who study craniofacial and dentofacial growth patterns have generally seen the tongue and other facial musculature as impediments to healthy development because of atypical function.  Over time therapeutic intervention for “myofunctional disorders” became hyper-focused on the lips-apart rest posture, often resulting from chronic mouth breathing.

There is substantial research evidence to support the understanding that chronic mouth-breathing results in poor orofacial development and malocclusion.  Hence the dental field’s ongoing focus on “airway.”  To address these patterns of mouth-breathing, many professionals advocate for the use of mouth tape, lip tap  for “lip taping” to seal the lips closed.  Unfortunately, while many well-meaning physicians recommend this method, few recognize the inherent danger that might coincide with physically sealing the lips closed and attempting to force nasal breathing. Especially when real nasal obstruction is present. The body will breathe. Nasally or orally. Air wins everytime.

Professionals who work with orofacial myofunctional disorders often focus on dysfunctional patterns by using breathing retraining program or techniques such as Butekyo (Butekyo breathing), Box breathing, and other programs that facilitate diaphragmatic breathing.

Other items commonly recommended by dental professionals to address ongoing airway patterns include using a MyoMunchee, a Myobrace Lip Trainer, SleepyStrip tape or other kinesiotape on the market.  These items have found to be useful when in conjunction with therapeutic services and not as a replacement for therapy. 

Registered Dental Hygienists (RDH), Dentists (DDS), MDs, Speech Language Pathologists (SLP-CCC) can all be certified to practice Orofacial Myology as a focus.

It should be noted that there is no existing state licensure for any specialist who refers to themselves as an: “oral myofunctional therapist (OMT)”, “myofunctional therapist (MFT)”, “certified orofacial myologist (COM®)”, or certified myofunctional specialist (CMS).” Rather, the diagnosis and treatment of orofacial myofunctional disorders remains a “scope of practice” for state licensed healthcare professionals who have undergone intensive extensive continuing education. Accrediting bodies overseeing “certifications” are limited with many privately held businesses offering “certification” in the programs they teach. To date, no privately held certifications are recognized as an accrediting body by any state licensing body in the United States.

A Certified Orofacial Myologist, or COM® for short, is the highest ranking of certification for the field.

“Myo therapy” is a term that is being broadly used in social media today. Why?  “Myo” is Latin for “muscle”.  “Functional” describe function.  Together “Myofunctional” describes “muscle function.”  There is, however, a broad difference between therapeutics that focus on muscle function than those that focus on the oral complex system.  Those are references as “oral myofunctional disorders.” 

The treatments within the field oral myofunctional therapy vary broadly, depending on the clinical and educational background of the one providing it. At its core, however, is the tenet of “proprioceptive neuromuscular facilitation”. (PNF). PFN intervention has been used for decades and relies upon developing new muscle memory to produced controlled voluntary movement through repetitive action. This repetitive movement builds automatics response and ultimately establishes brain neuroplasticity with unconscious responses.

Professionals who use the descriptor of “myo” or using “my myo program” as a treatment do the field great disservice as not all OMD’s require repetitive regimen “exercises” to correct them.  This same thinking applies to individuals who incorporation “ology” into business names.  Examples could include: like Faceology, Myology, Oromyology, Airwayology. The term “ology” means “the study of…”. Examples include urology, psychology, epidemiology. 

Many practitioners today are choosing to specialize in working with certain age groups.  This is especially true for infant care. Unfortunately, there remain a large number of clinicians whose clinical work experience with infants has been exceedingly limited. Many have been actively recruited to work with infants by other allied professionals or the general public and jump in without recognizing that the anatomy and physiology of babies are vastly different from the populations they have worked with prior.  In recent years, there have been many who have promoted the idea that babies can benefit from myofunctional therapy.  References to “Baby Myo” have surged with the recent flood of infant lingual frenectomies (tongue tie releases) being performed today.  Certain health professionals have attempted to establish routine course of care association with these procedures. 

The reality is that babies have not yet had any time to develop controlled volitional movement and coordination.  Therefore, the principles behind Proprioceptive Neuromuscular Facilitations (especially in the head/neck system) cannot be applied.  We cannot force repetitive movement in individuals who have not yet developed systems to support them.  To clarify even further: infants and toddlers who have not yet acquired the cognitive ability to perform repetitive action movements (even required for PNF, nor had time for primitive reflexes to integrate properly, nor acquired proper feeding and chewing techniques simply cannot benefit from the “repetitive regimens” being offered as “therapies” today.

Infants and toddler who present with signs and symptoms of ankyloglossia, struggle with early feeding, or other developmental struggles should seek out a International Board Certified Lactation Counselor (IBCLC), a licensed speech language pathologist or occupational therapist who is trained in infant feeding. Registered dental hygiensts are not licensed to do early infant feeding 

OMT is an acronym.  The use of acronyms arose with the advent of social media platforms alongside broad expansion of websites, meme’s, gif’s and other media shortcuts.  Acronyms were designed as shortcuts to typing out entire text and should not be confused as post-nominal credentials.  Below are a just a few of the ways the acronym is used today:

• Oral Motor Therapy 

• Oral Myofunctional Therapy 

• Oral Myofunctional Therapist 

• Opioid Maintenance Treatment

• Osteopathic Manipulative Therapy

• One Multipurpose Terminal

• Objective Modeling Technique

• Outcome Measurement Tool

• Operations Maintenance Test

By the same token the acronym MFT also encompasses a broad range of meanings:

• Marriage & Family Therapist 

• Medical Field Technician

• Master of Foreign Trade

• Master Fitness Trainer

• Mission Flight Trainer

• Myofunctional Therapist (unlicensed)

• Myofunctional Therapy 

FunctionFocus Academy trains already licensed therapists in the diagnosis and treatment of oral myofunctional disorders as a scope of practice.  We do not encourage the use of any acronym descriptors that cause consumer confusion. The use of such descriptors often infers a “professional license practice” which does not exist in the United States today.  Rather, we encourage the attendees to delineate their state licensure under which they treat Orofacial Myofunctional Disorders.

Orofacial Myofunctional Therapy, often shortned to just Myofunctional Therapy, is the method of treatment than an Orofacial Myologist uses to treat patients. The study and practice of this field is called Orofacial Myology. Technically speaking, it is incorrect to call a certified professional a myofunctional therapist.

An OMD = Orofacial Myology Disorder, or Disorders (plural = OMDs) ar ethe set of disorders that are treated by orofacial myologists.

The difference is in the details. 

Letters that follow names are officially called “post-nominal letters.” They can be earned for a number of accomplishments. Letters can be earned for academic education, accreditation, certification, designation and/or recognition. While the result of placing professional letters after one’s professional signature is the same, the prestigiousness of the accomplishments are often note the same.  In other words, some letters mean more than others.

There are 4 different ways to acquire post-nominal letters. 

1. Academic Education:  While one may acquire a certificate or degree, degrees do not merit post-nominal letters.  While it is acceptable in some professions to delineate advanced degrees such as Master’s of Science or Doctorate, few business professionals use them post-nominally. 
2. Accreditation and Certification: This is a process by which an 3rd party entity (ASHA, ADHA, AGD) grants public recognition to an organization (IAOM) that has existing qualification or standards and those individuals (members) who voluntarily meet the qualifications become recognized as “certified.” Certification programs generally require the professional to have met a certain number of years of experience in the field, pass a comprehensive test and complete ongoing education to meet the terms of the certification.  
3. Designation: Testing is generally not a requirement for earning a designation. Often times a test is not even required.  Though the entity (business) may require continuing education for designee, most do not.  Therefore, while a completion is worthy of letters, a designation is at a lower level than a true accreditation or certification. (Example: Vital Stim Certified)
4. Recognition:  Recognition, though still worthy of post-nominal letters viewed is the least prestigious. Recognition may be earned through specific training or by reaching a professional career milestone that is not often seen by others in the profession.  No testing, experience or continuing education are involved.  (Example: in 2018 Mary Billings was “recognized” as a Subject Matter Expert by ASHA when working on their OMD Practice Portal and again in 2022, when she was “recognized” as an ASHA Lifetime Member.

The American Speech Language Hearing Association adopted the area of Orofacial Myofunctional Disorders (OMDs) into its scope of practice documents in 1991.  ASHA encourages all speech-language pathologists to undergo extensive continuing education in the area prior to treatment patients with these diagnoses because of their complexity and university programs inability to dedicate the amount of time to learning them than should be desire.

ASHA does not require any speech language pathologist to be certified to treat these disorders nor does any state licensing board.

Therapy that focuses on “oral function” is also not taught not encompassed within the educational programs of occupational therapy, physical therapy, dentistry, or dental hygiene. For this reason many professionals often seek “certification” to support their area of clinical practice.

No current certifications program designating this field as a specialty is recognized nor supported by state licensing boards or other accrediting bodies. The team at Function Focus Academy does not support, nor endorse any existing certification program at this time.

In recent years for-profit businesses that teach educational courses have main broad claims regarding becoming “certified.”  Virtually every field can now find this buzzword used to generate people to sign up and take their courses.  Many are currently advertising myofunctional therapy training.  Not surprisingly this leads to a lot of confusion and misperception for the average individual.  

In actuality, Certification programs are vastly different from the “certificates of completion” one acquires for completing a single course or series of courses. While legal interpretations of certifications can be defined as either “internal” or “external” the differences between them should be clearly understood by those professionals who sign up for them.  An internal certification is a self-driven; self-created program where the company or agency certifies themselves.  An external Certification is one that is underwritten by an accredited university program or a professional membership organization. Until only recently, external certification programs were the norm.

Universities may be for-profit or non-profit but they must be legally registered, accredited and recognized by the Federal Department of Education. Examples of university-based certification programs: Certified Occupational Therapy (COTA); Certified Coding Specialist (CCS), Certified Nursing Assistant (CNA). These universities have an overseeing governing body that routinely accredits the programs to ensure they meet national competency and criteria. The universities offer programs (not just lectures) that include an extensive standardized curriculum and practicum.  They also require both written and clinical examination to assess competency. University certification graduates are generally conferred with an Associate’s Degree and thereafter become eligible for state licensure to practice. Proof of continuing education credits to maintain that licensure is a requirement.  Licensing also defines the scope of practice pertinent to a specified field.  To date there are currently no university accredited programs in the United States that certify graduates in “oral motor therapy,” “oral myofunctional therapy” or confer any degree of “myofunctional therapist” “oromyofunctional therapist” or otherwise.

In the absence of university accreditation, other external “certification” is acquired through an organization sponsored programs.  Organizations that offer such programs are generally non-profit 3rd party entities. These organizations retain a membership and have an elected Board of Directors, often accompanied by a separate Board of Examiners. While they sponsor educational programs most do not “profit” from them. 

A good example of a healthcare-based certification is the American Speech Language Hearing Association. ASHA is a non-profit membership driven professional organization. ASHA develops the standards of education and professional practice that helps universities establish curriculum for acquisition secondary degree.  As a result, nearly every university program that offers degrees in Communication Disorders is ASHA accredited.  ASHA also develops and scores the national Praxis Examination (clinical boards). Today most universities making passing the Praxis Examination a requirement before conferring a degree to the graduate.  New graduates must thereafter complete a Clinical Fellowship Year that meets the criteria of supervision and patient care diversity required by ASHA before being awarded the Certificate of Clinical Competence (CCC) the international gold-star for practice. Thereafter, as part of its requirement for ongoing membership, ASHA requires proof of continuing education in the field to demonstrate ongoing competence. Members are held to standards of care, requirements for malpractice, as well as ethics and scope of practice. 

Long before ASHA adopted diagnosis and treatment of orofacial myofunctional disorders into its scope of practice DDS were offering some form of what they referred to as “myofunctional therapy.” Most recruited speech language pathologists to do the therapy. As a result, the International Association of Orofacial Myology (IAOM) was begun in 1971.  The IAOM was created by 4 speech language pathologists with special interest and the field and used ASHA’s nonprofit membership driven organization as its model.  The COM® (Certified Orofacial Myology) post-nominal accreditation has been in place for 50 years. The IAOM has a Board of Directors, a separate Clinical Board of Examiners, a research journal published annually and extensive sub-committees comprised of member volunteers who work to develop and approve comprehensive and appropriate curriculum for treating these disorders.  Instructors whose educational content, candidate criteria eligibility, and IAOM standards of care in the field may be approved to teach. The IAOM also requires regular continuing education requirements be met or members rights to COM® are revoked.

Anyone considering pursuit of a “certification” should research their options very carefully and understand what their programs offer. Check out the IAOM Practice Portal for further information on the step to certification. http://www.iaom.com/

In 2015 the IAOM began an active marketing campaign actively publicizing its “certification” program. As it has always been understood that post-nominal letters add credibility to professional practice, the interest in the IAOM program began to rapidly accelerate resulting in a 300% increase in membership growth and 500% increase in course participation. 

As a result, competitors began to utilize the similar terminology in an attempt to improve demand for their own courses. While the IAOM continued to advocate for “certification” most competitors created their own program and described them as a “certification.” These self-developed “certifications” have today added unforetold layers of confusion for both the professionals signing up for the courses as well as the consumers seeking certified specialists who offer treatment.  As a result of this massive marketing blitz, the specialty field of Orofacial Myofunctional Disorders have developed a negative image among many other healthcare specialists.  The field became even more tarnished as these same for-profit entities began allowing individuals with limited or without any healthcare licensure to participate and begin to call themselves “myofunctional therapists.”

Obtaining the COM® is an investment.  Financially and in time.  Those professionals who have completed its requirements naturally become passionate about what it took to make it happen.  Nothing causes the blood to boil more than when another practitioner brings down the reputation of an industry.  Today, many practicing in the field outside the COM® are claiming levels of expertise where it is fully lacking, espousing the use of unproven medical techniques where there is no evidentiary research to support its claims, and are selling services to families when the clients cannot possibly progress because they do not meet the clinical criteria needed for progress.  Many of these same practitioners utilize these varied post-nominal letters for self-promotion while often working well outside the clinical boundaries of their healthcare education and experience and state licensure. Other programs defend themselves by claiming education is “information dispersal” only and they are not liable for what people do with the information. This refusal to establish qualification criteria will inevitably put public health at risk while simultaneously diminishing the credibility and reputations of those highly trained professionals who acquired true certification.

When communicating with potential clients then it becomes important that both our referral sources and the patients they serve recognize the difference and significance of the COM.®  Working with a COM® should be encouraged as these professionals work hard to stay at the top of their profession.  

Accreditation post-nominal letters mean things. Letters after names mean things. Look for them. Learn about them. Share the value with consumers and encourage them to hire professionals who have earned them.

The IAOM is the only existing nonprofit professional trade organization dedicated to the science of orofacial myofunctional disorders. The IAOM is membership-driven organization. As a legal corporation, the IAOM has a Board of Directors elected by membership (not designated by privately held company shareholders) whose role is to uphold its Article of Incorporation and support its stated Mission Statement.  The IAOM’s Mission is supported through the annual dues of its membership which goes to support its Certification program and professional development. 

Like most non-profits, the IAOM is excluded from paying taxes but must meet the federal criteria required to maintain that nonprofit status. Unlike other for-profit entities: (The Breathe Institute, AOMT, Coulson Institute of Myofunctional Science, NeoHealth Services, which offer certification and/or ambassador status), the IAOM (as a 501(c) 6 organization) is prohibited from “selling” or profiting from the courses they accredit.  For profit entities are usually privately held businesses, which again trademark a “designation” rather than meet the criteria for an accreditation or certification. Therefore, the IAOM requires its educators (like FunctionFocus Academy) to meet both professional and clinical standards alongside the curriculum and materials used to teach and IAOM approved course. The IAOM also delineates which professions meet eligibility standard, offer Continuing Education credit and enforce instructor Code of Conduct requirements. 

The IAOM’s “COM®” post-nominal accreditation is a legally recognized and protected trademark under USPTA after having been shown to be used in commerce for over 50 years.  The COM® descriptor of “Certified Orofacial Myologist” is also trademarked. In recent years, the IAOM has rigorously pursued legal actions against outside businesses/providers who have attempted to infringe on its post-nominal letters and description while claiming their own certification designation.

In short, the IAOM has provided oversight and established standards of care for its membership and therefore for the public at large who receive treatment for the disorders.  Private for-profit entities or NonGovernmental Organizations (NG0’s) (eg. AAMS) do not and are rooted in information dispersal only with no accountability to those who pursue continuing education through them.  

More than 90% of the for-profit entities currently offering a “certification” all trained originally under the IAOM. Most held or currently hold the COM®.  This begs the question: why set up a competing program rather than support the existing? 

The team at FunctionFocus Academy remains to dedicated to educating and producing quality clinician.  At this time our courses are a hybrid of both online learning and in-person lab based practiced learning.  

Diagnosis and treatment of orofacial myofunctional disorders is not a profession but a designated scope of practice for currently licensed professionals. Proof of educational background is required. Proof of licensure is required to register.

An individual who is not licensed as a speech-language pathologist, dental hygienist, dentist, or physicians may appeal to the IAOM Board of Directors for consideration.  A letter of appeal, transcripts, and references are required. 

The process begins by taking a course, joining the IAOM, and completing two clinical cases. Upon completion members are eligible to apply for certification. A review of clinical cases is required before being accepted for examination. 

The examination consists of a written essay, objective testing,  and clinical onside evaluation. 

Click here for a brief summary from the IAOM on this process. 

It can take candidates anywhere from 9-24 months to complete their certification after completion of clinical cases and their acceptance into the certification program.

The team at FunctionFocus Academy does not do billing.  Billing for services should be based on the individual participants clinical background, treatment methodology and approach. 

The American Medication Association does not currently have a Current Procedural Terminology (CPT) specific to “orofacial myofunctional disorders” not does the International Classification of Diseases (ICD10) diagnostics coding system itemize it as a clinical diagnosis.  Orofacial myofunctional disorders are a complex layering of multiple signs and symptoms that often overlap. 

Many healthcare professionals are looking to specialize today. As a result, the question related to income and “salary” related to this type of therapy often arises.

There are many models of practice for people new to the field but the standards related to income are varied and are generally based on whether one working for someone else or entering self-employment.  

Pricing for therapeutic services varies broadly across the United States and other international locations today.  In the US, reimbursements rates are based largely on consumer demand and geographical area.  It is recommended practitioners do their research to ascertain what their area’s “reasonable and customary” rate for reimbursement would be. 

We also recommended that anyone new to the field check out the demand and competition in their own location so they are aware of how much need exists in their area. As an example, if one resides in a small town of 5000, the likelihood of developing a full-time caseload to support themselves is much less than an individual in a city of 20,000 with no practitioners in site.  While referral sources often assure people new to the field they will “keep them busy” a referral does not always equate to a paying client.  

Research and awareness will make this process much easier to navigate.

This course is open to licensed professionals in the field of speech language pathology (speech pathology assistants are not eligible), and dentistry.

Individuals with background in occupational and physical therapy are encourage to apply.  Practice experience in oral function will be required. Please submit a vitae 

Proof of licensure will be required at the time of registration.

Click on the Courses & Seminars tab to view course requirements of choice, course locations and dates and register there. You’ll find a full agenda and learning outcomes/syllabus.

On the course page, Make The Connection for example, you will find a full agenda and learning outcomes/syllabus.