Orofacial Myofunctional Therapies

Added to Handbook: April 2013
Updated: September 2013

PURPOSE

To provide guidelines on the administration of orofacial myofunctional therapies by dental hygienists.

BACKGROUND

As stated in the Scope of Practice Statement "dental hygienists may assess the status of teeth and adjacent tissues and provide preventative and therapeutic dental hygiene care for teeth and adjacent tissues."

Appropriate Education is defined in the Scope of Practice Statement and applies to the acquisition of knowledge and skills required to incorporate Orofacial Myfunctional Therapies (OMT) within the dental hygiene care. The ethical obligation to maintain competence in a skill in order to continue to incorporate it within dental hygiene care also applies to OMT.

Provided that a dental hygienist follows the full Assessment, Diagnosis, Planning, Implementation, and Evaluation (ADPIE) process of care, OMT may be incorporated as an adjunct to dental hygiene care. The focus of ADPIE must remain on the muscles of the lips and tongue along with how they interact with those muscles associated with the face. Interventions provided must focus on the exercises related to soft tissues in the oral cavity proper relating to resting position and functional patterns of these muscles and those related in the face. No therapies may be provided past the oral cavity proper in the oropharyngeal region. For example: it would not be appropriate for a dental hygienist to provide pharyngeal muscle stimulation. Interventions in this region are restricted activities that do not fall within the dental hygiene scope of practice.

The Dental Hygienists Regulation does not require supervision for the provision of OMT. However, the dental hygiene scope of practice does not include a diagnostic-level decision making component for Orofacial Myofunctional Disorders; therefore a diagnosis would be required by a health care professional such as an orthodontist, dentist or physician.

POLICY

Dental hygiene professionals who have received the appropriate education and certification in OMT and maintain currency may incorporate OMT into their dental hygiene practice. OMT may be used as an adjunct therapy supported through the Dental Hygiene ADPIE Process of Care.

Any diagnosis of an orofacial disease and/or disorders must be made by a dentist or appropriate health professional and not by the dental hygienist. Appropriate referrals are required when care is required not relating to soft tissues of the oral cavity or when deemed appropriate. OMT therapies should be completed in collaboration with other health care professionals involved in the client's care when appropriate.

Dental hygienists must remain within the dental hygiene scope of practice when providing OMT. Therefore, treatment provided beyond the oral cavity proper into the pharyngeal region is not permitted as this is considered a restricted activity that is reserved for other health professionals such as: speech language pathologists, physicians and dentists.

In conjunction with upholding Continuing Competency expectations required by the CDHBC, a registrant practicing OMT must maintain competence by upholding appropriate continuing education specific to OMT practice.

REFERENCES

  • American Speech-Language-Hearing Association. Orofacial Myofunctional Disorders (OMD) [Internet]. 2012 [Cited 2013 Sept 3]. Available from:
    ASHA Public Speech Disorders
  • Andresen T, Bahr C, Ciranna-Raab C. Efficacy Of Osteopathy and Other Manual Treatment Approaches For Malocclusion - A Systematic Review of Evidence. Int J Osteopath Med. 2013 June; 16(2):99-113.
  • Mason, RA. A Retrospective and Prospective View of Orofacial Myology. Int J Orofacial Myology 2005 Nov; 34:5-14.
  • CDHBC Scope of Practice. Victoria: College Of Dental Hygienists Of British Columbia; 2013.
  • The International Association of Orofacial Myology [Internet]. 2013 [Cited 2013 Sept 3]. Available From: http://www.iaom.com/