Orofacial Myofunctional Disorders

An orofacial myofunctional disorder, or OMD, is also called tongue thrust. It can cause problems eating, drinking, and speaking. Speech-language pathologists can help. 

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About OMD 

Your tongue usually stays in your mouth when you are not talking or eating. You may stick your tongue out a little bit to make some sounds or eat some foods. With OMD, your tongue moves forward too much. It may rest on your lips or stick out too far when you talk or eat. 

Symptoms of OMD 

As they grow, babies learn what to do with their tongue to eat and talk. It is normal for them to stick their tongue out and push food out of their mouth. Over time, they do this less. If your child keeps doing this, he may have OMD. Older children and adults can have OMD that started when they were young. OMD may cause problems eating and speaking. It can also cause your child’s teeth to be out of place because he pushes on them with his tongue.  


When you have OMD, your tongue may come too far out of your mouth as you chew. You may push food out from your lips. You may put your tongue on the bottom of your cup to drink. You may have trouble using a straw because you do not know where to put your tongue. Eating can be messy.  


You may have trouble saying sounds with OMD. You may have the most trouble with:  

  • "s" as in "sun" 
  • "z" as in "zoo"
  • "sh" as in "ship" 
  • "ch" as in "chew" 
  • "j" as in "jump" 

You use your tongue to make all of these sounds. Having your tongue in the wrong place can make it hard to say these sounds correctly. For example, you may say "thumb" instead of "some." Sounds like "t", "d", "n", and "l" can also be hard to say.  

You may not have problems saying any sounds. But your tongue may stick out when you talk. You also may not have any problems eating or drinking. Your only problem may be that your tongue moves forward too much or that your teeth are out of place.  

Causes of OMD 

Causes of OMD include any of the following: 

Allergies. It can be hard to breath through your nose when you have allergies. You may breathe through your mouth. Your tongue may rest on the bottom of your mouth. You may end up keeping your mouth open all the time to help you breathe. 

Large tonsils and adenoids. These can block your airway, making it hard to breathe. You may keep your mouth open to let more air in. Keeping your mouth open and tongue out may become a habit. 

Thumb or finger sucking, lip and fingernail biting, and teeth clenching. Over time, the shape of your mouth may change if you suck your thumb or grind your teeth. You may push your teeth forward and need to see a dentist or orthodontist. Your dentist may be the first person to tell you that you have OMD. 

Family history. The size and shape of your mouth and teeth comes from your genes. Your family may have a history of allergies or large tonsils. Other people in your family may have OMD.  

Testing for OMD 

You may see a few professionals to find out if you have OMD. They may include: 

  • A dentist 
  • An orthodontist 
  • A doctor 
  • A speech-language pathologist, or SLP 

Your dentist and orthodontist will look at your teeth and how your jaw moves. Doctors can test for allergies and check your tonsils and adenoids. SLPs test your speech and look at how you eat and drink. 

Treatment for OMD 

The SLP can help you change how you use your tongue. You may work on closing your lips when you are not talking or eating. The SLP can also work on how you say sounds and how you eat and drink.   

Treatment may include: 

  • Paying closer attention to your tongue and mouth movements. 
  • Knowing where your tongue and mouth muscles are when you rest, speak, and eat. 
  • Saying sounds more clearly. 
  • Changing how you chew and swallow. 

OMD is hard to treat if you still have breathing problems from allergies or large tonsils. You may need to see your doctor before you start working with an SLP. It is also hard to treat if you are still sucking your thumb or grinding your teeth. The SLP may try to help you stop doing these things first.  

Other Resources


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