Common but Not Normal: Orofacial Myofunctional Disorders in Children

Signs & Symptoms of Orofacial Dysfunction in Pediatrics

Parents today are sorting through more health information than ever, yet clear guidance about oral development in kids can still be surprisingly tough to find. Things we tend to think of as a simple ‘little quirk,’ like extra drooling or picky eating in toddlerhood, are often seen as phases kids will eventually grow out of, so they don’t always get a closer look. The reality is that these common behaviors, while common, can tell us that something might be up with your child’s orofacial development. If you’re asking Google, “is this normal?” it absolutely is worth getting a second opinion for! 

Why does this matter? Because dysfunction in our orofacial system can lead to problems with breathing, eating, speech and sleep. All necessary pieces to a healthy growing child. So what is orofacial function? Think of it as the coordination between the tongue, jaw, and facial muscles that lets us breathe, chew, swallow, and speak comfortably. Each of these skills start to develop as early as 15 weeks in the womb, when babies begin to practice swallowing their amniotic fluid. The orofacial myofunctional system is complex. It includes both structural and functional parts, and—like any other body system—those pieces need to work together for us to thrive. When things are not developing optimally, we see orofacial myofunctional disorders (OMDs) occur. While this may seem like just another thing parents need to worry about (I know, there’s too many things already), the reality is that if identified early, we can make some pretty incredible changes that positively impact your child’s health for the long term.

Why does proper oral function matter for kids?

The mouth and nose are involved in some of the body’s most important jobs, including breathing, eating, speaking, and even supporting good sleep. When you add in the tongue, teeth, and jaw, their influence stretches even further, affecting things like posture, stability, and sometimes even how well the eyes work together.

I’ll break each part of this system down below so you can identify when things are going right, and when you might need to have someone take a closer look.

Breathing

When all systems are working accordingly, we are breathing through our nose 100% of the time (awake and asleep) unless we’re talking or eating. This should be achieved with the full surface of the tongue lightly placed against the roof of the mouth, what we call “proper oral resting posture”. This is important for a few reasons:

1. Our nose has the job of slowing down, filtering, hydrating and warming up the air that we inhale so the air arrives in the lungs in a gentle, lung-friendly state. 

2. Nasal breathing helps the body make a natural molecule called nitric oxide. This molecule acts like a tiny helper that opens the airways, supports healthy blood flow, and helps the lungs use oxygen more efficiently. For children, this means calmer breathing, better sleep, and stronger support for growing bodies. 

3. When we breathe through the mouth instead of the nose, the mouth can get dry. Over time, this can cause issues like bad breath and make children more prone to cavities or infections

Here are a few other signs to watch for when it comes to your child’s breathing:

• Shallow breathing that occurs mostly in the chest, rather than the belly

• Loud or consistently congested breathing when awake

• Snoring or noisy breathing during sleep

• Teeth clenching and/or grinding in sleep

• Restless sleep, tossing and turning. In small children we often see the hair on the back of the head being difficult to comb due to knots

• Bed wetting past potty training age

• Daytime sleepiness, irritability and attention concerns

While many of the above examples, particularly related to sleep behaviors, might seem odd, these are signs of compromised airway health. 

Eating

Good nutrition is essential for children’s long-term health. It helps build the foundation for healthy growth of their bones, joints, muscles, and brain. That said, feeding young children isn’t always easy, and it’s common for parents to feel frustrated or unsure. Clinically, we see that when a child has difficulty chewing, moving food with their tongue, or swallowing, it can lead to challenges like gagging or picky eating. 

While it may seem like children simply ‘grow out of’ certain habits, these behaviors often persist because the body has adapted in ways that may not fully support overall health. One example is a retained tongue-thrust swallowing pattern, where the child pushes food forward with the tongue. This pattern usually doesn’t self-correct after about six months of age. While a child can often learn to eat fairly well despite it, the tongue-thrust pattern can lead to an open bite, which may cause difficulties with chewing and proper dental development.

Here are a few signs that might suggest your child could benefit from further evaluation:

• Pushing food forward with the tongue, which may leave food on the lips or cheeks

• Difficulty clearing food from the teeth or palate

• Frequent coughing, choking, gagging, or sputtering while eating

• Picky eating, especially avoiding certain textures

• Trouble chewing harder foods

• Eating very slowly or relying on liquids to help swallow food

• Food pocketing in the cheeks

• Puckering around the lips or grimacing while swallowing

• Difficulty swallowing pills (in older children)

• Struggles with weight gain, digestive concerns and constipation are also signs something might be amiss with oral function

  
  

Speech & Communication

Oral motor function and the structure of the mouth play a big role in how children speak and communicate. The tongue, lips, jaw, and soft palate all need to move in coordinated ways to produce sounds clearly, chew and swallow efficiently, and control airflow for speech. When a child has difficulties with tongue posture, chewing patterns, or oral muscle strength, it can affect how easily they form certain sounds or speak clearly. Over time, these subtle challenges can make communication more effortful, even if the child is otherwise healthy. Supporting proper oral motor development helps children not only eat and breathe effectively, but also build the foundation for clear, confident speech and communication.

Here are some indicators that your child’s speech may be impacted due to an orofacial myofunctional disorder: 

• Lisping or difficulty with specific sounds

• Tongue sticking out to create speech sounds

• Low-volume or “mumbled” speech”

• Persistent drooling

Rest assured, many challenges related to speech are subtle signs of oral motor patterns, not your child’s intelligence, or your parenting.

Dental & Facial Development Clues

Dental and facial development can reveal important clues about a child’s oral function—if you know what to look for. There isn’t yet a clear consensus on how to manage these concerns, since airway-focused dentistry is a relatively new field that prioritizes airway health over the cosmetic appearance of the teeth and jaws. Some features that often seem hereditary are actually the result of early oral dysfunction. These may include patterns in jaw shape, palate width, bite alignment, and other facial characteristics, which can all influence breathing, chewing, and overall oral function. Here are a few of the signs clinicians commonly observe:

• Crowded baby teeth

• Deep bite or open bite

• High, narrow palate

• Long facial shape and/or lower facial tone

• Retruded lower jaw

• Upturned nose

• Tight appearing or asymmetrical dimples

• Mouth that hangs open frequently

• Chapped lips from chronic mouth breathing

• Frequent dark circles under the eyes or “allergic shiners” 

When to Check In If your child is showing any of the signs mentioned above, such as sleep difficulties, chronic congestion, ear or throat infections, challenges with feeding or speech, or dental concerns—it’s a good idea to have them evaluated by a provider trained in Orofacial Myofunctional Therapy. While early intervention can support long-term development, it’s important to know that at any age, there are ways to address these concerns using approaches tailored to your child and family situation.

Who Can Help? Care for Orofacial Myofunctional Disorders works best as a whole-body, team approach that keeps your child and family in mind. Some of the practitioners you may want to consult include:

• Pediatric airway-focused dentist

• Ear, nose, and throat specialist (preferably airway-aware)Sleep specialist (MD and/or dental)

• Orofacial myofunctional therapy-trained practitioner

• Speech-language pathologist (some may also have OMT training)

• Feeding therapist

• Occupational therapist or physiotherapist

• Chiropractor, osteopath, or other bodyworker

Your child may not need all of these specialists. The key is finding providers who can help you navigate care and build a team suited to your child’s needs. In our office, part of the Orofacial Myofunctional Assessment includes helping families assemble a care team and providing resources to support their journey.

If reading this list feels overwhelming, try not to worry. Children’s bodies and brains are remarkably adaptable. By noticing these signs and seeking support early, you are already ahead of many adults who face similar issues without explanation. You are on the right track to supporting your child’s long-term health and well-being.

If you are looking to have your child evaluated for Orofacial Dysfunction, please connect with us at Spotspeech@gmail.com or take a look through our website and submit a booking inquiry www.spotspeech.com