In case you’ve been living under a rock, sleeping, nutrition and breathing are hot topics in health and wellness. Connecting these behaviors is surprisingly the mouth and the tongue.
After taking the Academy of Orofacial Myofunctional Therapy’s introductory course this past December, I am convinced this is a missing piece in our understanding of lifelong health and wellness.
Orofacial myofunctional therapy (OMT) is a multi-disciplinary field that focuses on treating disorders of the face and mouth that impact many whole body systems and several behaviors. OMT helps activities such as eating, speaking, breathing and sleeping through exercises focused on optimizing tongue posture/mobility and orofacial neuromuscular coordination.
The mainstay of OMT exercises is establishing proper resting tongue posture. If you haven’t heard of resting tongue posture (RTP) it is when the tongue rests on the roof of your mouth rather than the floor of the mouth.
When the tongue rests in this proper position several other things are facilitated:
-breathing, particularly nasal inhalation
-proper swallowing
-speech and the ability to articulate certain sounds
-proper occlusion
The problem is many people think they have their tongue on the roof of their mouth when in fact they don’t. I was one of those people. I thought only having the tip of my tongue on my palate was correct. I 've found many people are also making this assumption so I decided to make a blog/vlog post about how you can master the resting tongue posture – yourself or by helping your patients/clients
Follow the Steps outlined below:
First off you need to figure out what is their current RTP. Do this by simply asking. “Where does your tongue rest in your mouth?”
I’ve found it helpful to follow up with this question/analogy: “Does your tongue rest in your mouth like a hammock or does it make contact with the whole roof of your mouth, feeling its shape of an arch or rainbow?
If they have a correct RTP, AWESOME! I would progress to further assessment.
If they don’t this how I proceed:
Step 1: Figure out if they can do it with cues:
Give them a chance!
Here are the instructions:
1. With your LIPS SEALED
2. Teeth are gently touching
3. Place the tip of your tongue on THE SPOT ( 1-2 cm behind your front teeth)
4. Then gently LIFT your whole tongue up to the roof of your mouth.
Step 2: Educate with Visual Aides
A limiting factor in the development of oral sensory awareness is that the visual experience inside the mouth is limited. You can use a mirror and/or a smartphone to develop some awareness.
I also educate my patients with 3 pictures:
-One is for the palatine SPOT – where the tip of your tongue goes
-Another image is of the tongue - divided in 3 sections :FRONT (Anterior), MIDDLE, and BACK (Posterior)
-The third is a sectioned lateral image of the face so they get an appreciation for the hard and soft palate as the roof as well as how the nasal cavity lies just above it.
Step 3. Develop Oral Somatosensory Awareness
If someone is unable to perform the RTP or are they are not confident in their abilities I like to facilitate the development of improved oral somatosensory awareness.
“Oral somatosensory awareness refers to the somatic (body) sensations arising within the mouth and to the information these sensations provide about the state and structure of the mouth itself and objects in the mouth.” 1
Establishing a mind-body connection will help not only the establishment of good positioning but be the key that allows for the translation into function more effectively.
You can break this down into 2 areas
Awareness about their TONGUE
Your tongue occupies space in your mouth. How does it feel in relation to the other structures?
Where does the front, middle and back of the tongue rest? Where do these parts come into contact with other parts of your mouth? –ie, your palate, your teeth
The tongue is like any other muscles in that in can hold tension- Is their tongue relaxed or tensing and pressing in a particular part of the mouth cavity? Perhaps the front teeth? Maybe their jaw muscles are tight?
Awareness of the ORAL CAVITY
The human body has many cavities, aka spaces. The oral cavity is one you can improve somatosensory awareness of by orienting to the surface area with your tongue.
By taking the tongue and tracing the inside and outside of their teeth as well as tracing forward-back and side to side on the roof of their mouth, you can develop not only improved awareness of the mouth cavity but improved tongue mobility as well.
I have my patients focus on forward and back palate tracing because this is the area I want them to feel when improving their RTP.
Step 4: Revisit the instructions to perform the Resting Tongue Posture
Once you establish a Mind- Body Connection you want to have them perform this movement and positioning again.
Here you get more specific about the individual steps in the Instructions
1: With your LIPS SEALED
Make sure the lips are lightly closed and not pushed together with excessive effort
2: Teeth are gently touching
No clenching, their face and jaw muscles should look and feel relaxed.
3: Place the tip of your tongue on THE SPOT
Using a picture of the “SPOT” , you can take a tongue depressor and/or put a glove on it and palpate it.
If you want to stay hands off with your coaching- have them say “N”. The tip of the tongue goes to the “SPOT” when one says “N”
4: Gently lift the tongue to the roof (palate) of your mouth
Remind them that a low oral resting position will be like a hammock. A tongue in the proper resting position will contact the whole surface of the palate and feels more like a rainbow- or– an arch.
Also the tongue should not be forced up onto the palate.
Step 5. Make it Meaningful
The resting tongue posture is a habit that you want to promote. To do this you have to make it meaningful to your patient/client.
This can be done in a couple ways. First off, education. Education should include why it is important – for your particular patient/client – some examples:
Decreased Pain (cervical, TMJ, etc)
Improved Breathing
Improved Outcomes from Exercises
Improved Sleep
The most effective way to make it meaningful though is to get them to FEEL a difference.
The easiest way to assist this is to have someone pay attention to how a nasal inhalation feels without the RTP and then with. I consistently have folks tell me they perceive less resistance and the ability to inhale better with their tongue in the RTP.
In review, if you want to master doing or coaching the Resting Tongue Posture, follow the following steps:
Step 1: Figure out if they can do it with cues
Step 2: Educate with Visual Aides
Step 3. Develop Better Oral Somatosensory Awareness
Step 4: Revisit Instructing the Resting Tongue Posture
Step 5. Make it Meaningful
It’s important to state that there are a lot of reasons why achieving a good RTP can be difficult for some people. The shape and architecture of the mouth and other aspects of the orofacial complex may need more than learning the resting tongue posture and OMT exercises. It is common to see that the tongue itself may not have adequate mobility for achieving the RTP because of a tongue tie or lack of use.
These and many other factors that inhibit the functions of the orofacial complex do have a significant impact on health and by starting to put the pieces together we can help solve more of the puzzles when improving health and wellness.
Reference
1. Haggard P, de Boer L. Oral somatosensory awareness. Neurosci Biobehav Rev. 2014;47:469–484.
Photo credit Merch Hussey from Unsplash