omt after frenuloplasty - academy of laser dentistry · omt after frenuloplasty grace sun dds 3...

OMT After Frenuloplasty Grace Sun DDS

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Lasers Coming of Age: 21 Years of Enlightenment

OMT After Frenuloplasty

Los Angeles

Grace Sun, DDS FAACD MALD MAGD MICOI

Lasers Coming of Age: 21 Years of Enlightenment

I have no commercial relationships.

Accredited Fellow of American Academy of Cosmetic Dentistry

Master and Educator of Academy of Laser Dentistry

Master of Academy of General Dentistry Master of International Congress of Oral

Implantologist Certified Orofacial Myologist Certified Buteyko Practitioner


To facilitate the tongue assume proper posture and function.


Learning Objectives:

• Review Proper tongue posture and function

• Reasons behind OMT

• OMT exercise after frenuloplasty

Frenuloplasty / Frenectomy

Assessment Indications:

• Tongue tie with impaired function

• Restricted ROM (Range of Motion)

Normal ROM: 40-53mm

“On-Spot” ROM: 50-60% of Normal ROM

* On-Spot (the tip of the tongue resting on the incisive papilla/gum ridge

behind the upper front teeth)


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Frenuloplasty / Frenectomy

Treatment • Surgically release the restricted frenum

• Monitor healing

• Rehabilitation w/ OMT( Orofacial Myofunctional Therapy)

• Re-pattern the habit

• Strengthen the oral musculature

Before After

OMT

(Orofacial Myofunctional Therapy)

• A series of exercises to re-pattern and optimize oral and facial

function

• Neuro-Muscular re-patterning

• Behavior modification to eliminate unhealthy habits

• Promote stable, proper and healthy oral postures

Neuroplasticity

• The brain’s ability to restructure itself after training or practice

• Neural pathways being set with respect to increased practice

• The more practice you accumulate, the more ingrained or

grooves the pathways become

Forming a new N-M pathway

• Thinking about the new action activates the sensory and motor areas

• During internal rehearsal and recall, the supplementary motor area is active

• Rehearsed activity is stored in the brain

• Routine action does not require activation of sensory input

Function of the Tongue

• Speech (Articulation)

• Chewing (Mastication)

• Swallowing (Deglutition)

• Taste (Gustatory Perception)

• Facilitate Maxillary Growth

(Stimulation of “the Spot”,

Functional Matrix)


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Tongue Muscular Strength

The tongue muscular structure consists of 4 pairs of

extrinsic and 4 pairs intrinsic muscles, which can exert

and generate substantial force

Tongue Muscle : 500 g/cm²

Cheek & Lips :300-400 g/cm²

Orthodontic force: 10-175g/cm²

Physiology

Physiology of muscles

• Movement

• Posture maintenance

• Joint stability

• Heat generation

Tongue Musculature


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Tongue Musculature

• Extrinsic-

(Chewing & Swallowing)

• Genioglossus

• Hyoglossus

• Styloglossus

• Palatoglossus

• Geniohyoid

• Mylohyoid

• Stylopharangeal

Tongue Musculature

• Intrinsic - speech

• Superior longitudinal ( tip & edges up)

• Inferior longitudinal ( tip down & dorsum up)

• Transverse ( narrow & elongated)

• Vertical ( flat & wider)

Swallowing

• Safely transport food from the mouth to the stomach

• Complex neuromuscular activities consisting 3 phases,

an oral, pharyngeal and esophageal phase.

OMT after Frenectomy Exercises

• Level 1 = Immediate post-op healing, range of motion • Swallow pattern establishment

• Level 2 = Long-term strength building • Swallow pattern improvement

• Neuroplasticity

• Neuromuscular repatterning

LEVEL 1 EXERCISES

Immediate post-op healing, range of motion

Swallow pattern establishment

The Waggle


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Level 1 Exercises

1. Horizontal Tongue Waggle (64 sec.)

o Extend tongue to the corners of the mouth. Tempo is 3 extends and

hold, 8 repeats.

Level 1 Exercises

2. Vertical Tongue Waggle (64 sec.)

o Extend tongue to the upper and lower lips, Tempo is 3 extends and

hold ,8 repeats.

Level 1 Exercises

3. Tongue Pops (64 sec.)

o Pops 3 times, on the 4th, tongue tip on spot ,dorsum on palate,

resist then release. 12 repeats.

Level 1 Exercises

4. Lizard Extensions (64 sec.)

o Extend tongue forward 2 times, on the 3rd, extend further , hold

then release. 12 repeats.

LEVEL 2 EXERCISES

Repatterning the swallow of motion – neuroplasticity

Neuromuscular benefits | Posture improvements

Resistance

Level 2 Exercises

1. Ping-Pong Press (64 sec.)

o Push tongue against fingers pressed upon cheek (Isometric

resistance).

Tempo is 3 and hold, 8 repeats.


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Level 2 Exercises

2. Double Trace (64 sec.)

o Rotation + Extension: Brush tongue against the inside of the dental

arches 360°, then trace against cheeks + lips 360°.

Level 2 Exercises

3. Push-Ups (64 sec.) o Hold a pen or stick across the corners of the mouth.

o Extend tongue under the stick and push up for 8 pulses.

o Extend tongue over the stick and press down for 8 pulses. (Isometric pushup –

extension)

Level 2 Exercises

4. Ballistic Tick-Tocks(64 sec.)

Level 2 Exercises

5. Clockwork + Center Extensions (Each point tempo is 3

extensions and hold)

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Looking Beyond

• Besides frenectomy and OMT

• Posture, diet, motivation, oral habits, occlusion, dental history , physical health , airway etc. are part of the total picture.


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Mission:

•Provide the best training to identify, treat OMDs •Educate Healthcare Providers, General Public

•Facilitate Research

[email protected]

www.myoacademy.com

Grace Sun DDS

462 North Doheny Drive

Los Angeles, CA 90048

310.274.4200

[email protected]

www.sundds.com

Thank you!

www.sundds.com

@sundentalgroup

@sundds

mailto:[email protected]

omt after frenuloplasty - academy of laser dentistry · omt after frenuloplasty grace sun dds 3...

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