PATIENT EDUCATION: CHEWING

Written by Dr. Sandra Kahn, an orthodontist, and Dr. Paul Ehrlich, a Stanford evolutionary biologist, Jaws explores the modern crisis of underdeveloped facial structures. The authors argue that our epidemic of crooked teeth, mouth breathing, and obstructive sleep disorders isn't genetic—it's functional.

This book is a must-read for anyone interested in airway health, oral development, or preventative care. Kahn and Ehrlich explain how the shift to soft, processed foods, pacifiers, and bottle feeding has reshaped our faces across generations—reducing tongue space, crowding teeth, and collapsing our airways.

Their central message: Form follows function—and chewing is essential for proper development.

While genetics influence craniofacial structure, epigenetic expression—how genes are activated or suppressed based on environment and behavior—plays a far greater role.
Our ancestors chewed tough, fibrous foods daily. This constant load on the masticatory muscles stimulated growth of the:

• Maxilla (upper jaw) 
• Mandible (lower jaw) 
• Palate and airway space
   

Today’s diet is soft, requiring little force. As a result:

• Jaws under-develop 
• Faces narrow 
• Airway space collapses 
• Teeth crowd
   

Supplemental chewing (chewing gum or masticatory devices designed to resist compression) may help counteract this modern deficiency, providing critical muscular and skeletal stimulus for:

• Facial bone remodeling 
• Salivary gland stimulation 
• Oral muscle tone development
   

Chewing isn't just helpful—it's necessary in today’s low-demand food culture.

Chewing is the first phase of digestion, but its influence goes beyond breaking food down.

Neuroscience shows that chewing activates the trigeminal nerve, a cranial nerve responsible for:

• Jaw movement 
• Facial sensation 
• Stimulation of parasympathetic pathways (rest-and-digest)
   

Chewing also:

• Increases blood flow to the brain 
• Enhances memory and attention 
• Stimulates vagal tone, promoting digestive enzyme release and gut motility
   

Soft diets reduce this activation, potentially altering the neurological signals that support digestion, focus, and autonomic regulation.

Chewing plays a critical role in training the tongue and stabilizing the airway. Each bite encourages:

• Lateral tongue movement, essential for swallowing and palate shaping 
• Strengthening of orofacial muscles, which support the tongue and airway 
• Proper oral rest posture, as a toned tongue more easily rests on the palate
   

Without proper chewing, the tongue may sit low in the mouth, contributing to:

• Mouth breathing 
• Tongue thrust 
• Snoring and airway collapse 
• Orthodontic instability
   

Myofunctional therapy often includes chewing exercises or supplemental chewing routines to reinforce muscle tone, improve posture, and stimulate the neuromuscular patterns tied to nasal breathing and efficient swallowing.

Whether you're an adult looking to improve function or a parent supporting a growing child, introducing consistent chewing can be a simple yet powerful step.

• Prioritize whole foods over soft processed meals 
• Introduce safe, sugar-free chewing options with resistance 
• Consider chew-training tools approved for airway-focused development 
• Integrate myofunctional exercises guided by a qualified therapist
   

Disclaimer:
The content on this page is intended for educational and informational purposes only. It is not medical or dental advice and should not be used as a substitute for professional diagnosis or treatment. Always consult with a qualified healthcare or dental provider before making changes to your diet, oral health routine, or treatment plan. Statements about supplemental chewing are based on current research in craniofacial development and are not intended to treat or cure medical conditions. 

Ansar, J., Maheshwari, S., Verma, S. K., Singh, R. K., Agarwal, D. K., & Bhattacharya, P. (2015). Soft tissue airway dimensions and craniocervical posture in subjects with different growth patterns. The Angle orthodontist, 85(4), 604–610. https://doi.org/10.2319/042314-299.1 

Corruccini, R. S. (1999). How anthropology informs the orthodontic diagnosis of malocclusion's causes (Mellen Studies in Anthropology, Vol. 1). Edwin Mellen Press. 

Graber, L. W., Vanarsdall, R. L., & Vig, K. W. L. (2012). Orthodontics: Current principles and techniques (5th ed.). Elsevier Mosby. 

Guilleminault, C., Huang, Y. S., Monteyrol, P. J., Sato, R., Quo, S., & Lin, C. H. (2013). Critical role of myofascial reeducation in pediatric sleep-disordered breathing. Sleep medicine, 14(6), 518–525. https://doi.org/10.1016/j.sleep.2013.01.013 

Hasegawa, Y., Ono, T., Hori, K., & Nokubi, T. (2007). Influence of human jaw movement on cerebral blood flow. Journal of dental research, 86(1), 64–68. https://doi.org/10.1177/154405910708600110 

Kahn, S., & Ehrlich, P. R. (2018). Jaws: The Story of a Hidden Epidemic. Stanford University Press. 

Kahn, S. L., & Ehrlich, P. R. (2018). Vicious cycles in the evolution of the human face. The Anatomical Record, 301(2), 322–329. https://doi.org/10.1002/ar.23723

Krüsi, M., Vacher, C. M., Delplanque, S., et al. (2021). The soft diet: A risk factor for altered jaw development. Scientific Reports, 11, 2467. https://doi.org/10.1038/s41598-021-81928-w 

Newton, J. T., Awojobi, O., Nasseripour, M., Warburton, F., Di Giorgio, S., Gallagher, J. E., & Banerjee, A. (2020). A Systematic Review and Meta-Analysis of the Role of Sugar-Free Chewing Gum in Dental Caries. JDR clinical and translational research, 5(3), 214–223. https://doi.org/10.1177/2380084419887178 

Ono, Y., Yamamoto, T., Kubo, K. Y., & Onozuka, M. (2010). Occlusion and brain function: mastication as a prevention of cognitive dysfunction. Journal of oral rehabilitation, 37(8), 624–640. https://doi.org/10.1111/j.1365-2842.2010.02079.x 

Proffit, W. R., Fields, H. W., & Sarver, D. M. (2012). Contemporary Orthodontics (5th ed.). Elsevier.

Facial asymmetry is more than a cosmetic concern—it often reflects underlying functional imbalances. Orofacial Myofunctional Disorders (OMDs) can subtly shift the way facial muscles develop and operate over time, leading to uneven muscle tone, postural compensation, and strain patterns that pull the face out of balance.

• Mouth Breathing: Chronic open-mouth posture can lead to underdeveloped midface structures and long facial growth patterns.
   
• Low Tongue Posture: Without upward pressure from the tongue, the palate may narrow and the face may elongate asymmetrically.
   
• Chewing Imbalance: Favoring one side for chewing or breathing can create dominant muscle tone on one side of the face, altering symmetry.
   
• Jaw Dysfunction: TMJ tension and compensations can contribute to shifts in jaw alignment and facial muscle usage.
   

These imbalances are often subtle in childhood but become more apparent with time, especially during growth spurts or after orthodontic intervention.

Orofacial Myofunctional Therapy (OMT) retrains the muscles of the face, tongue, lips, and jaw to function in harmony. By restoring proper:

• Tongue posture
   
• Oral rest posture (lips sealed, nasal breathing)
   
• Chewing balance
   
• Swallowing mechanics
  

Therapy can help reduce uneven muscle tension and encourage more symmetrical function. When integrated early—particularly during craniofacial growth—OMT may support more balanced facial development. In adults, OMT can help improve muscle tone and posture, offering functional improvement and subtle cosmetic changes.

OMT often works alongside orthodontists, physical therapists, craniosacral practitioners, and vision or ENT specialists to address the full picture of asymmetry. Structural alignment and muscle function are most successfully corrected when approached as a team.

Disclaimer:
The information provided on this page is for educational and informational purposes only and is not intended to diagnose, treat, or cure any medical or dental conditions. Facial asymmetry may result from a variety of structural, neurological, or developmental factors. Myofunctional therapy is a supportive, non-invasive modality that addresses functional patterns within the scope of orofacial muscle training. Therapy should be pursued in collaboration with licensed medical and dental professionals when structural, surgical, or diagnostic evaluation is needed. Always consult with your healthcare provider for individualized care.  

Harari, D., Redlich, M., Miri, S., Hamud, T., & Gross, M. (2010). The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients. Laryngoscope, 120(10), 2089-2093. https://doi.org/10.1002/lary.20991 

Graber, T. M., Vanarsdall, R. L., & Vig, K. W. L. (2012). Orthodontics: Current Principles and Techniques (5th ed.). Elsevier Health Sciences. 

Guilleminault, C., Huseni, S., & Lo, L. (2016). A frequent phenotype for paediatric sleep apnoea: short lingual frenulum. European Respiratory Journal, 47(6), 1716–1725. https://doi.org/10.1183/13993003.02150-2015 

Mew, J. R. C. (2004). Craniofacial dystrophy, the cause of orthodontic relapse. Journal of Orthodontics, 31(4), 256-262. https://doi.org/10.1179/146531204225020338 

When most people think about fertility, they think about hormones, reproductive organs, or assisted treatments. But a growing body of research reveals that something as basic as how you breathe—specifically, whether you breathe through your nose or mouth—can influence the hormonal and physiological conditions that support fertility.

Breathing through the nose activates essential biological systems that affect everything from stress hormones to reproductive blood flow. Unlike mouth breathing, nasal breathing:

• Stimulates the parasympathetic nervous system, lowering stress and cortisol levels 
• Triggers the production of nitric oxide (NO) in the paranasal sinuses, a molecule essential for circulation and oxygenation 
• Improves sleep quality, hormone regulation, and immune function 
• Supports optimal oxygen delivery to all tissues—including the reproductive organs
   

These mechanisms create the internal environment that fertility depends on.

“Nasal breathing improves the exchange of gases and releases nitric oxide, which enhances blood flow and oxygen delivery.”
– Ignarro, L. J., Nobel Laureate in Physiology or Medicine, 1998
 

Nitric oxide (NO), produced during nasal inhalation, acts as a vasodilator—meaning it widens blood vessels and increases blood flow. This is especially important for reproductive function:

• Uterine and ovarian perfusion: NO increases blood flow to the uterus and ovaries, supporting egg maturation and endometrial lining development 
• Implantation and placental health: Adequate NO supports implantation and early placental circulation 
• Oxygen efficiency: NO improves the lungs’ ability to absorb oxygen, ensuring productive tissues receive adequate oxygenation

Chronic mouth breathing is associated with elevated cortisol, the body’s primary stress hormone. Elevated cortisol can disrupt:

• Ovulation by suppressing the release of GnRH (gonadotropin-releasing hormone) 
• estrogen/progesterone balance, critical for egg development and implantation 
• Thyroid function, which affects menstrual cycle regularity
   

Nasal breathing helps regulate the autonomic nervous system, promoting hormonal stability and improved sleep—both key factors in natural fertility.

Mouth breathing bypasses nitric oxide production and activates a sympathetic stress response, leading to:

• Poor sleep quality 
• Reduced oxygenation 
• Hormonal imbalances 
• Increased systemic inflammation
   

These changes can create a biological environment less supportive of conception.

(Mygind et al., 2020)

In addition to supporting implantation and reproductive blood flow, nitric oxide may also play a protective role in pregnancy maintenance. Research conducted on primates has shown that nitric oxide can help inhibit uterine contractions and delay the onset of preterm labor.

A study published in The Journal of Maternal-Fetal Medicine found that nitric oxide administration in rhesus monkeys inhibited premature labor, suggesting its potential role in sustaining pregnancy and supporting full-term development.
(Jennings et al., 1993)  https://doi.org/10.3109/14767059309017336
 

This reinforces the broader role of nasal breathing—by promoting nitric oxide production—in creating a stable internal environment for reproductive success and fetal development.

Your breath is the most fundamental function of life—and it’s intimately tied to your reproductive health. By choosing nasal breathing over mouth breathing, you activate your body’s own system for improving circulation, hormone balance, and stress regulation.

Better breathing doesn’t just support general wellness—it may support your path to parenthood.

Disclaimer:
The information provided on this page is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider regarding your individual health needs, especially when addressing fertility concerns. Nasal breathing may support general wellness but is not a substitute for medical or reproductive care. 

Fournier, S. B., D'Errico, J. N., & Stapleton, P. A. (2021). Uterine Vascular Control Preconception and During Pregnancy. Comprehensive Physiology, 11(3), 1871–1893. https://doi.org/10.1002/cphy.c190015 

Herman, J. P., McKlveen, J. M., Ghosal, S., Kopp, B., Wulsin, A., Makinson, R., Scheimann, J., & Myers, B. (2016). Regulation of the Hypothalamic-Pituitary-Adrenocortical Stress Response. Comprehensive Physiology, 6(2), 603–621. https://doi.org/10.1002/cphy.c150015 

Jennings, R. W., MacGillivray, T. E., & Harrison, M. R. (1993). Nitric Oxide Inhibits Preterm Labor in the Rhesus Monkey. Journal of Maternal-Fetal Medicine, 2(4), 170–175. https://doi.org/10.3109/14767059309017336 

Luo, Y., Zhu, Y., Basang, W., Wang, X., Li, C., & Zhou, X. (2021). Roles of Nitric Oxide in the Regulation of Reproduction: A Review. Frontiers in endocrinology, 12, 752410. https://doi.org/10.3389/fendo.2021.752410 

Mariotti A. (2015). The effects of chronic stress on health: new insights into the molecular mechanisms of brain-body communication. Future science OA, 1(3), FSO23. https://doi.org/10.4155/fso.15.21 

Mörlin, B., Andersson, E., Byström, B., & Hammarström, M. (2005). Nitric oxide induces endometrial secretion at implantation time. Acta Obstetricia et Gynecologica Scandinavica, 84(11), 1029. https://doi.org/10.1080/j.0001-6349.2005.00804.x 

Richard, K., Holland, O., Landers, K., Vanderlelie, J. J., Hofstee, P., Cuffe, J. S. M., & Perkins, A. V. (2017). Effects of maternal micronutrient supplementation on placental function. Placenta, 54, 38–44. https://doi.org/10.1016/j.placenta.2016.12.022 

Rooney, K. L., & Domar, A. D. (2018). The relationship between stress and infertility. Dialogues in clinical neuroscience, 20(1), 41–47. https://doi.org/10.31887/DCNS.2018.20.1/klrooney 

As myofunctional therapists, we’re trained to assess the function and coordination of the orofacial muscles—often treating patients who struggle with airway instability, swallowing dysfunction, and TMJ pain. But how often are we asking ourselves why those dysfunctions are present in the first place?

One often-overlooked answer: hypermobility.

Hypermobility refers to excessive joint mobility often stemming from differences in connective tissue integrity—commonly linked to conditions like hypermobile Ehlers-Danlos Syndrome (hEDS) or Hypermobility Spectrum Disorder (HSD).

These connective tissue disorders are frequently missed but highly relevant to orofacial therapy. Hypermobile patients often present with:

• Tongue instability or poor palatal suction
• Chronic TMJ subluxation or clicking
• Forward head posture and cervicogenic tension
• Difficulty sustaining oral rest posture
• Fatigue during postural or oral motor exercises
• "Tight" muscles that resist progress with conventional stretching

In hypermobile patients, tension is often compensatory rather than structural. The body is bracing for lost stability. Applying standard stretching protocols can worsen dysfunction.

What these patients often need is:

• Proprioceptive input
• Controlled neuromuscular engagement
• Gentle, stability-based retraining

• History of joint dislocations, sprains, or subluxations with minimal trauma
• Early TMJ clicking or joint pain
• High, narrow palate or crowded dentition with open-mouth posture
• Sensory sensitivity or low interoceptive awareness
• Diagnoses like POTS, MCAS, IBS, or chronic fatigue
• Family history of hypermobility or connective tissue conditions
• Fascial strain that doesn’t respond to manual therapy

Hypermobile patients are also at greater risk for binocular vision dysfunction (BVD):

• Convergence insufficiency
• Difficulty with tracking or fixation
• Head tilt or compensation during reading
• Visual fatigue or dizziness

Cervical and cranial instability can disrupt extraocular muscle coordination. Without vision screening or referral to a developmental optometrist, patients may plateau in therapy.

Hypermobility affects:

• Airway and postural stability
• Tongue control and proprioception
• Fascial tone and craniosacral rhythm
• Muscle coordination and sleep quality

Without recognizing these patterns, we risk:

• Overprescribing mobility exercises that create further instability
• Missing key contributors to fatigue, dysfunction, or lack of progress
• Ignoring visual-motor deficits affecting posture and orofacial control

Screen:

• Use the Beighton Score or 5-point questionnaire for joint hypermobility
• Ask about vision fatigue, headaches, or reading difficulties

Refer:

• Collaborate with PTs, optometrists, ENTs, and other airway-focused providers

Adjust Protocols:

• Prioritize postural awareness, controlled oral-motor engagement, and proprioception
• De-emphasize passive stretching unless integrated into a broader stabilization strategy

Educate Your Patients:

• Normalize their symptoms and explain the complexity
• Offer resources for connective tissue health and collaborative care

If a patient presents with persistent dysfunction despite doing everything "right," pause and ask: Is there a vision or stability component we’re missing?

Hypermobility is not rare—it’s just under-recognized. Understanding its impact on airway, fascia, posture, and neurodevelopment gives you powerful insight into why function breaks down, and how to help it heal.

Assessing Joint Hypermobility - The Ehlers Danlos Society 

Disclaimer:
The information provided on this page is for educational and informational purposes only. It is not intended to diagnose, treat, or cure any medical or dental condition. Orofacial Myofunctional Therapy is a behavioral-based therapy and does not replace medical, dental, or speech-language pathology services. Always consult with a licensed healthcare provider before beginning any treatment. 

Castori, M., Tinkle, B., Levy, H., Grahame, R., Malfait, F., & Hakim, A. (2017). A framework for the classification of joint hypermobility and related conditions. American journal of medical genetics. Part C, Seminars in medical genetics, 175(1), 148–157. https://doi.org/10.1002/ajmg.c.31539 

De Coster, P. J., Van den Berghe, L. I., & Martens, L. C. (2005). Generalized joint hypermobility and temporomandibular disorders: inherited connective tissue disease as a model with maximum expression. Journal of orofacial pain, 19(1), 47–57. 

de Félicio, C. M., Freitas, R. L., & Bataglion, C. (2007). The effects of orofacial myofunctional therapy combined with an occlusal splint on signs and symptoms in a man with TMD-hypermobility: case study. The International journal of orofacial myology : official publication of the International Association of Orofacial Myology, 33, 21–29. 

Nosouhian S, Haghighat A, Mohammadi I, Shadmehr E, Davoudi A, Badrian H. Temporomandibular Joint Hypermobility Manifestation Based on Clinical Observations. J Int Oral Health. 2015 Aug;7(8):1-4. PMID: 26464530; PMCID: PMC4588772. 

Oelerich, O., Daume, L., Yekkalam, N., Hanisch, M., & Menne, M. C. (2024). Temporomandibular disorders among Ehlers-Danlos syndromes: a narrative review. The Journal of international medical research, 52(4), 3000605241242582. https://doi.org/10.1177/03000605241242582 

The Ehlers-Danlos Society. (n.d.). Assessing joint hypermobility. https://www.ehlers-danlos.com/assessing-joint-hypermobility/ 

Yekkalam, N., Sipilä, K., Novo, M., Reissmann, D., Hanisch, M., & Oelerich, O. (2024). Oral health-related quality of life among women with temporomandibular disorders and hypermobile Ehlers-Danlos syndrome or hypermobility spectrum disorder. Journal of the American Dental Association (1939), 155(11), 945–953. https://doi.org/10.1016/j.adaj.2024.08.013 

Lip incompetence refers to the inability to maintain a closed mouth posture at rest without conscious effort. In other words, the lips do not seal together naturally and comfortably when the face is relaxed.

Proper lip seal supports healthy oral and facial development, encourages nasal breathing, and maintains a stable oral environment. When lips remain open at rest:

• Airway resistance increases, often leading to mouth breathing 
• Tongue posture is altered, contributing to facial and dental changes 
• Lip and chin muscles compensate, leading to muscle fatigue or tension 
• Salivary flow is disrupted, increasing risk of tooth decay and dry mouth
   

• Constant open-mouth posture 
• Dry or chapped lips 
• Strained lower facial muscles or dimpling in the chin 
• Mouth breathing, especially during sleep 
• Dental malocclusions such as an open bite

1. Mouth Breathing
   – Often both a cause and effect of lip incompetence
   – Prevents natural lip seal and leads to compensatory postures
    
2. Low Resting Tongue Posture
   – Without proper tongue support to the palate, the lips may remain open at rest
    
3. Weakness of the Orbicularis Oris Muscle
   – Inadequate strength or tone in the lip muscles prevents sustained closure
    
4. Tongue Thrust
   – Forward tongue pressure during swallowing or speech often results in an open mouth and lip strain
    
5. Atypical Swallow Pattern
   – Dysfunctional use of facial muscles during swallowing can prevent lips from closing at rest
    
6. Enlarged Tonsils/Adenoids or Airway Obstruction
   – Forces the child or adult to breathe through the mouth, keeping lips open
    
7. Anterior Open Bite or Malocclusion
   – Poor dental alignment may make it difficult or impossible to close the lips comfortably
    
8. Structural Restrictions (e.g., Lip Tie)
   – Restrictive labial frenulum may limit upper lip mobility
    
9. Neurological or Sensory Processing Disorders
   – May interfere with the ability to sense or maintain closed lip posture
    
10. Habitual Postures
    – Learned or habitual open-mouth postures during childhood that become chronic over time
     

Myofunctional therapy strengthens and retrains the orofacial muscles to support:

• Lip strength and seal 
• Nasal breathing habits 
• Balanced facial muscle tone 
• Improved oral posture at rest and during function

• Improved Nasal Breathing
  – Encourages proper air filtration, humidification, and nitric oxide production
  – Reduces risk of respiratory infections and sleep-disordered breathing
   
• Optimized Tongue Posture
  – Helps the tongue rest against the palate, supporting proper jaw and facial growth
   
• Better Swallowing Mechanics
  – Reduces compensatory muscle strain and promotes more efficient swallowing
   
• Enhanced Oral Health
  – Minimizes mouth dryness, plaque buildup, and risk of cavities from open-mouth posture
   
• Reduction in Orofacial Pain and Strain
  – Eases tension in lips, chin, and jaw caused by overactive or strained muscles
   

• Balanced Facial Development
  – Supports ideal growth of the midface, lips, and chin
  – Helps prevent long-face syndrome and narrow facial structure
   
• Improved Jawline Definition
  – Strengthens muscles around the lower face, enhancing tone and structure
   
• More Symmetrical Appearance
  – Reduces muscle imbalances that contribute to facial asymmetry
   
• Healthier, Youthful Appearance
  – Closed lips contribute to natural facial tone and prevent “mouth-breathing face”
   

By addressing the root functional patterns behind lip incompetence, therapy promotes long-term improvements in breathing, facial growth, and dental stability.

Disclaimer:
The information provided on this page is for educational and informational purposes only. It is not intended to diagnose, treat, or cure any medical or dental condition. Orofacial Myofunctional Therapy is a behavioral-based therapy and does not replace medical, dental, or speech-language pathology services. Always consult with a licensed healthcare provider before beginning any treatment. 

Graber, T. M., Vanarsdall, R. L., & Vig, K. W. L. (2012). Orthodontics: Current Principles and Techniques (5th ed.). Elsevier Health Sciences. 

Harari, D., Redlich, M., Miri, S., Hamud, T., & Gross, M. (2010).
The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients. Laryngoscope, 120(10), 2089–2093.
https://doi.org/10.1002/lary.20994 

Moss, M. L., & Salentijn, L. (1971). The primary role of functional matrices in facial growth. American Journal of Orthodontics, 57(6), 566–577. https://doi.org/10.1016/0002-9416(70)90261-8 

Most people know that menopause affects hormones, mood, sleep, and metabolism. But few realize that it also affects something as fundamental—and as often overlooked—as tongue posture.

Yes, your tongue. That powerful, posture-defining, airway-supporting muscle in the middle of your face. During menopause and perimenopause, hormonal shifts can subtly—but significantly—disrupt how your tongue rests, moves, and functions. And that shift can ripple through the entire body.

Tongue posture refers to the resting position of the tongue in the mouth—ideally, gently pressed against the roof of the mouth, with the tip near the incisive papilla ("the spot" just behind the front teeth), lips sealed, and breathing through the nose.

Proper tongue posture:

• Supports the airway and nasal breathing
• Stabilizes the jaw and TMJ
• Shapes the palate and facial structure
• Activates cranial nerves and improves postural control
• Promotes efficient swallowing and digestion

Poor tongue posture—such as when the tongue rests low or pulls back—can lead to:

• Mouth breathing
• Snoring or sleep-disordered breathing
• TMJ strain
• Forward head posture
• Digestive disruption
• Chronic tension or fatigue

For women in menopause, these symptoms often worsen at the same time tongue posture begins to decline. But it’s not a coincidence—it’s physiology.

During perimenopause and menopause, declining estrogen and progesterone levels alter muscle tone, fluid regulation, and connective tissue support throughout the body—including in the orofacial region.

Key factors linking menopause to tongue dysfunction:

• Decreased muscle tone: Estrogen supports neuromuscular control. As it drops, tongue strength and stability decline.
• Increased soft tissue laxity: The soft palate and pharynx become less supportive, increasing airway collapse during sleep.
• Dry mouth (xerostomia): Lower saliva production increases tension and alters swallowing.
• Impaired sleep architecture: Poor sleep triggers compensatory muscle use and altered oral posture.
• Breathing pattern changes: Nasal congestion, weight changes, and stress promote mouth breathing and shallow respiration.  [coupon and link below for breathing class]

These changes may be subtle at first—but over time, they create a cycle of dysfunction that affects sleep, jaw comfort, posture, and even digestion.

The good news: tongue posture is trainable.

Orofacial Myofunctional Therapy (OMT) uses gentle, evidence-based exercises to:

• Restore proper tongue posture and oral rest position
• Strengthen the lips, tongue, and jaw
• Reinforce nasal breathing and airway tone
• Improve proprioception and neuromuscular coordination

OMT exercises may include:

• Tongue elevation and suction hold practice
• Jaw and lip resistance work
• Habit elimination (mouth breathing, clenching)
• Postural retraining and diaphragmatic breathing support

For women navigating menopause, OMT offers a proactive, empowering, and non-invasive tool to reclaim function and comfort.

You may not hear this from your doctor. You may not read it on a menopause blog. But your tongue posture could be at the root of your sleep issues, jaw discomfort, brain fog, or chronic fatigue.

Restoring healthy oral function supports:

• Better airway mechanics and oxygenation
• More restorative sleep
• Relief from facial tension and TMJ discomfort
• Improved digestion and posture
• A sense of strength and self-awareness from the inside out

This is functional healing. And it starts with awareness.

Disclaimer:
The information provided on this page is for educational and informational purposes only. It is not intended to diagnose, treat, or cure any medical or dental condition. Orofacial Myofunctional Therapy is a behavioral-based therapy and does not replace medical, dental, or speech-language pathology services. Always consult with a licensed healthcare provider before beginning any treatment. 

Berger M, Szalewski L, Bakalczuk M, Bakalczuk G, Bakalczuk S, Szkutnik J. Association between estrogen levels and temporomandibular disorders: a systematic literature review. Prz Menopauzalny. 2015 Dec;14(4):260-70. doi: 10.5114/pm.2015.56538. Epub 2015 Dec 22. PMID: 26848299; PMCID: PMC4733902. 

Kravitz, H. M., Kazlauskaite, R., & Joffe, H. (2018). Sleep, Health, and Metabolism in Midlife Women and Menopause: Food for Thought. Obstetrics and gynecology clinics of North America, 45(4), 679–694. https://doi.org/10.1016/j.ogc.2018.07.008  

Popovic, R. M., & White, D. P. (1998). Upper airway muscle activity in normal women: Influence of hormonal status. Journal of Applied Physiology, 84(3), 1055–1062. https://doi.org/10.1152/jappl.1998.84.3.1055

Over the last few years, “mewing” has gained attention on social media as a way to change facial appearance, improve jawline definition, or enhance breathing. While it is often portrayed as a quick aesthetic trick, mewing is actually rooted in a much deeper concept: functional oral posture and muscle balance—principles long addressed in Orofacial Myofunctional Therapy (OMT).

Mewing refers to consciously placing the tongue against the roof of the mouth, keeping the lips closed, and breathing through the nose. The term comes from Dr. John Mew and Dr. Mike Mew, orthodontists who promoted the role of oral posture in jaw development.

Key components include:

• Tongue posture: Resting the tongue gently on the palate 
• Lips together: Maintaining a light seal 
• Nasal breathing: Breathing through the nose instead of the mouth
   

Social media trends often frame mewing as a single, isolated movement for the jaw. In reality, correct oral posture influences multiple systems:

1. Airway Health 
   • Proper tongue posture supports the upper airway and can reduce airway collapse during sleep. 
   • Nasal breathing filters, warms, and humidifies air, enhancing oxygen delivery.
     Source: NIH – Nasal nitric oxide and respiratory health
      

1. Craniofacial Development 
   • In growing children, consistent proper tongue posture can encourage optimal growth of the upper jaw and midface. 
   • In adults, while bone changes are minimal, improved posture can help stabilize the bite and facial symmetry.
     Source: PubMed – Orofacial myofunctional therapy and craniofacial growth
      

1. Muscle Function & Balance 
   • Engages the suprahyoid and orofacial muscles in a balanced, low-strain position. 
   • Works with the muscles of swallowing, chewing, and speech.
      

1. Posture & Body Alignment 
   • The tongue’s position influences head and neck posture, which can affect spinal alignment and muscle tension patterns.
      

OMT goes beyond “just mewing” by:

• Evaluating why a person cannot naturally maintain proper tongue posture (e.g., nasal obstruction, tongue-tie, muscle weakness, habitual mouth breathing) 
• Addressing breathing mechanics to ensure nasal breathing is comfortable and sustainable 
• Coordinating oral posture with swallowing, speech, and chewing patterns 
• Using progressive exercises to strengthen and retrain the orofacial complex
   

• “It’s a quick fix for facial aesthetics”
  True structural changes take time and, in adults, are usually subtle. 
• “You can force your jawline into shape”
  Overly tense or incorrect positioning can cause jaw discomfort or temporomandibular joint (TMJ) strain. 
• “It replaces medical or dental care”
  Mewing does not correct structural airway obstructions or orthodontic needs—professional evaluation is essential.
   

If nasal breathing is difficult, the tongue cannot rest comfortably on the palate, or jaw discomfort develops, an airway-focused dental provider or a myofunctional therapist can help determine the cause and guide safe, effective exercises.

Disclaimer:
The information provided on this page is for educational and informational purposes only. It is not intended to diagnose, treat, or cure any medical or dental condition. Orofacial Myofunctional Therapy is a behavioral-based therapy and does not replace medical, dental, or speech-language pathology services. Always consult with a licensed healthcare provider before beginning any treatment. 

Mew, M. [Orthotropics]. (2023, July 10). Dr. Mike Mew's ultimate mewing guide | BEGINNER [Video]. YouTube. https://www.youtube.com/watch?v=3Z_Fp9lGrGY 

A proper swallow is more than just a reflex—it’s a complex, coordinated movement that involves the tongue, lips, jaw, and throat. The average person swallows between 500 and 1,000 times per day, making your swallow pattern a fundamental part of orofacial health.

An atypical or dysfunctional swallow pattern (commonly known as a tongue thrust swallow) occurs when the tongue pushes forward or sideways against the teeth during swallowing rather than resting against the roof of the mouth. This compensatory pattern often develops early and, if left unaddressed, can contribute to:

• Orthodontic relapse or open bites 
• Mouth breathing or low tongue posture 
• Speech articulation issues (e.g., lisping) 
• Digestive inefficiency from poor coordination 
• Facial strain and muscular imbalance
   

Dysfunctional swallow patterns can stem from various causes:

• Early bottle feeding or prolonged pacifier use 
• Thumb or finger sucking 
• Enlarged tonsils or adenoids 
• Tongue-tie (ankyloglossia) 
• Chronic nasal congestion 
• Neurological or developmental delays
   

Orofacial Myofunctional Therapy (OMT) targets the neuromuscular patterns of the face and mouth, helping to retrain the swallow and promote proper tongue posture. With consistent guidance, patients can:

• Learn to swallow with the tongue up and lips sealed 
• Reduce strain on the orofacial muscles 
• Prevent relapse after orthodontic treatment 
• Support nasal breathing and balanced facial growth
   

OMT is especially effective when started during childhood, but adults can also experience lasting improvements through guided therapy.

Disclaimer:
The information provided on this page is for educational and informational purposes only. It is not intended to diagnose, treat, or cure any medical or dental condition. Orofacial Myofunctional Therapy is a behavioral-based therapy and does not replace medical, dental, or speech-language pathology services. Always consult with a licensed healthcare provider before beginning any treatment. 

Baxter, R. (2018). Tongue-Tied: How a Tiny String Under the Tongue Impacts Nursing, Speech, Feeding, and More. 

Gommerman, S. R., & Hodge, M. M. (1995). Effects of orofacial myofunctional therapy on swallowing and sibilant production. American Journal of Speech-Language Pathology, 4(4), 51–60. 

Mason, R. M. (2005). A retrospective and prospective view of orofacial myology. International Journal of Orofacial Myology, 31(1), 5–14. 

Mew, J. R. C. (2004). Craniofacial dystrophy, the cause of orthodontic relapse. Journal of Orthodontics, 31(4), 256-262. https://doi.org/10.1179/146531204225020338 

Proffit, W. R., Fields, H. W., & Sarver, D. M. (2013). Contemporary Orthodontics (5th ed.). Elsevier Health Sciences. 

Tongue thrust refers to a pattern in which the tongue pushes against or between the teeth during swallowing, speech, or at rest. This movement may seem minor, but over time, repeated improper tongue positioning can contribute to changes in facial development, speech articulation, dental alignment, and airway health.

1. Anterior Tongue Thrust
   The tongue pushes forward between or against the front teeth, often resulting in an open bite, overjet, or lisp. This is the most commonly recognized form of tongue thrust.
    
2. Lateral Tongue Thrust
   In this variation, the sides of the tongue press against or between the back teeth (molars or premolars) during function or at rest. It can lead to crossbites, posterior open bites, or asymmetrical facial growth. This pattern is often compensatory, linked to tongue-tie restrictions, narrow palates, or inadequate tongue space.
    

• Forward or sideways tongue pressure against the teeth 
• Open bite or spacing between teeth 
• Lisping or articulation errors 
• Mouth breathing or low tongue posture 
• Chin dimpling or facial tension when swallowing 
• Orthodontic relapse following braces
   

Tongue thrust exerts low but continuous pressure that can influence how the jaw, face, and airway develop—especially during childhood. Without proper intervention, it can:

• Disrupt bite and jaw alignment 
• Lead to long-term instability post-orthodontics 
• Impact breathing, sleep, and speech 
• Cause facial asymmetry and muscular imbalance
   

Orofacial Myofunctional Therapy (OMT) targets the root cause by retraining the muscles of the face, tongue, and lips to:

• Establish correct tongue resting posture (up against the palate) 
• Strengthen oral muscles to eliminate compensations 
• Repattern swallowing without pressure on the teeth 
• Support stable orthodontic and airway outcomes
   

OMT is especially effective when used in coordination with orthodontists, speech-language pathologists, or airway-focused dentists.

The information provided on this page is intended for educational and informational purposes only and is not a substitute for professional medical or dental advice, diagnosis, or treatment. Always consult with your healthcare provider for any concerns related to oral function, swallowing, speech, or airway health.

Gommerman, S., & Hodge, M. (1995). Treating articulation disorders associated with tongue thrust using a myofunctional approach. Canadian Journal of Speech-Language Pathology and Audiology, 19(1), 17–22.    

Hornsby, S. (2018, September 19). Tongue Thrust Video, Myofunctional Therapist [Video]. YouTube. https://www.youtube.com/watch?v=loXCfn7m41k
 

Mason, R.M. (2005). A retrospective and prospective view of orofacial myology. International Journal of Orofacial Myology, 31, 5–14.
 

Paskay, L.C. (2012). Tongue Thrust: A Concept Revisited. International Journal of Orofacial Myology, 38, 30–40.

Proffit, W.R., Fields, H.W., Sarver, D.M. (2013). Contemporary Orthodontics (5th ed.). Elsevier.
 

Zaghi, S., et al. (n.d.). The Breathe Institute. Retrieved from https://www.thebreatheinstitute.com/

Tongue-tie is a condition where the tissue (called the lingual frenulum) that connects the tongue to the floor of the mouth is unusually tight, thick, or short. This restriction can interfere with essential functions like breathing, swallowing, speech, oral posture, and facial development.

• Visibly restricts the front of the tongue. 
• Often presents as a heart-shaped tongue tip when elevated. 
• May cause early challenges with breastfeeding, speech articulation, or visible tongue mobility issues.
   

• Located deeper under the tongue, less visible on initial inspection. 
• Restriction is concealed beneath the mucosal layer of tissue. 
• May go undiagnosed, yet still severely limit tongue elevation and function.
   

Note: The term "posterior tongue-tie" is no longer commonly used, as it can be misleading. Many experts, including those at The Breathe Institute, now refer to these restrictions as submucosal tongue-ties to more accurately describe their anatomical location.

Restricted tongue movement can disrupt:

• Proper swallowing mechanics 
• Nasal breathing 
• Oral rest posture 
• Speech articulation 
• Sleep quality 
• Jaw and facial development 
• Neck and facial muscle tension
   

Many individuals develop compensation patterns—such as mouth breathing, forward head posture, or facial asymmetry—that can persist long-term if not addressed.

Orofacial Myofunctional Therapy (OMT) plays a vital role in addressing the functional consequences of tongue-tie:

• Improves tongue awareness, mobility, and strength 
• Prepares the muscles for surgical release (frenectomy or frenuloplasty) 
• Reduces risk of poor healing
   

• Re-educates the tongue on how to function properly in speech, breathing, Swallowing, and rest 
• Supports wound management and optimal healing 
• Restores long-term functional patterns
   

Tongue-tie release is most successful when part of a multidisciplinary approach. We collaborate with:

• Biological and airway-focused dentists 
• Speech-language pathologists (SLPs) 
• ENTs and pediatricians 
• Trained tongue-tie release providers
   

This integrated approach is supported by leaders such as Dr. Soroush Zaghi of The Breathe Institute, who emphasizes combining surgical precision with neuromuscular retraining to optimize long-term outcomes.

All information provided on this page is for educational purposes only. Tongue-tie should be evaluated and diagnosed by a licensed healthcare provider. Myofunctional therapy does not treat or release the tongue-tie itself but provides functional support before and after care. Always consult your healthcare provider for medical decisions.

Becker S, Brizuela M, Mendez MD. Ankyloglossia (Tongue-Tie) [Updated 2023 Jun 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/sites/books/NBK482295/ 

Guilleminault, C., Huang, Y.S., Monteyrol, P.J., Sato, R., Quo, S., Lin, C.H. (2013).
“Critical role of myofascial reeducation in pediatric sleep-disordered breathing.”
Sleep & Breathing, 17, 627–636. 

Suter, V.G.A. & Bornstein, M.M. (2009). “Ankyloglossia: Facts and myths in diagnosis and treatment.” Journal of Periodontology, 80(8), 1204–1219. 

Zaghi, S. (n.d.). Head and neck anatomy and physiology for airway disorders. The Breathe Institute. Retrieved from https://www.thebreatheinstitute.com/ 

Vision isn’t just about how clearly we see — it’s about how our eyes work together to interpret the world. Visual function plays a key role in posture, balance, breathing, and orofacial development.

When the eyes are out of sync (a condition called binocular vision dysfunction, or BVD), the entire body may compensate. This can cause or worsen:

• Head tilt or forward head posture 
• Jaw asymmetry 
• Tongue thrust or low tongue posture 
• Breathing through the mouth instead of the nose 
• Muscle tension around the face, neck, and shoulders 
• Difficulty with reading, concentration, or headaches
   

These postural adaptations often lead to chronic orofacial muscle imbalances — the same dysfunctions myofunctional therapy addresses.

• Eye strain or fatigue with reading 
• One eye drifting or not aligning properly 
• Frequent headaches or squinting 
• Poor balance or clumsiness 
• Postural compensations like tilted head or uneven shoulders 
• TMJ pain linked with facial asymmetry
   

Orofacial Myofunctional Therapy (OMT) focuses on correcting oral posture, breathing, and neuromuscular patterns. However, when underlying visual dysfunction is present, these patterns may relapse — unless vision is addressed too.

That’s why collaboration with vision specialists, such as developmental optometrists or neuro-optometrists, is essential.

They may recommend:

• Vision therapy 
• Corrective lenses with prisms 
• Tracking and convergence training 
• Visual-postural alignment support
   

You may benefit from a vision referral if you or your child:

• Has difficulty coordinating eye movement 
• Experiences facial or jaw asymmetry 
• Has trouble with depth perception or tracking 
• Struggles with schoolwork or attention 
• Experiences dizziness, motion sickness, or chronic headaches
   

Leading voices advancing the relationship between vision, posture, neurology, and orofacial function. These experts help shape how we understand and support patients through collaborative care:

• Dr. Bryce Appelbaum, OD, FCOVD – A nationally recognized leader in functional vision and visual neurorehabilitation. Dr. Appelbaum is known for transforming lives through personalized vision therapy and for educating practitioners about the neurological impacts of visual dysfunction.   Vision Therapy - Holistic Family Vision Clinic Bethesda, MD
   
• Dr. Charles Beck, DO, FAAO – An osteopathic physician known for his work in cranial osteopathy and neurological integration. Dr. Beck’s techniques reveal how cranial patterns and visual input influence posture, balance, and facial symmetry.   drcharliebeck.com
   
• Dr. Amy Thomas, OD, FCOVD – A board-certified developmental optometrist dedicated to functional vision care and interdisciplinary collaboration in cases involving orofacial and postural dysfunction.    Vision Therapy in Tucson: Expert Care Since 2009 | Adult & Child Vision Rehabilitation | Arizona's Premier Vision Therapy Center
   
• Dr. Debra Zelinsky, OD – Founder of the Mind-Eye Institute and a pioneer in neuro-optometric rehabilitation. Her research explores how light and peripheral input influence brain processing and autonomic regulation.   Visual Rehabilitation | TBI | Learning & Processing Disorders
  
   

Just like breathing, swallowing, and posture — Vision is a piece of the puzzle.
At MYOPHYSX, we recognize that long-term function requires an integrated approach. If visual dysfunction is suspected, we’ll support you in finding the right providers for collaborative care.

The information provided on this page is for educational and informational purposes only. It is not intended to be used as medical advice, diagnosis, or treatment. Any mention of visual dysfunction, postural compensations, or interdisciplinary care is meant to promote awareness and support collaboration among healthcare professionals. MYOPHYSX does not diagnose vision conditions or prescribe vision therapies. Always consult a licensed optometrist, ophthalmologist, or appropriate medical provider for individualized care related to vision and eye health.

Bennett, C. R., Bex, P. J., Bauer, C. M., & Merabet, L. B. (2019). The Assessment of Visual Function and Functional Vision. Seminars in pediatric neurology, 31, 30–40. https://doi.org/10.1016/j.spen.2019.05.006 

Cleveland Clinic. (2023, April 18). Binocular vision dysfunction (BVD). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/binocular-vision-dysfunction-bvd 

Freitas-da-Costa, P., & Madeira, M. D. (2024). Functional anatomy of the orbit in strabismus surgery: Connective tissues, pulleys, and the modern surgical implications of the "arc of contact" paradigm. Journal of anatomy, 244(6), 887–899. https://doi.org/10.1111/joa.14009 

Portela-Camino J. A. (2021). Advances in Research in Binocular Vision. Journal of optometry, 14(3), 227–228. https://doi.org/10.1016/j.optom.2021.06.001 

Shapiro, I Jonathan B.Sc. (Hons.), F.B.C.O., F.A.A.O. Relation between Vertical Facial Asymmetry and Postural Changes of the Spine and Ancillary Muscles. Optometry and Vision Science 71(8):p 529-538, August 1994. 

Teodorescu L. (2015). ANOMALOUS HEAD POSTURES IN STRABISMUS AND NYSTAGMUS DIAGNOSIS AND MANAGEMENT. Romanian journal of ophthalmology, 59(3), 137–140.