How urgent is a myofunctional therapy referral from an orthodontist?

Timing depends on where your child is in their orthodontic treatment. If braces are starting soon or already in place, acting promptly matters — untreated tongue habits can work against the alignment the braces are trying to achieve. If treatment is further out, you have a bit more flexibility, but earlier intervention still produces better results because it allows more time to retrain the muscle patterns before mechanical treatment begins.

How many sessions will my child need for myofunctional therapy?

A typical myofunctional therapy program runs 4 to 6 months, with sessions once or twice a week. The exact length depends on the severity of the muscle dysfunction and how consistently the child completes the home exercises between sessions. The evaluation appointment gives you a realistic timeline based on your child's specific presentation.

What to Do After Your Orthodontist Refers Your Child for Myofunctional Therapy

You left the orthodontist appointment with a referral slip for something called myofunctional therapy. Your child's ortho mentioned tongue posture, swallowing patterns, maybe mouth breathing. They said it could affect how the braces work. Now you are home, the slip is on the counter, and a week later you still are not sure what to do with it.

This is the most common situation I see as a myofunctional therapy specialist in Sandy Springs. The referral is real. The professional who gave it is credentialed. But the paper comes with no instructions, no urgency, and no clear path forward. So it waits while life continues.

This post exists to change that. Here is exactly what the referral means, why timing matters, and what happens when you actually make the call.

Why Orthodontists Refer for Myofunctional Therapy

Orthodontists straighten teeth using mechanical force. Braces, aligners, expanders, retainers. What they cannot do is retrain the muscles that work against that force every day.

The tongue rests in the mouth approximately 2,000 times per hour during swallowing. If it pushes forward against the front teeth or sits low in the mouth rather than resting on the roof, it creates constant pressure that works against alignment. No wire or bracket can compete with that. The teeth move into position and the tongue moves them back.

Mouth breathing creates a similar problem. Lips apart, tongue dropped, airway compensating. The resulting muscle patterns change how the face and palate develop, which affects how teeth come in and how well orthodontic results hold over time.

When an orthodontist refers your child for myofunctional therapy, they are saying: the mechanics alone will not hold unless we address the muscle patterns underneath. It is not a nice-to-have. It is a clinical observation about what will determine whether the treatment actually lasts.

What Myofunctional Therapy Actually Treats

Orofacial myofunctional therapy retrains the muscles of the mouth, tongue, and face to function correctly. The four core patterns it addresses are:

Tongue thrust. The tongue pushes forward against or between the teeth during swallowing, rather than pressing up on the roof of the mouth.
Low tongue posture. At rest, the tongue sits on the floor of the mouth instead of gently contacting the palate. This affects how the palate develops and how the airway is positioned.
Mouth breathing. Habitual breathing through the mouth rather than the nose. Often connected to enlarged adenoids or tonsils, allergies, or learned patterns.
Lip incompetence. The lips do not close naturally at rest, which alters facial muscle development and the position of the front teeth.

These are not behavioral problems. They are muscle patterns, often in place since infancy, that the child is simply not aware of. The therapy works through structured exercises and habit retraining over several months.

Dental professional examining a young patient's teeth and bite alignment to assess underlying muscle patterns

The Connection Between Tongue Habits and Orthodontic Results

Research on this has been consistent for decades. Children who complete myofunctional therapy before or during orthodontic treatment retain their results better than those who do not. The reason is mechanical: straight teeth held in place by muscles that support that position stay straight. Straight teeth held in place by a retainer while the tongue pushes against them relapse.

The orthodontist's referral is a clinical judgment about your child's specific situation. They saw a pattern in how your child's bite developed, how the palate is shaped, or how the teeth are moving, and they concluded that orthodontic mechanics alone will not produce a stable, lasting result. That judgment deserves to be acted on.

The orthodontist referred your child for a reason. The habits myo therapy addresses can work against the braces every single day. Without addressing them, the alignment may not hold long term.

What Happens If You Wait

The most common thing that happens when the referral sits on the counter is that orthodontic treatment either gets delayed or proceeds without the muscle patterns being corrected. If treatment starts without addressing tongue thrust, the force applied by the tongue during swallowing continues to work against alignment. Some orthodontists will pause treatment, or will not start, until the myo evaluation is complete.

If braces are already on and the tongue habits are not addressed, the risk is relapse: teeth that drift back toward their original positions once the hardware is removed. Retainers help, but they are designed to maintain position, not to hold position against active muscle dysfunction.

The best time to act on the referral is before treatment starts. The second-best time is now, wherever you are in the process.

What to Expect at a Myofunctional Therapy Evaluation

The evaluation appointment is 60 to 90 minutes. It is not a commitment to begin treatment. It is a diagnostic session that tells both you and the therapist exactly what is present and what a treatment plan should look like.

What We Assess in an Evaluation

✓ Tongue rest posture — where the tongue sits naturally when the child's mouth is relaxed and closed.

✓ Swallowing pattern — how the tongue moves during swallowing. We observe several swallows in different conditions to identify any thrust patterns.

✓ Lip seal and tone — whether the lips close naturally at rest and whether lip muscle tone is sufficient to support closed-mouth breathing.

✓ Nasal airway — whether mouth breathing appears habitual or related to a structural issue like enlarged adenoids or allergies.

✓ Speech sound clarity — tongue position often affects articulation; we note any patterns worth addressing alongside the muscle work.

At the end of the evaluation, I explain exactly what I found, what it means for your child's orthodontic situation, and what a realistic treatment plan looks like. You leave with a clear picture of what is involved before any commitment is made.

How Long Does Myofunctional Therapy Take?

A typical program runs 4 to 6 months, with sessions once or twice a week. Each session is 30 to 45 minutes. Between sessions, children complete daily exercises at home — usually 10 to 15 minutes, building habits through consistent repetition rather than intensive practice.

The length of the program depends on which patterns are present, how long they have been established, and how consistently the child completes the home exercises. Younger children (ages 6 to 10) often progress quickly because their patterns are less entrenched. Older children and adolescents can still achieve excellent results, but the habits have had more time to become automatic and take more deliberate work to replace.

What to Look for in a Myofunctional Therapist

Not every speech-language pathologist offers myofunctional therapy. When evaluating providers, ask whether myo therapy is a primary area of practice or an occasional add-on. For licensed SLPs, myofunctional therapy falls within scope of practice — what matters is that the clinician has dedicated training and treats it as a specialty, not a side service.

At Lasting Language Therapy, myofunctional therapy is one of the three core specialties the practice was built around, alongside Parkinson's voice rehabilitation and pediatric speech therapy. It is not something done occasionally alongside general caseload work.

Speech therapist working with a child on the oral muscle exercises that reinforce myofunctional therapy outcomes

The referral slip is not just a suggestion. Your orthodontist identified a clinical reason your child's results may not hold without addressing the muscle patterns underneath. The evaluation costs nothing but an hour of your time. What you learn from it determines whether the braces actually work long term.

Frequently Asked Questions

Is myofunctional therapy the same as speech therapy?

Myofunctional therapy is related to speech therapy and is often delivered by a speech-language pathologist, but it is a distinct specialty. It focuses on retraining the tongue, lips, and facial muscles to function correctly rather than on speech sounds specifically. The orthodontist referred your child out because this requires specific training beyond general speech therapy.

How urgent is a myofunctional therapy referral?

Timing depends on where your child is in orthodontic treatment. If braces are starting soon or already in, acting promptly matters. If treatment is further out, you have more flexibility, but earlier intervention allows more time to retrain the muscle patterns before mechanical treatment begins. The free intake consult helps clarify where your child's situation falls.

What age can children start myofunctional therapy?

Most myofunctional therapy for orthodontic referrals begins between ages 6 and 12. Some programs can start as early as age 4 for specific concerns. An evaluation determines whether your child is developmentally ready for a structured program and what the right starting point looks like.

How many sessions will my child need?

A typical program runs 4 to 6 months with weekly or twice-weekly sessions. The exact length depends on the severity of the muscle dysfunction and home exercise consistency. The evaluation gives you a realistic timeline based on your child's specific presentation.

Does insurance cover myofunctional therapy?

Coverage varies. Some plans cover it as a speech-language pathology service; others do not. We can provide a superbill for out-of-network reimbursement. Call your insurance member services line and ask specifically about out-of-network speech therapy or orofacial myofunctional therapy benefits.

Got the Referral Slip? Let's Figure Out the Next Step.

Amanda Smith, M.Ed., CCC-SLP is a Speech-Language Pathologist specializing in myofunctional therapy at Lasting Language Therapy in Sandy Springs. The intake consultation is free — and it answers every question on that referral slip.

Book a Free Intake Consult