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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
OMT After Frenuloplasty
To facilitate the tongue assume proper posture and function.
OMT After Frenuloplasty
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)
OMT After Frenuloplasty Grace Sun DDS
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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)
OMT After Frenuloplasty Grace Sun DDS
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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
OMT After Frenuloplasty Grace Sun DDS
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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
OMT After Frenuloplasty Grace Sun DDS
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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.
OMT After Frenuloplasty Grace Sun DDS
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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
www.myoacademy.com
Grace Sun DDS
462 North Doheny Drive
Los Angeles, CA 90048
310.274.4200
www.sundds.com
Thank you!
www.sundds.com
@sundentalgroup
@sundds