Orofacial Myofunctional Therapy and Myofunctional Devices Used in Speech Pathology Treatment: A Systematic Quantitative Review of the Literature

Abstract

Purpose A growing number of speech-language pathologists (SLPs) are using orofacial myofunctional therapy (OMT) and/or myofunctional devices (MDs) in the treatment of their clients. However, governing bodies suggest SLPs carefully consider the availability and quality of evidence in the utilization of these therapies in speech-language pathology treatment. The purpose of this study was to review the existing evidence for OMT and MDs used by SLPs. Method A systematic quantitative review was conducted using key search terms in three electronic platforms housing multiple databases, along with a hand search, to identify additional literature. All studies published in English in full text were included if they reported pre- and posttreatment data of OMT and/or MDs provided by an SLP. Data were extracted and analyzed by the first author and confirmed by the co-authors. Results Twenty-eight studies met the criteria for inclusion in the review. Two thirds were published in the last decade and involved the use of OMT/MDs targeting multiple areas of speech pathology intervention within the same study, that is, swallowing, breathing, oral hygiene, and speech production. Majority of studies were rated as low level of evidence. All studies used OMT, with very few using MDs. While the assessment, treatment protocols, and outcome measures were highly variable, all of the studies reported an improvement in the function of the orofacial systems posttreatment. Few studies reported long-term follow-up data. Almost half of the studies recommended the use of OMT/MDs in a multidisciplinary/interdisciplinary team or in conjunction with other therapy. Conclusions There has been an increase in literature over the last decade in SLPs' use of OMT; however, there are only a small number of studies to date that explore the use of MDs. There is a growing body of evidence to support the use of OMT and MDs within a multidisciplinary team for people with communication and swallow difficulties. However, development of future research should consider investigating assessment and outcome measures, optimal dosage, and service delivery.

Myofunctional Device Use in Oral Care and Swallowing: Protocol for a Pilot Study in an Aged Care Population

“…The results of Shortland and colleagues [15] systematic review reported improvements in oral hygiene, oral behaviours, and swallowing, along with breathing and speech to be associated with the use of myofunctional devices. Therefore, it would be relevant to further explore treatment dosage, utilisation, and outcomes of a myofunctional device in a population such as the elderly who make up a large proportion of those whose oral health and swallowing function may be impacted [20].…”

“…This is of concern to speech pathologists due to the impact of poor oral health on mastication, swallowing function and increased risk of aspiration. However, a recent literature review [15] found that improvements in oral hygiene, oral behaviours, and swallowing, along with breathing and speech have been found to be associated with the use of orofacial myofunctional therapy and myofunctional devices [16].…”

“…Despite this increase of evidence, there is limited research in speech pathology that addresses the use and outcomes of myofunctional devices in clinical practice [15]. The potential impact of improvement on orofacial function, including oral hygiene and swallowing, has already been identi ed with the use of myofunctional devices in literature from various health disciplines [17].…”

Myofunctional device use in oral care and swallowing: a protocol for a feasibility study in an aged care population

“…This is of concern to speech pathologists due to the impact of poor oral health on mastication, swallowing function, and increased risk of aspiration. However, a recent literature review highlights improvement in swallowing function, oral behaviours, speech, and oral hygiene with the use of orofacial myofunctional therapy and myofunctional devices [15,16]. The positive changes in orofacial functions such as lip seal, mastication, swallowing, and nasal breathing patterns are important in maintaining good oral hygiene which is identified as being problematic in an aged care population [12].…”

“…Despite this increase of evidence, there is limited research in speech pathology that addresses the use and outcomes of myofunctional devices in clinical practice [15]. The potential impact of improvement on orofacial function, including oral hygiene and swallowing, has already been identified with the use of myofunctional devices in literature from various health disciplines [18].…”