Beyond the Lisp: Is Your Child Showing Signs of an OMD?

As parents, we naturally celebrate our children’s milestones — their first words, first steps, and the day their baby teeth start giving way to adult teeth. But what if subtle signs like a persistent lisp, mouth breathing, or tongue-thrusting hint at something deeper? That “something” could be an Orofacial Myofunctional Disorder (OMD). A condition many parents don’t know exists until a dentist, speech therapist, or orthodontist points it out.

In this guide, we’ll break down what OMD is in simple terms, help you spot the early signs, and explain how myofunctional therapy can correct oral habits and support long-term growth, breathing, and speech development.

So, What Is OMD? — And Why Is It More Than Just A Speech Issue?

Orofacial Myofunctional Disorder (OMD) describes a set of conditions where the muscles of the mouth, tongue, lips, cheeks, or jaw don’t function or rest properly.

In simple words:

An OMD occurs when the tongue and facial muscles don’t rest, move, or function the way they should.

Instead of the tongue resting gently against the roof of the mouth, lips sealing comfortably, and swallowing happening smoothly, children with OMD may exhibit:

• Tongue thrusting (tongue presses forward between or against teeth during swallow or at rest) 

• Chronic mouth breathing or open-mouth posture 

• Dental or jaw alignment issues — for example, misaligned teeth, open bite, or overjet 

• Speech distortions (like a frontal lisp), difficulty articulating certain sounds, or unusual swallowing and chewing patterns. 

These may seem like small quirks — but over time, OMD can affect not just speech, but proper facial and dental development, breathing, eating, and even posture. That’s why OMD isn’t just an aesthetic or cosmetic issue — it can influence a child’s long-term oral health and well-being. 

Why OMD Happens — Possible Causes

There isn’t always a single cause for OMD, but experts point to several common contributing factors:

• Prolonged oral habits — such as thumb or finger sucking, pacifier/thumb sucking beyond infancy, or long-term bottle use. 

• Chronic mouth breathing, often due to nasal obstruction, allergies, enlarged tonsils or adenoids, or other airway issues. 

• Structural or anatomical differences — such as narrow dental arches, jaw misalignment, or genetic predisposition affecting oral musculature. 

  
  

The Hidden Ways OMDs Impact Development

OMDs can influence more than just speech. They can affect:

1. Facial and Jaw Growth

When a child breathes through the mouth or holds the tongue low, the jaw and palate may develop in a narrow or elongated shape. This can lead to crowding of teeth and orthodontic challenges.

2. Breathing and Sleep Quality

Mouth breathing can reduce oxygen intake, contribute to restless sleep, and even affect energy and focus during the day.

3. Dental Alignment

A forward tongue thrust can push teeth out of place, creating open bites or flared front teeth.

4. Speech Sound Production

Sounds like S, Z, SH, CH, and J are commonly distorted when the tongue has poor control or incorrect resting posture.

This is why professionals now view OMDs as a whole-body concern—not just a speech or dental issue.

How Myofunctional Therapy Works — Retraining Mouth & Face Muscles

That’s where myofunctional therapy (also called orofacial myofunctional therapy, or OMT) becomes a powerful tool.

Myofunctional therapy is essentially a set of exercises and training designed to retrain and strengthen the muscles of the tongue, lips, cheeks, and jaw so they function correctly for breathing, swallowing, speaking, and resting posture.

Depending on a child’s needs, a myofunctional therapist may guide them through gentle, age-appropriate exercises — for example: improving lip seal, training the tongue to rest against the palate instead of pushing forward, strengthening cheek and lip muscles, and teaching proper swallowing mechanics.

Over time, with regular practice and supervision, these exercises can help:

• Eliminate tongue thrust and encourage proper tongue posture at rest and during swallowing 

• Promote nasal breathing instead of mouth breathing, helping airway function and even reducing the risk of breathing-related sleep issues. 

• Support dental alignment and jaw development — reducing or preventing malocclusion, open bites, or overjet problems. 

• Improve speech clarity and swallowing/chewing, which can boost confidence, comfort, and overall oral health. 

In many cases, myofunctional therapy is recommended alongside dental or orthodontic treatment, especially when teeth alignment or jaw growth is involved. This combined approach helps address both function (muscle habits) and form (teeth/jaw alignment) for lasting results.

When Should Parents Suspect an OMD?

You might want to talk to a pediatric dentist, orthodontist, or speech-language therapist if your child shows:

• A persistent lisp or difficulty pronouncing certain sounds (especially /s/, /z/), or speech distortion despite no hearing issues 

• Tongue that pushes forward between the teeth during swallow, rest, or speech — or visible tongue thrust 

• Habitual mouth breathing, open mouth posture even when calm or resting, or difficulty breathing comfortably through the nose alone 

• Problems like frequent drooling beyond early childhood, difficulty chewing, swallowing, or frequent choking/gagging during meals 

• Dental or orthodontic issues such as crowded teeth, open bite, overjet, or narrow jaw arch — especially if these worsen over time 

If you notice a combination of these signs — especially speech issues + tongue posture + mouth-breathing or dental misalignment — it’s worth exploring whether your child may have OMD.

What to Expect from Myofunctional Therapy: Journey & Results

Each child’s journey with myofunctional therapy will differ depending on their age, specific issues, and how consistently they practice. Typically:

1. Initial assessment — The therapist evaluates the child’s tongue resting posture, swallowing pattern, lip seal, breathing habits, facial/oral muscles, and dental alignment. 

2. Personalized exercise plan & training — The child (with parental support) performs specific orofacial exercises — often fun and engaging — to strengthen and retrain muscles. 

3. Regular follow-ups — Progress is tracked periodically; adjustments are made as the child grows or habits change.

4. Complementary care if needed — Sometimes therapy is combined with orthodontic treatment, dental care, or airway/ENT evaluation if structural issues (e.g., nasal obstruction) are present. 

Most parents and clinicians report gradual but meaningful improvements: better tongue posture, more nasal breathing, improved swallowing, clearer speech, and — over time — more stable dental alignment. 

Because myofunctional therapy targets habits and muscle function rather than just “fixing teeth,” it can prevent some problems from recurring — even after orthodontic treatment or braces.

Why Early Intervention Matters

Children’s faces, jaws, and oral muscles are still developing. That means early detection of OMD and timely intervention can have long-lasting benefits. By retraining muscles while growth is ongoing, you can often avoid more invasive treatments later — such as complicated orthodontics or even surgical interventions.

Moreover, correcting tongue posture, breathing, and swallowing early helps build a foundation for healthy oral function, improved speech, and proper facial development.

A Note for Parents: Is Myofunctional Therapy Right for Every Child?

Myofunctional therapy is not a magic wand — but for many children with OMD, it is a safe, non-invasive, and evidence-based option. That said:

• Success depends on consistency: daily exercise and supportive parental involvement are important. 

• It works best when combined with proper dental or ENT evaluation if needed (e.g., for structural issues, airway obstruction, or orthodontic needs).

• The timeline can vary. Some children respond quickly; others take months of regular work to show noticeable changes.

Still, given the potential long-term benefits for speech, breathing, facial growth, and oral health, for many families, myofunctional therapy is worth considering.

Recognizing OMD Early Can Make a Big Difference

If your child has a persistent lisp, breathes through their mouth, shows tongue thrusting, or has recurring dental or speech concerns — understanding what OMD is is the first step.

Myofunctional therapy offers a way to correct oral habits, retrain muscles, and support healthy development — potentially saving your child from more extensive interventions later.

If you suspect OMD, consider consulting a qualified myofunctional therapist (often a speech-language pathologist, trained in OMT). Early evaluation and a consistent therapy plan can help your child achieve better breathing, clearer speech, proper oral posture, and a healthier smile that lasts.