Blog · Orthodontics · August 28, 2026 · 7 min read

How myofunctional therapy and orthodontics work together.

A short explanation of why orthodontists often refer to myofunctional therapists — and what changes when both work on the same patient.

By Gina Sabbak, RDH · Myofunctional Therapist, Louisville KY. Last reviewed 2026-08-28. Educational content — not medical advice and not a substitute for in-person evaluation.

Why this matters

Orthodontists move teeth. Myofunctional therapists work on the muscles that hold the teeth in place. When the two are coordinated, treatment tends to be faster, more stable, and more comfortable. When they're not, the same orthodontic result can relapse within a few years because the muscle patterns that caused the original crowding or open bite are still there.

What orthodontists typically see

Crowded lower incisors. Anterior open bite. Maxillary constriction. Class II or III patterns. Crossbite. Proclined upper incisors. Relapse after previous orthodontic treatment.

These are the teeth-and-bite presentations. What the orthodontist is often really seeing — but can't address with braces alone — is the underlying muscle and posture picture:

• Tongue resting low or thrust forward during swallow
• Chronic mouth breathing (often from nasal obstruction or habit)
• Low tongue posture that doesn't support the palate
• Lip incompetence (lips apart at rest)
• Habitual tongue, lip, or cheek posture that pushes against teeth

Braces can move teeth through bone. They can't change where the tongue sits or whether you breathe through your nose. That's where myofunctional therapy comes in.

What the coordination looks like

In a coordinated case, the orthodontist and the myofunctional therapist communicate. The patient typically:

1. Starts myofunctional therapy first — establishes nasal breathing, lip seal, tongue-to-palate resting posture, and proper swallow pattern. This usually takes 2–4 months.
2. Begins orthodontic treatment while continuing myo exercises. The new muscle patterns support the orthodontic movement and reduce relapse risk.
3. Continues myofunctional therapy through orthodontic treatment. As teeth move, the muscles adapt; the therapist adjusts exercises accordingly.
4. Tapers myofunctional therapy after orthodontic removal. The patterns are now habit, not just exercise.
5. Uses a retainer as instructed. Myofunctional therapy alone is not a substitute for retention.

When myofunctional therapy is most helpful

In my practice, the clearest cases are:

• Anterior open bite (tongue thrust is a common driver)
• Lower incisor crowding (low tongue posture doesn't support the arch)
• Crossbite with mouth-breathing habit
• Relapse after previous orthodontic treatment
• Pre-orthodontic in children age 7–11 to set up better growth before Phase II

When myofunctional therapy is not the right tool

Sometimes the muscle work alone is not enough:

• Skeletal patterns that require surgery (severe Class II/III)
• Airway obstruction from enlarged tonsils/adenoids — ENT first
• Congenital craniofacial differences that need specialist care

What to ask your orthodontist

If you're considering braces or aligners and want to know whether myo work would help:

• Ask whether the orthodontist routinely coordinates with a myofunctional therapist.
• Ask whether the treatment plan addresses the underlying muscle patterns, not just the tooth positions.
• Ask what happens after treatment to prevent relapse.
• If you've had orthodontic relapse before, ask why that happened and whether myo could help this time.

What to expect if you do both

If you start myo first, expect 2–4 months of weekly visits before orthodontic treatment begins. Most patients describe the exercises as short, easy to fit into a routine, and noticeable in how they breathe and swallow within a few weeks. During orthodontic treatment, you'll keep doing the exercises — adapted as your bite changes.

Read more about pre- and post-orthodontic support or book a comprehensive myofunctional evaluation.