Most oro myofunctional problems are associated with a deviate swallow and / or a low tongue position at rest. So it is important to find out how a person grinds his food, shapes it to a ball and swallows it, and to make him/her aware of the deviate swallow. With the Payne technique you can determine if the tongue tip comes addentally or interdentally during a swallow. It is also shown whether or not the dorsum of the tongue is well aspirated against the palate: a condition for a good swallow. The technique is simple:
- Apply with a clean spatula some dots of Payne paste on several points of the tongue
- After the client has swallowed several times, the traces of the Payne paste show how the tongue moved during the swallow
- This is easily made visible by shining with a Payne lamp in the mouth: the Payne paste lights up and shows the swallowing traces
- It is important to show your client these traces (by means of a mirror in combination with a disposable mouth mirror), to make him/her aware of the deviate swallow.
How to learn a correct swallow
When teaching to swallow in the right way, you can practice the swallowing steps by letting the client drink water from a glass. But if the tongue comes out inmediately at the start of the sip or too large gulps are swallowed, you can use a syringe. Also if the client can not hold a sip of water with the tongue while the molars are not in occlusion, the syringe can be helpful.
Ask the client to bring the tip of the tongue to ‘the spot’, behind the upper teeth (papilla incisiva). The molars are brought into occlusion and the lips are closed. Place the end of the dosing syringe in between the lips in the corner. Spray a small amount of water into the mouth, towards the molars. Let the client suck the water on the tongue. The client then lowers the lower jaw while the tongue is being placed against the palate and holds the water. Subsequently swallowing is done according to the swallowing steps described in the oro myofunctional protocol. No sound may be heard during the swallow moment. If a slurp is heard, this indicates the unwinding of the tongue is insufficient.
With open mouth behavior and mouth breathing, the strength of the orbicularis oris muscle is insufficient. Whether the force is (un)sufficient can be measured with the Force scale and the Myoscanner. Strengthening a too weak orbicularis oris muscle is necessary for obtaining a good mouth closure and nasal breathing. In addition to the various lip strengthening exercises for this, such as the knot or bottle exercise, the use of masking of the lips with a lip plaster is regularly used within the oro myofunctional therapy (OMFT). This can be done with different techniques and materials, such as Fixomull stretch, Leukopor and kinesiotaping, for which Cure tape is usually used. The kinesiotape is set up in such a way that it has an activating effect: it stimulates the hypotonic muscles and inhibits hypertonic muscles. The client feels the orbicular muscle oris contract, causing the lips to close. Yet there is the possibility to open and speak. This way of kinesiotaping can be applied during sleep as well as during the day. Within our OMFT courses the use of kinesiotaping to activate the orbicularis oris muscle is extensively discussed and practiced.
Other helps for therapy
Cotton rolls can be used to correct a short upper lip: insert a cotton roll behind the upper lip and then let the lips held closed for at least 5 minutes.
Orthodontic elastics can be used to as a help to find the right position of the tonque in rest and to train the correct swallow.