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Primal Air, LLC Shirley Gutkowski

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  • Shirley Gutkowski, RDH, BSDH

    Practice focusing on orofacial myofunctional therapy and Buteyko breathing retraining.

    Orofacial Myofunctional Therapy is the practice of teaching clients neuromuscular techniques to alleviate orofacial disorders.

    These disorders include things like:

    Tongue thrusts

    Lip and tongue sucking

    Snoring

    Pacifier, thumb uses or nail biting

    Orofacial disorders can show up as crazy things like

    Restless legs

    Silent acid reflux

    Sinus infections

    Temporomandibular pain

    Neck and shoulder pain

    Fibromyalgia

    Orthodontic failures

  • Shirleys Therapy

    My teacher and mentor, Joy Moeller, has been on the

    forefront of this science for over 30 years. I use her

    treatment sequence which shes developed over her

    time practicing in the Los Angeles area.

    Using simple movements and using simple implements

    in usual and unusual ways the muscles of the face

    and the tongue are asked to be reprogrammed. For

    instance the tongue is asked to sit on the palate.

    Keeping people motivated is always the trick, so we

    use innovative and proven motivational tools.

  • Scope of practice of a dental hygienist working as a orofacial myofunctional

    therapist

    In the United States, the Scope of Practice of a Dental

    Hygienist working as a myofunctional therapist ADHA

    Policy Statement:

    The American Dental Hygienists Association (ADHA)

    policy has been in place regarding the practice of

    Orofacial Myology by Dental Hygienists since 1992. The

    ADHA policy statement is listed under the section

    PRACTICE, Patient Care Services, policy #9-92: The

    American Dental Hygienists Association acknowledges

    that the scope of dental hygiene practice includes the

    assessment and evaluation of orofacial myofunctional

    disorders; and further advocates that dental hygienists

    complete advanced clinical and didactic continuing

    education prior to providing treatment.

  • To study, evaluate, prevent and

    treat orofacial muscle dysfunctions.

    -Abnormal sucking habits

    -Other orofacial habits

    -Abnormal orofacial rest posture

    -Abnormal chewing and

    swallowing patterns

    -Dysfunctional breathing patterns

  • EVALUATIONS

  • SCREENING TOOLS

    Epworth Sleepiness ScaleReflux Symptoms

    Lip strengthBlood pressure

    Neck circumference

  • Records appointment

    1- Frontal view of patient swallowing

    2- Right and left side views

    of patient swallowing

    3- Frontal view of patient at

    rest

    4- Frontal view of teeth

    occluded in centric

  • Treatments vary from simple to super simple

  • The Spot is the first landmark of treatment

    The Spot

  • 2009

    CONCLUSIONS:

    Instructions to place the tongue on the

    roof of the mouth are not instructions that

    will promote reduced physiological

    functioning (i.e., relaxation) but rather

    promote small, but potentially important

    increases in overall activity as indexed by

    muscle tone and cardiac function.

  • Treatment Plans

  • Treatment sequences

    Develop a lip seal

    Phase 1

    Generalization and Maintenance

    Phase 2

    Habituation

    Phase 3

  • Exercises that develop the tip of the tongue

    Waggle Spot

    Words that begin with the sound T, D, L, N

    Tongue Point and Trace

    One Elastic Swallow elastic on the spot

    Snake

    Drag & Swallow

  • Exercises to promote lip seal

    Rubber band hold

    Button pull

    Upper Lip Stretch

    Lip Curl

    Cork pop

  • Techniques to get the facial muscles and the

    tongue to move right

  • NSF's 2004 Sleep in America poll found

    that two-thirds of children experience

    frequent sleep problems and that

    children's poor sleep habits take a toll on

    parents/caregivers, some of whom lose an

    estimated 200 hours of sleep a year due

    to their child's nighttime awakenings.

    NSF's 2007 Sleep in America poll found

    that 20% of women are awakened to give

    care to a child during the night.

    https://sleepfoundation.org/sleep-topics/adhd-

    and-sleep/poll-data

    National Sleep

    Foundation Poll

  • Suggestions for better sleeping

    Mouth taping

    Breathe right strips

    Nasal cones

    Teas and supplements

  • Breathing retraining Buteyko

  • Breathing Retraining

  • Biofeedback neuromuscular

    appliance

    0:00 Reverse swallow

    1:58 Mouth breathing

  • Cross Link RadioHost Shirley Gutkowski