Braces, expanders, and aligners all move teeth and bone — none of them retrain the muscles around those structures. That’s a separate job, and it belongs to a myofunctional therapist.

Myofunctional therapy focuses on how the tongue, lips, and cheeks function day to day: where the tongue rests, how someone swallows, and whether breathing defaults to the nose or the mouth. These habits carry more weight in orthodontic outcomes than most patients expect. A tongue that pushes against or between the teeth on every swallow (a tongue thrust), or one that rests low instead of against the palate, can quietly undo the effects of orthodontic treatment or prevent an expanded palate from holding its new width.

We typically refer to a myofunctional therapist when we see:

• A persistent tongue thrust during swallowing
• Low tongue resting posture linked to a narrow palate
• Mouth breathing that continues even after an airway obstruction is medically cleared
• Thumb-sucking or pacifier habits that have already shaped the bite
• Elevated relapse risk following palatal expansion, where retraining tongue posture helps the new width hold

The process itself is a series of guided exercises, practiced at home and reinforced in therapy sessions, aimed at building correct resting patterns for the tongue and lips along with nasal breathing habits. It’s a real time commitment — usually several months — but it’s what makes structural treatment durable instead of temporary.

We think of it as the piece that makes everything else stick. Dr. Zitterkopf can widen a palate or straighten a bite, but if the tongue and lips keep working against that new structure daily, the muscles tend to win over time. Myofunctional therapy is what gets the muscles working with the new structure instead.

If your child has a known tongue thrust, ongoing mouth breathing, or a habit affecting their bite, ask our Woodland Park team whether a myofunctional therapy referral belongs in their treatment plan.