Abstract
Purpose Orofacial myofunctional disorders are disruptive patterns that can impact orofacial growth and development. The purpose of this study was to explore orofacial myology education, certification, and practice by dental hygienists (DH) as well as the advantages and barriers to the practice of orofacial myology for DHs.
Methods A phenomenological heuristic qualitative approach was used for this study. Purposive sampling was used to solicit participants with experience in orofacial myology through the online membership lists of the International Association of Orofacial Myology (IAOM), Academy of Orofacial Myofunctional Therapy (AOMT), Breathe Institute and Neo-Health Services. Semi-structured, virtual interviews, personal experiences of the primary investigator, and historical documents were used for triangulation of the collected data to identify emerging themes.
Results Data analysis resulted in five core themes and nine sub-themes. The core themes included: uniform credentialing, autonomous workforce models, identity distinctiveness, business management, and access to myofunctional care.
Conclusion Cost and complexity were the largest barriers to the practice of myofunctional therapy, while autonomy and a wide array of work assignments were identified as advantages. While myofunctional therapy education and certification can be complex and costly, this specialty deserves further attention as part of the delivery of preventive and therapeutic oral and systemic health care.
INTRODUCTION
An orofacial myofunctional disorder (OMD) is a disruptive pattern related to factors that can negatively influence orofacial growth and development.1-3 These disorders involve the cranio-orofacial complex and interfere with the typical function of orofacial structures.3 With expertise in oral structures, dental professionals are equipped to expand their knowledge in myofunctional therapy to provide care to individuals who present with disorders impacting the typical function of orofacial structures.3 In 1992 the American Dental Hygienists’ Association (ADHA) recognized the need for a collaborative approach in addressing myofunctional therapy as part of providing comprehensive oral health care. In 2021, the ADHA updated their policy and continued support of oral myofunctional therapy (OMT).4 Orofacial myofunctional therapy provides an opportunity for dental hygienists to function as team members in supporting airway evaluation and management alongside other health care professionals associated with treatment including surgeons, orthodontists, speech pathologists and dentists.
Myofunctional therapy courses vary widely in their delivery methods, ranging from fully online and asynchronous formats to synchronous sessions and in-person clinical components. For example, Neo-Health Services and Academy of Orofacial Myofunctional Therapy (AOMT) offer primarily online instruction, with AOMT combining live virtual instruction and on-demand content, while the International Association of Orofacial Myology (IAOM) includes case studies, a proficiency exam, and an on-site clinical evaluation.5–7 MyoMentor provides a 12-week online program with an optional in-person clinical experience.8 Interested health care professionals may choose which program to enroll in based on personal preferences, considering factors such as course delivery format, cost, time commitment, and existing prerequisites. Additional considerations may include the potential to gain certification, such as IAOM testing, the Myofunctional Airway Specialist (MAS) certification from Dental Sleep Toolbox, the qualified Orofacial Myologist (QOM) designation from Orofacialmyology.com, or the Certified Orofacial Myology Specialist credential from the Professional School of Behavior Health Sciences.
While there is support for dental hygienists (DHs) to practice OMT, a literature search of orofacial myofunctional therapy, orofacial myofunctional disorders, and certification in orofacial myology, produced few articles when combining these terms with dental hygiene or DHs. Evidence supporting OMT is poorly represented in literature.9 To date, there is no literature which examines the experiences of licensed DHs working as myofunctional therapists, nor of those undergoing the training and/or credentialling/distinction process for OMT services. An increasing body of evidence supports the use of OMT and myofunctional devices within a multidisciplinary team for individuals with communication and swallowing difficulties.10 However, current literature suggests the need for further study exploring assessment and outcome measures, optimal amount of therapy, and service delivery for OMT.10 Additionally, OMT outcomes related to sleep disordered breathing and oral hygiene should be considered for study as they add challenges to individuals’ overall health.10 Therefore the purpose of this study was to explore orofacial myology education, certification, and practice by DH providers as well as the advantages and barriers to the practice of orofacial myology for DHs.
METHODS
Study Design
This study used a phenomenological heuristic qualitative design to explore the subjective experiences of DHs practicing as orofacial myologists. Phenomenologically aligned heuristic inquiry clarifies the principle of the lived experience for an individual or group and is personalized in that it does not separate the individual from the experience.11 Heuristic inquiry focuses on the exploration of the essential nature of the relationship or interaction between both.11 As such, the researcher includes analysis of their own understandings as part of the data.11,12 This study was approved by the University of Missouri Kansas City Institutional Review Board (IRB #374492).
Sample Population
Purposive sampling was used to gain insight and understanding of the experiences of myofunctional therapists. Dental hygienists who had either received training in orofacial myology from various organizations or held a certification in the field were invited via email to take part in the study. A solicitation email was sent in May 2022 to these organizations to distribute to their members, as well as a follow-up email to ensure receipt. Participants residing outside of the United States were excluded from participation. No incentives were given for participating in the study and the completion of the interview indicated their consent to the study. Interviews were conducted online from May 16 to June 16, 2022. Participants were enrolled until saturation of responses was achieved. While a specific number of interviews is not required to indicate saturation, there is agreement that the quantity for saturation is between 9 and 16 interviews.13 Saturation is characterized by no new themes or sub themes, which was achieved within the study’s 25 interviews.12,13
Procedures and Measures
Multiple data sources, triangulation, included semi-structured interviews, the primary investigator’s personal experiences or perspective as an educator, and historical policy documents from the ADHA.12 The semi-structured interviews were guided by a list of questions to be explored which had been derived from keywords in literature pertaining to orofacial myology but without a determined wording or word order to allow for more flexibility (Table I).14 The questions were developed by the primary investigator and shared with the investigation team (three dental hygiene educators who are not formally trained in OMT but with experience in research) for evaluation with the study aim and refinement. During the process of refining the topics and questions, the investigation team shared their own curiosities and questions about the training and certification, as well as eventual practice of orofacial myology for the dental hygienist. The team captured these curiosities and questions until the final inclusive list of topics/questions was approved by the group. Participant interviews were conducted via a video teleconferencing software program (Zoom; San Jose, CA, USA) and recorded. The semi structured interviews were conducted by the primary investigator.
Semi-structured interview questions
Data from the recorded interviews were collected and transcribed by the primary investigator using the software program’s audio transcription feature and organized into sub-themes.15 The primary investigator conducted the interviews and confirmed the accuracy of the transcription. Participants had the option to leave their camera off and change to a fictitious name during the interviews prior to recording. No names were included in the transcripts, and no demographic data was collected. To maintain participant anonymity, any identifying details like names, affiliations, and state residency were discarded after the interviews were completed. The interview sessions concluded when saturation of data was achieved, and no new information was forthcoming. The 25 interview sessions ranged from 50 minutes to one hour.
Data Analysis
Heuristic analysis involves the understanding and experiences of the primary investigator.11 Sources of data included the semi-structured interview responses, the primary investigator’s field notes pertaining to curiosity, previous CE courses, the primary investigator’s knowledge of education and curriculum, and informal comments overheard from colleagues regarding orofacial myology education and curriculum. Examples of documents analyzed were historical aspects of orofacial myology from the ADHA including policy adoptions, various dental practice acts, and the primary investigator’s journaled experiences over a three-year time frame from 2019-2022.4
Data were coded and thematically analyzed by the primary investigator and a second investigator. The findings from each investigator were compared and an independent audit conducted by a third investigator of the investigation team, not involved in the first round of data analysis, to confirm dependability of results. Thematic analysis was applied to the interview transcripts and following close examination by the investigators, common themes were identified.11
A six-step process was followed including familiarization, coding, generating themes, reviewing themes, defining themes, and reporting findings.16 Familiarization involved getting an overview of all the data prior to the analysis, by reading through the text and taking initial notes. This was followed by coding where various phrases or sentences that described feeling or ideas were highlighted in the text. Patterns were identified among the color codes and sub-themes were generated by the primary investigator and one other investigator. Once the sub-themes were determined, the four investigators reconvened, to review the sub-themes and determine accurate representation of the data, which included various suggestions for reorganizing the data, until all duplicity was eliminated. Investigation team members then defined and named the collections of similar sub-themes as core themes. Each core theme was given an easily understandable name prior to writing the analysis, inclusive of recognizable and representative key words. Document analysis was performed and analyzed in a similar manner in support of triangulation of the data and to draw on the two remaining sources of evidence, researcher field notes and historical documents, to reduce potential biases and increase validity.16
RESULTS
Saturation was achieved with 25 participants. The respondents represented various regions across the United States, with the majority being from the midwestern states. Thematic analysis yielded five core themes and nine sub-themes (Table II). The core themes included: Uniform Credentialing, Autonomous Workforce Models, Identity Distinctiveness, Business Management, and Access to Myofunctional Care.
Synthesized core themes and emergent sub-themes
Uniform Credentialing
A core theme that emerged from the data was Uniform Credentialing, reflecting a widespread concern among participants about inconsistencies in how orofacial myology is recognized, regulated, and practiced. This theme highlights the challenges faced by professionals due to varying standards for training, certification, and legal recognition across organizations. Participants expressed a strong desire for more cohesive and standardized pathways to legitimacy in the field. Within this core theme, two subthemes were identified: regulatory frameworks and career trajectory.
Regulatory frameworks
A barrier noted by a few participants was the lack of uniformity for myofunctional therapy. One participant indicated, “Everybody has a different style, it would be nice to have like standardized stuff that one should cover, and everybody should go through that just like hygiene school...I feel like standardization needs to happen...” The lack of standardization in education programs and credentialing for practice causes confusion for those DHs interested in advanced education in myofunctional therapy. Moreover, professionals from other health care fields may practice myofunctional therapy slightly differently depending on their education and training.
Comments indicated the need for guidance from one universal governing system. One participant stated, “I think that the legalities are such that you have to have your dental hygiene background and your license in order to specialize in this, but there is no explicit governance, there is no explicit oversight or regulation of the field.” Another mentioned, “I think that if there were one universal governing board and everyone was held to the same standards, that would make me more inclined to get the certification, because there’s not, that definitely gives me pause.”
Barriers to certification that exist for dental hygienists such as differing practice acts within states, were highlighted by the participants. One participant stated, “...it’s hard to get the proper verbiage from the state. They basically just said, if you don’t practice hygiene, you know, and you don’t combine the two, then you’re okay to go ahead...I keep everything separate.”
Another participant reflected on the practice act regulations by noting that, “The ADHA made a blanket statement that they support dental hygienists doing it...”
Participants revealed differing opinions regarding certification. One participant stated, “The biggest reason I went with ___ to get certified is because to me, it was like a true certification, just like I have a true dental hygiene license. So, by that I mean there were different people educating me, then were examining me to really verify what my knowledge was.”
Another participant indicated, “I don’t think people should try to do certification right off the bat, there’s so much to learn,” and “There’s a lot of well-known myofunctional therapists that are not certified at all, or speech pathologists that are not certified at all.”
Career Trajectory
Different myofunctional training programs may have the same end goal but arrive at the outcome differently. Some courses may highlight aspects of the practice that another course does not. One participant’s thoughts were,
“There can still be multiple credentialing programs that still educate you in such a way that you are a competent and confident therapist. So, I feel like right now it’s confusing but I’m hoping, with time... you can go this path, or you can go this path, but these are the paths that get you confidently credentialed and certified as an OMT, but it doesn’t necessarily have to be just one correct path...”
Several participants mentioned taking more than one OMT training course to gain insights they may have missed from previous courses, or out of curiosity to determine whether the courses from various providers were the same. Another participant stated, “...I think when you take one class you, personally, I think you know just enough to know you don’t know enough, and then you kind of want... another course, and then another course.” The majority agreed that they would have liked to have been introduced to OMT in dental hygiene school. One participant stated, “I think dental hygienists don’t know enough about this...I think it should be included in our general schooling, at least a little bit.”
Autonomous Workforce Models
A core theme that emerged from the data was Autonomous Workforce Models, which reflects participants’ perspectives on the benefits and challenges of pursuing independent or expanded practice roles within orofacial myology and related fields. This theme captures the evolving nature of professional identity and the interest in models that allow for greater control over one’s work environment, decision-making, and patient care. Participants emphasized how autonomy could lead to improved job satisfaction, reduced burnout, and new professional opportunities. Three subthemes were identified within this theme: independence, wellbeing, and increased income/compensation.
Independence
Independence emerged as a collective theme in all three data points, semi-structured interviews, researcher field notes and historical documents. Although myofunctional therapy was reported to be delivered separately from dental hygiene services, having this skill set may set clinical dental hygienists apart from one another and expand the practice’s breadth of services. One participant indicated, “I think I want to do something different, and somebody mentioned it in the clinic.” Another stated, “It was a way for me to start thinking outside of the box.”
Many dental hygienists seek more autonomy in their practice setting and OMT is an avenue for increased autonomy. One participant stated, “...I think you need to have a license and I think you need to invest yourself in it fully...I think it’s best to have your own practice.”
Participants remarked on autonomy in practice. One explained, “The state of ____ is very unique because hygienists can actually own our own practice here. You do not have to be owned by a dentist. In fact, there’s several in the area, independent hygiene practices.”
Relative confusion over how to implement the practice of orofacial myology emerged from participant interviews. One participant stated, “So orofacial myology is under the scope of practice in the dental hygiene national scope...If your hygiene scope of practice doesn’t mention orofacial myology, then what the lawyers are saying is that you fall back on the, you know, whole federal one, the American Dental Hygiene [Association] and there are all kinds of information on orofacial myology under the scope of dental hygiene.”
Another indicated, “I am very careful to state that I don’t do any sort of speech therapy...I also let them know that I am a dental hygienist, but I don’t practice dental hygiene. I do keep those separate...really try to make sure that I’m doing everything you know, without going over scope of practice...”
Wellbeing
Participants mentioned the need to transition out of the clinical setting, but still wanted to use their current degree, and bring value to patients. One expressed, “...I was feeling mentally bored with dental hygiene. I love my patients. I love helping people. There were things that I enjoyed about my work, certain aspects of my work, but I was like...is there anything else that I can do with my degree?” Another stated, “It was probably about two and half years ago, I was looking to figure out how to transition out of clinical hygiene... and I was like, I don’t want to retire, I’ve got so much knowledge, I want to help people.”
Participants indicated pain associated with hygiene practice was a factor in seeking a new practice. One participant detailed, “I was a broken hygienist. I had so many surgeries, back problems, neck problems... needed to get out of hygiene, but I wanted to use my hygiene degree.” Another explained learning OMT as an investment, “I think that for the long-term strain on the body, it’s [OMT] worth you know, its weight in gold...that’s a long-term benefit and long term, you know it’s basically investing in my body in the future.”
Increased income/compensation
Most participants expressed there is potential for increased income with OMT, but it depended on how many days a week or hours they are willing to work, and the geographic location. One stated, “...the earning potential is higher if your schedule is full. So, I guess it depends on how many patients you’re able to see initially... but then once your schedule is fuller, then the earning potential is much higher for OMT.” Another indicated, “...it depends on what part of the country you are in...so what they can get in ___ they are getting $200-$300 an hour per session, where people in ___ are getting $35-$100 an hour.”
Identity Distinctiveness
The core theme of Identity Distinctiveness emerged as a reflection of the internal and external challenges professionals face in defining and communicating their role within the broader healthcare landscape. Participants described uncertainty in how they view themselves professionally, as well as how they are perceived by the public and other health professionals.
Participants noted that a lack of confidence hindered them from moving forward with pursuing the OMT profession, but after certain training programs they felt more confident in getting started. One stated, “You know, even though you never feel confident when you’re first starting out just like with dental hygiene, you at least want to know you have the right tools that you need to get started, and that’s why I chose that route.” Another indicated, “The ___ was fantastic, I came out feeling, not that I knew everything, but I had a good grasp...good understanding of what needed to be done. ___ also gave me the confidence to start my own business as well, which is huge.”
The majority were unaware that OMT was an opportunity available outside of clinical hygiene. One stated, “I was kind of disappointed later that I was never offered that...nobody at school ever told me that that was an option and I graduated well beyond the years of orofacial myology. They never talked about what can you do with your degree, other than working for a dentist.”
Another stated, “...so I think one of the biggest roadblocks, the awareness by all the professionals...” Furthermore, another participant indicated, “...so I would love to see some basic information taught to dentists and hygienists and pediatricians and you know, ENTs and everybody because we don’t get taught that and...I think hygienists are in the exact perfect location in career and education to be able to say, oh, this is my field, this is my area, I can totally do this.”
Lack of public awareness and lack of routine screening for myofunctional disorders were identified by the participants. One indicated, “...people need to get educated about it, I mean, even in my area, that’s one of the roadblocks that I have.” Another stated, “The dentist or the orthodontist can certainly talk about it...that patient doesn’t have an awareness of what it is, they’re not going to buy in.”
Business Management
The core theme of Business Management reflects participants’ recognition that clinical expertise alone is not sufficient for success in independent orofacial myology practice. Many highlighted the importance of developing foundational business skills and navigating the complexities of practice ownership or self-employment. Participants discussed challenges such as financial investment, billing systems, and the need for business insight to ensure sustainability and growth. Two subthemes were identified within this theme: entrepreneurship and compensation.
Entrepreneurship
Oral myofunctional therapy program costs and necessary time for training were identified as barriers. However, some participants indicated that the benefits outweighed the challenges.
Another stated, “I would say financially, it took a few thousand dollars, just to get you know, my new computer... desk...the marketing materials, the business licenses, the training. I mean, the training alone was thousands...So it’s a commitment, it’s not for the faint of heart definitely, but it’s an area that there are not enough people doing it and it’s so so sorely needed...”
Most dental hygienists do not own and operate their own business; therefore, their experiential knowledge of business could be limiting. One participant expressed, “...so for me, it was starting out, it’s not cheap to do these courses...but to really get in and do it and practice it successfully, it requires a lot of startup money and you also have to have a really good sense of a business and I feel like a lot of hygienists either don’t have that, or they just don’t know.”
Compensation
One participant noted, “So as far as I’m aware there’s not a whole lot of insurance reimbursement. I practice on a cash basis, and I don’t bill insurance at this point.” The majority stated that they use a superbill instead of filing insurance themselves. One participant stated, “I do make it clear that if they’d like to go through insurance, they’re going to need to seek reimbursement themselves via the superbill, and a lot of patients either haven’t requested it, or haven’t had any luck. As far as I know, no one has been reimbursed.”
Similarly, another indicated, “I have the patients submit to their insurance, so I provide them with a superbill. They will then turn that into their insurance to see if they can get reimbursed...” Additionally, one participant reflected, “I will give them a superbill, so that they can send it to their own insurance for reimbursement and so far, I haven’t heard a lot of feedback on if they’ve gotten any reimbursement.”
The majority indicated that they did not take insurance for the services performed. As one participant shared, “...the problem is, we don’t have our own code, so we have to borrow from physical therapy and speech therapy. We typically at this point, do not get coverage, because when it comes back to where’s your licensure, well, we’re dental hygiene...you need to file through dental insurance, but as therapists, we are considered medical practitioners. So, this has been a long-term issue and it is really probably the biggest frustration for hygienists going into the field versus speech because they can say oh, we can get you insurance coverage.”
Access to Myofunctional Care
The theme of Access to Myofunctional Care highlights the participants shared concerns about the limited availability and visibility of orofacial myofunctional services. Many emphasized the importance of expanding access through collaborative care models and stronger integration into existing healthcare systems. Improved access was also seen to enhance patient outcomes and raise awareness of the benefits of therapy. Two subthemes were identified within this theme: integration and health outcomes.
Integration
Participants indicated the field of oral myology combines specific knowledge in multiple areas in a collaborative approach to care. One participant stated, “I learned over the years before all this was accessible knowledge that there were so many other missing pieces. So, you have to look at the airway, you have to look at posture, you have to put the whole-body system together. TMJ is a whole other gamut even more so...I would say it’s that collaborative team approach that heals people, gets them out of pain, helps them grow.”
In further recognition of the intraprofessional collaboration required in OMT, several of the participants noted they receive their clients through dentists and orthodontists. Furthermore, OMT may also refer to oral surgeons or periodontists for procedures to correct anatomical issues such as frenectomies. One participant indicated, “Most of my referrals come from orthodontists and dentists...so my main referral base is dental...”
Health Outcomes
One of the biggest reported benefits to the practice of orofacial myology according to participants were improvements pertaining to sleep. A participant discussed patient benefits by stating, “The biggest way as quality of sleep, and them understanding … how they breathe at night impacts their sleep...” One advantage the data revealed was the impact that myofunctional therapy has on patients undergoing treatment. Many benefits were noted by the participants and patient satisfaction was apparent. One stated, “Physical symptoms, as far as like open bites closing, coming out of cross bite, sleep disordered breathing eliminated...I’ve seen stuff like reflux resolve, sleep improve so behavior in children improve...” Another participant noted, “...physical and emotional mental effects, you know because of like how their face looks, they’re getting teased at school because the way they breathe...they’re just so happy and thankful it changes, you know, the rest of life.”
DISCUSSION
This qualitative study provided a unique opportunity to explore the lived experiences of DHs working as OMTs using semi-structured interviews. Questions about how participants entered the field, obtained certification, and navigated state regulations informed five core themes: Uniform Credentialing, Autonomous Workforce Models, Identity Distinctiveness, Business Management, and Access to Myofunctional Care. Responses revealed inconsistencies in training, variation in scope of practice, challenges in professional identity, financial and administrative barriers, and the importance of collaborative care in improving access and outcomes. Despite national support for DHs practicing OMT, the scope of practice of a dental hygienist differs by state and the language pertaining to OMT is either missing or underdeveloped for ease of practice. Without further guidance, participants are affirmed in their feedback regarding scope of practice and the dental hygienist’s role in the use of OMT. The lack of formalized support within the dental practice act verbiage may cause concern for those practicing OMT with no available license and with or without a uniform credential.
Dental hygienists participating in the study were motivated to bring awareness of OMT to other oral health providers and the public. Although a previous report discussed several organizations focusing on increasing awareness of OMT over the past five years, the findings of the current study express a continued lack of awareness of the specialty.17 Further investigation shows many different myofunctional training programs across the US without a recognized accrediting body, agreed upon educational standards, and shared oversight. While investigating different states dental practice acts, very little to no verbiage was found using the search terms: myofunctional therapy, orofacial myofunctional therapy or myofunctional disorders. Further, accreditation for this course of study is not housed within any of the health care professions, training those who could become a myofunctional therapist, but within different organizations such as the IAOM, AOMT, Breathe Institute and Neo-Health Services, that provide certification in the practice of OMT.18,19 Certification in myofunctional therapy is not a requirement to practice.
The lack of uniformity in training programs, the absence of a universal governing board, and the lack of specific verbiage in practice acts caused confusion. This appeared to contribute to the tendency of DHs practicing OMT to not seek certification as it was unclear regarding the advantage of certification. Furthermore, the lack of procedure codes for OMT in the Code on Dental Procedure and Nomenclature (CDT) resulted in reimbursement issues, which was a common concern amongst the majority of participants. This limits the patient pool to those who can afford to self-pay for OMT services and in turn, could limit the income potential of an OMT. These findings demonstrate the need for research evaluating credentialing uniformity and licensure in the field, which could support the advancement of dental billing codes for reimbursing oral health OMT providers. Additionally, this research could inform the development of a formal accreditation process for the profession. Exploring the experiences of DHs as myofunctional therapists brings an awareness and further curiosity to the specialty and could open new opportunities for more comprehensive treatment for patients’ overall health.
The ADHA’s support of the dental hygienists’ role in OMT has been a progressive step for a more comprehensive approach to oral health care. In 1992, ADHA adopted its first policy for dental hygiene and myofunctional therapy. Dental hygiene services policy 9-92 states that the ADHA acknowledges that the scope of dental hygiene practice includes the assessment and evaluation of orofacial myofunctional dysfunction; and further advocates that DHs complete advanced clinical and didactic continuing education prior to providing treatment.4 In 2020 a second policy was adopted and amended in 2021. The Orofacial Myofunctional Therapy policy 10-21/11-20 states that the ADHA acknowledges and supports registered DHs who are educated in Orofacial Myofunctional Therapy (OMT). Dental hygienists educated in OMT may provide orofacial myofunctional assessments and treatment independently in a variety of practice settings and for patients of all ages.4
Increasing the awareness of alternative clinical fields in which DHs may enter is an essential element of emerging workforce models. Similar to the findings in a study discussing emerging allied dental workforce models, the findings of the current study may challenge academic institutions to prepare for changes brought by this increased demand of allied dental workforce models.20 The expansion of services parallels findings in reports discussing range of services and career growth for DHs1,9 Participants in the current study expressed an increase in practice autonomy and income, resolution of burnout, and musculoskeletal relief as some of the advantages of OMT training. The potential for training in focused areas adds to the number of services DHs can provide. While myofunctional therapy is delivered separately from dental hygiene procedures, having this skill set can expand services offered and set DHs apart from one another.
A limitation of this study was that it is the first of its kind to examine these experiences, therefore it was hypothesis generating versus hypothesis testing. There is a lack of research in OMT training for dental hygiene professionals and of literature explaining the means of incorporating OMT in other professions. A second limitation is the nature of qualitative studies in that the interviews consist of self-reported data. Additionally, the role of primary investigator’s personal field notes as a data source can create the potential for bias.
Future research should be conducted to quantitatively examine procedure codes used in the superbills by DHs and other myofunctional therapy providers to examine reimbursement rates, and whether certain credentials earn better reimbursement. Additionally, a study could be conducted to investigate DHs practicing myofunctional therapy on an international level to further understand the impact of myofunctional therapy outside the US, from a dental hygienist’s perspective.
CONCLUSION
This qualitative study collected perceptions of DHs with respect to the practice of orofacial myology, and its perceived benefits, and barriers. Participants drew attention to the practice of OMT as an opportunity for an interdisciplinary approach to comprehensive oral health care. The experiences of the participants revealed barriers such as reimbursement issues and lack of congruent training programs. While myofunctional therapy education and certification can be complex and costly, this specialty deserves further attention as part of the delivery of comprehensive oral and systemic health care.
IMPLICATIONS FOR DENTAL HYGIENE PRACTICE
The practice of oral myofunctional therapy can increase dental hygienists’ autonomy in providing comprehensive oral health care services as well as expanding career opportunities beyond clinical dental hygiene.
Oral myofunctional therapy creates opportunities for interprofessional collaboration and enhanced patient care leading to improved oral and systemic health outcomes.
The integration of orofacial myology into dental hygiene care enables dental hygienists to play an active role in screening for overall health issues related to airways, sleep and temporomandibular joint management.
Footnotes
NDHRA priority area, Professional development: Education (educational models).
DISCLOSURES
The authors have no conflicts of interest to disclose.
- Received March 3, 2025.
- Accepted September 11, 2025.
- Copyright © 2025 The American Dental Hygienists’ Association
This article is open access and may not be copied, distributed or modified without written permission from the American Dental Hygienists’ Association.
