Shirley Gutkowski is an expert in orofacial myofunctional therapy, which teaches neuromuscular techniques to alleviate orofacial disorders like tongue thrusts and snoring. The American Dental Hygienists’ Association recognizes dental hygienists can assess and treat these disorders, advocating for advanced education prior to practice. Treatment plans incorporate exercises to improve muscle function and overall health, addressing issues such as sleep problems in children.

2. 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

3. Shirley’s 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 she’s 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.

4. 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”.

5. 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

6. EVALUATIONS

7. SCREENING TOOLS
Epworth Sleepiness Scale
Reflux Symptoms
Lip strength
Blood pressure
Neck circumference

8. 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

9. Treatments vary from
simple to super simple

10. The Spot is the first
landmark of treatment
The Spot

11. 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.

12. Treatment Plans

13. Treatment sequences
Develop a lip seal
Phase
1
Generalization and
Maintenance
Phase
2
Habituation
Phase
3

14. 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

15. Exercises to
promote lip seal
Rubber band hold
Button pull
Upper Lip Stretch
Lip Curl
Cork pop

16. Techniques to get the
facial muscles and the
tongue to move right

17. 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

18. Suggestions for better
sleeping
Mouth taping
Breathe right strips
Nasal cones
Teas and supplements

19. Breathing retraining
Buteyko

20. Breathing Retraining

21. Biofeedback
neuromuscular
appliance
0:00 – Reverse swallow
1:58 – Mouth breathing

22. Cross Link Radio
Host Shirley Gutkowski