What I've Seen: Lessons From Years of Retraining Tongues, Ages 4 to 72

By Carol Chavez, RDH — Certified Myofunctional Therapist, Myofunctional Mastery, San Antonio

When I started practicing myofunctional therapy, I knew what the research said. I had read the studies on tongue posture and sleep-disordered breathing, on nasal breathing and airway health, on muscle function and orthodontic relapse. What I didn't have yet was the thing no journal can give you: years of working one-on-one with real people, watching what actually happens when the tongue learns where it belongs.

My patients range from four years old to seventy-two. Some are kindergartners whose parents are worried about snoring and restless sleep. Some are adults who have spent years on a CPAP machine. Some are teenagers about to get their braces off. I want to share what this journey has taught me, because it has changed how I talk about this work.

The research holds up

The simplest thing I can say after all these patients is this: the outcomes described in the literature are real. I see them in my clients week after week.

When the tongue rests in the roof of the mouth, the lips stay sealed, the swallow is driven by the tongue rather than the lips and cheeks, and breathing moves through the nose, people breathe better. They sleep better. They simply function better. It sounds almost too simple, and I understand the skepticism, because I had some of it myself. But the four goals of therapy (lips sealed, tongue up, nasal breathing at all times, and a correct tongue swallow) are the foundation for just about everything else I'm about to describe.

Sleep is where the biggest changes show up

Many of the adults who come to me already carry a sleep apnea diagnosis. They arrive tired, often frustrated, and often struggling to tolerate the CPAP machine they've been given. By retraining the muscles of the tongue, soft palate, and throat, many of these patients have been able, in coordination with their sleep physician, to reduce their reliance on CPAP and in some cases move away from it altogether while still getting restful, uninterrupted sleep. That is not a promise I can make to anyone on day one, and every patient is different, but it is something I have watched happen again and again.

The changes in children may matter even more. Many of my young patients don't have an official diagnosis of anything. What their parents describe is a child who snores, tosses and turns, wakes up cranky, wets the bed, or struggles to focus at school. When we establish nasal breathing and a proper tongue resting posture, parents consistently report calmer, deeper sleep, and often a calmer, more focused child during the day. Watching a family get their nights back is one of the most rewarding parts of this job.

Teeth that stay where the orthodontist put them

Every orthodontist has seen it: beautiful results that slowly drift once the braces come off. In a great many of those cases, the tongue is the reason. A tongue that rests low and pushes forward with every swallow (and we swallow somewhere between five hundred and a thousand times a day) is a force no retainer can fully resist.

What I see in my patients who complete therapy is long-term orthodontic stability. The teeth stay straight because the tongue is no longer pushing on them in ways it shouldn't. The tongue, resting up in the palate, becomes the natural retainer it was always meant to be. For the orthodontists I work with, this is often the outcome that makes them a believer.

Allergies: the nose becomes a filter again

I want to be careful here, because myofunctional therapy does not cure allergies, and I would never tell a patient it does. What I can say is that when we re-establish nasal breathing, the nose goes back to doing its job. It warms, humidifies, and filters the air before it reaches the lungs, catching a great deal of pollen, dust, and other irritants that a mouth breather inhales unfiltered.

The result, in patient after patient, is a noticeable reduction in allergy symptoms. Less congestion, fewer flare-ups, less reliance on medication for some. When allergies or swollen tonsils and adenoids are blocking the nose to begin with, I work alongside ENTs and primary care providers to get that under control, because nasal breathing can't happen through a nose that is closed. But once the airway is open and the habit is retrained, the nose does remarkable work.

Jaw pain, neck tension, and the things people didn't expect

Some of the most surprising feedback I get has nothing to do with the reason a patient came in. People come for snoring and mention, a few weeks in, that their jaw doesn't ache in the morning anymore. They come for orthodontic retention and notice their neck and shoulders have loosened up.

This makes sense when you think about it. A tongue that rests low pulls the jaw down and forward, strains the muscles of the face and neck, and often goes hand in hand with clenching and grinding. When the tongue moves up into the palate and the jaw finds its natural resting position, the whole system relaxes. A reduction in TMJ pain and in neck and shoulder tension is something I now tell new patients to watch for, because it happens so often.

What makes the difference

If there is one thing I've learned that I wish every new patient understood from the start, it is this: the results I've described belong to the people who did the work. Therapy is built on short exercises, about two minutes each, done morning and evening. The patients who practice consistently are the ones who breathe, sleep, and feel better. The exercises aren't complicated. They just have to happen.

I also want to be honest that therapy is not always enough on its own. Sometimes a tongue-tie needs to be released before the tongue can physically reach the palate. Sometimes an orthodontist needs to create room. Sometimes an ENT needs to address tonsils or adenoids. Part of my job is recognizing when that is the case and bringing the right provider onto the team. The best outcomes I have seen are almost always team outcomes.

Why I'm still excited

After years of doing this, I am more convinced of the value of this work than when I started, and I'm more careful about how I describe it. I don't promise cures. I do promise that when we retrain the tongue to rest where it belongs and the body to breathe the way it was designed to, good things tend to follow, and I have a long list of patients, from four to seventy-two, who would tell you the same.

If you or your child breathe through the mouth, snore, struggle with sleep, have teeth that keep shifting, or live with jaw and neck tension that nobody can quite explain, I would love to talk with you. Sometimes the answer really is as close as the tip of your tongue.

Carol Chavez, RDH, is a certified myofunctional therapist and the owner of Myofunctional Mastery in San Antonio, Texas. She works with children (age four and up) and adults, and collaborates with dentists, orthodontists, ENTs, sleep professionals, and speech therapists. Learn more at www.myofunctionalmastery.com or call 830.423.6762.

This article is for educational purposes and is not a substitute for medical advice. Never stop or change a prescribed treatment such as CPAP without talking to your physician.