Unraveling the Myofunctional Therapy Solutions for Development of Proper Chewing, Swallowing, and Sleep Dysfunction

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I'm Dr. Sandhya Moldovan, periodontist and nutritionist. Welcome to the Holistic Dentistry Podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body as we explore together the root cause of disease. Remember, you're not healthy until your mouth is healthy, so take care of it in the most natural way.

Hi everyone. Welcome to the Holistic Dentistry show and today I have a very special guest and I'm really, really excited to talk about this subject because so many people don't know what myofunctional therapy really is and how it could really, truly change your life and your sleep. And with me I have Joy Moeller. She is a dental hygienist, author, and formerly an associate professor at Indiana University who has worked as a myofunctional therapist for many years and currently has a private practice in Pacific Palisades, California. Joy is founding lecturer with the Academy of Orofacial Myofunctional Therapy IOMT and a founding board member of the aams. She has taught postgraduate courses in myofunctional therapy at universities and hospital worldwide doi, wrote a chapter in Sleep Medicine Clinics, a chapter in Sleep Disorders and Pediatric Dentistry, and a chapter in Management of Obstructive Sleep Apnea textbook for oral surgeons in 2021 and a children's book on tongue position, as well as many published studies and other chapters in textbook and a book that's soon going to be coming out. Joy has lectured worldwide, was the first myofunctional therapist to be on staff at the Pinke Institute. He currently teaches at the Palo Alto School of Sleep Medicine and taught for seven years with UCLA Dental Sleep Postgraduate Program and the Pedo Ortho Residency. Joy received a lifetime achievement award from the AAPMD and a Louis Pasteur award from the association of Applied Myofunctional Sciences in Rome. Welcome to the show, Joy. So excited to have you.

So excited to be here. Spring yeah, definitely.

So let's start with what is myofunctional therapy?

Okay, well, nobody knows about it, but I'll explain. Myo is muscle function, is function of the oral muscles. We deal with 58 muscles of the head and neck and the function of those muscles. And we work on breathing, chewing and swallowing correctly and eliminating habits. So many people have habits that they're not even aware of, like playing with their hair or leaning or biting their cuticles or so many things. And we figure out why they're doing it and then work on that. It's all about the why?

So who are your clients? Is it children, adults, or both?

Young babies. All the way to. My oldest patient was in his 90s.

Wow, impressive.

He didn't like wearing a CPAP, so we helped.

So myofunctional therapy is really working with these 50 plus muscles of the face and kind of help them be working synonymously together.

Yeah, well, it's restoring normal function. What's happened is people have changed. And there's a lot of research coming out showing that breastfeeding done correctly long enough and eating more solid foods rather than baby foods. Like before 1930, there. There was only people food. There wasn't baby food because we didn't have blenders. So.

That's right.

So just reach over and grab something off mom's plate and chew on it and develop their jaws. But people now, they eat baby food and then they transition to pouches, and then they transition to macaroni and cheese and pasta and, you know, sauce smoothies and chicken nuggets. And they don't chew.

Yes, absolutely. But let's go back to the. Yeah, to the breastfeeding, because this is so important. And a lot of moms actually don't know that breastfeeding actually helps to form the jaws. So that's why maybe we have so many kids nowadays doing orthodontics because they weren't breastfed long enough. So what is the norm with breastfeeding and how long do we have to do it in order for the arches to develop properly?

That's a great question. About 15 years ago, I worked in an office with an environmental medicine specialist, and she introduced me to Shelly Marmet, who was the lady who pioneered and conceptualized the whole field of lactation consulting. She said that because I asked that same question when she stopped breastfeeding. Well, the reality is you need to let the baby take the lead. Some babies at 9 months, they don't ever want to look at another breast. And some babies need to go on to three years or even longer if they have allergies, because the breast milk will prevent allergies. Even if you just breastfeed once a day, it helps. But it's like mothers knew that for millions of years, and even as the child got older, they still would breastfeed a little bit. And they knew that breast milk helped the immunity.

Absolutely. And a lot of moms might say, oh, you know what? I can get a bottle that basically mimics the breast. And it's basically the same thing. Are we really using the same muscles when we.

No, you can't fool Mother Nature. Because when there's, when you're breastfeeding, the tongue is trying to strip the nipple and, and milk the nipple. When you're bottle feeding, your tongue is resting down and you're moving your jaws to get the milk out. There isn't a bottle a nipple made that will do what a mother's breast will.

Absolutely, I agree with you.

So hard work. It's hard work. But once the baby gets it and learns how to do it and the mother learns the health, the health parameters are so much different for that person.

So if the baby is not breastfed, what do you see in terms of the formation of the jaws?

What are the signs show you on my little rubber mouth? This is the palate. And when the breast is in here and the tongue is pushing, this area widens and grows and forms forward and wider. And when it's, when it doesn't form, when there's no. When it's just a little rubber nipple, this is what happens.

That's right.

You get crowding high and narrow. There's not enough room for the teeth and the muscles in the back of the throat collapse. We call that the Mellon potty score. The airway gets smaller and then the child develops a mouth breathing habit. And when they breathe through their mouth, the mandible slips back. Then they become a habitual mouth breather. You're not getting enough oxygen. And so they develop a condition called adhd.

How interesting. A lot of people don't, wouldn't even associate breastfeeding to adhd. But clearly there's a connection there in the way our jaws get shaped from, from breastfeeding.

Yeah. Actually I have a good diagram here. Really interesting. So like these are your teeth. This is the house for the tongue. This is where your tongue is supposed to rest. But if you're bottle fed or suck your thumb or do the mouth breathing, this is what happens. And the roof of your mouth is the floor of your nose. So as that collapses and gets narrower, people become mouth breathing. What we do as myofunctional therapists, get the tongue to go up and help that arch to widen.

So once you get somebody, let's see, that has this narrow palate or the mouth, through myofunctional therapy, you can change.

That shape again, correct it's form and function. You swallow 502,000 times a day with 4 pounds of pressure, 55 grams per centimeter. So if your tongue is going up over time, it's going to help to create a better form.

Up to what age can you Actually reshape these facial scars.

Even as an adult. I can show you pictures before and after of how patients have widened. It's a lot harder. And certainly I'd like the help of orthodontists or functional dentists that can help, but that doesn't always happen. Sometimes we're on our own. People just want nature to do it. They've already worn braces two or three times and don't want to do it again.

So what's the ideal age for a patient to get to you to kind of help with this?

I just saw a four year old that was diagnosed with sleep apnea today on my schedule. Little, little boy Zachary. And he's, he's been working with me a while and he's now sleeping.

Amazing.

That's great.

So that's around. So around four and six years of age. That would be.

Yeah. So three. I like to see them at three.

Okay. And they follow instructions properly to where.

Oh, they have fun. There's chewing fun things and all kinds of prizes we have, and buttons and strings and pulleys and. Okay, great. Love doing it.

Yeah. So for those of you are there that are listening, thinking, oh my God, this might be something really scary. It's not, you know, for kids it can be really fun. Something that they could look forward to and also improve their sleep, which is great.

They're chewing too. You know, so many kids have not mastered the art of chewing. And so we have little devices that we use, chewing devices and things that are fun to, to chew on and that. So this the building.

How does one not know how to chew?

Well, if they've been given baby food and if their tongue is not functioning, their tongue is actually an organ. It's a respiratory organ. Everybody thinks the tongue is muscle or it's really an organ. It has 16 muscles in it. And it works with the diaphragm. The diaphragm is this muscle muscle that goes around your waist like it attaches to your low back. And when you breathe in and out, it expands and contracts. And if the back of the tongue is functioning, it works with the diaphragm to fill the lungs with air all the way down to the base of the lungs. So it's very important to have your tongue in the right place all the time and functioning correctly.

That's really fascinating, Joy.

It helps chewing because the muscles can gather the food and put the food in between the molars that grind the teeth.

Fascinating. I always thought as a tongue about muscle. So you're teaching me. Definitely Something new that it's attached to the diaphragm. So people that are not breathing with their diaphragm, are they impacted?

Oh, yeah. They. They can't breathe. They don't. They're. They can't focus. They're groggy and tired.

They.

They'll wake up in the middle of the night gasping for air, and they choke because their tongue is falling into the airway. People don't realize the snoring, the noise of snoring is the back of the tongue, the genealglossus, which is falling into the airway. Yeah. Strong. The back of the tongue. Strong and going up.

So with myofunctional therapy, you can help strengthen the tongue.

Yeah.

So it doesn't fall in the back of the throat.

Right, right.

Fascinating. Actually, I was looking at a study just before we got on this. And you can improve sleep apnea with myofunctional therapy. Up to 50% in 50% of the cases, which is quite.

In adults and 62% in children.

Yeah. Amazing. They're probably more receptive and to therapy.

I think every dentist should have access to a myofunctional therapist because it goes along with gum disease. If you're mouth breathing, the bacteria multiply.

Absolutely.

If you're. If you're breathing through your nose and you have a. Develop a lip seal, that's one of our goals is lip seal. Then it all kind of works together to help the. And also if you're a tongue thruster, if your tongue is coming forward when you swallow, it weakens the ligaments around the teeth.

Yeah. And mouth breathing is a real problem. Actually. I used to be a mouth breather as a child, so I had some myofunctional therapy back in Romania to strengthen. Because I have this lip incompetence. So I remember this little, like, button with the. An elastic to work my muscles. Is that still being done today?

It's interesting that you said in Romania is. Because other countries are on this. In Brazil, they do my functional therapy in schools.

Amazing. I think we should be doing the same thing in schools because that's where we have their attention the most. Definitely.

There are some schools that are starting at some holistic schools in, I think, Manhattan beach, they're going to start doing that.

Yeah. Fantastic. Because as more and more moms are now breastfeeding, we have more and more problems in children. Is that what you're seeing?

Yeah, yeah, yeah. Because we have now epigenetics where so say you weren't breastfed long enough and Your mother wasn't, but your grandmother was. And so now we have three or four generations where things are going awry. Myofunctional therapy becomes life enhancing.

Yes, absolutely. I want to go back to the mouth breathing because I have a lot of patients that are saying, oh, you know what, I am just taping my mouth. So is that enough for somebody with mouth breathing or.

It's still something that helps at night when you tape, but during the day you have to behavior modify yourself to do it correctly.

How long does it take to do this behavioral modification for mouth breathers?

Well, I use different techniques. Of course, I'm trained by the Buteyko method, but other things I do as well. Well, it usually takes about two months, three months. You can do it. Yeah. Okay.

So it's a relatively short treatment. So for those of you out there listening and they're mouth breathers, look up Joy and Pacific Palisades and they should come see you for that because that's definitely going to be worth it.

Yeah, but you need to do everything, not just the breathing, the chewing and swallowing too. And we eliminate habits and we help to develop facial symmetry of the with the muscles. But breathing is always done first. Okay, so you have a certain part of it. Yeah. Because if you're not breathing, where's your tongue? It's down.

That's right. So it's not used for chewing.

Yeah, and chewing. Too many people now have smoothies and.

Just not enough fiber in our diets.

Yeah, yeah.

And I'm a big proponent of this. You know, like people need to have fiber, they need to eat a whole fruit, a whole vegetable. Absolutely.

And if you're not chewing, the muscles here, the masseter muscles collapse. And then what happens is the, the gland called the parotid gland back here when you chew, you're milking that gland. That gland secretes enzymes that help you pre digest your food in your mouth. So if you like smoothies, what I tell people to do is right before you turn it off, throw some nuts in there. So you have to chew your smoothie. That way you're getting the enzymes that help to break your food down. So many people have gut problems. Yes, I like that.

Chew your smoothie. Definitely put something crunchy with fiber there. So don't fully blend the smoothie. Also to give you something to chew on.

Yeah. Of course, your teeth have to be aligned pretty good to chew properly.

Yeah. And what about the people who don't have back molars? And they say, oh, you know what I'm missing teeth who cares? It's fine. I don't need them. What would you say to them?

You can. You can use the alveolar ridge to chew a lot of people like in other countries that have lost all their teeth. I knew a fellow that used to take his dentures out to chew because he could eat a steak easier with the bone.

With the bone than with a denture. Yeah. So, so true. Yeah. But let's go back to. How did you get interested in myofunctional therapy? How did you find out about it?

Well, I was a dental hygienist, and I taught at Indiana School Dentistry. And I had two kids, and one of them had the issues. He was born a breech. We took his tonsils out at three. He couldn't breathe. He couldn't sleep. He didn't like to eat anything unless it was soft. He couldn't chew. He had headaches. He had TMJ problems. And at the time, we lived in Chicago, a suburb of Chicago. And I took him to every doctor. Even I took him up to Mayo Clinic.

Wow. How scary that must have been for you.

Yeah. He wasn't sleeping. His headaches were so bad, I would get a call from the school nurse saying he has another skull crusher come and get him. And I tried everything. And then we got transferred. My husband got transferred to San Diego, and I started working in a holistic dental office.

Great.

And my eyes were open because at the Mayo Clinic, they wanted me to take them to a neurologist who wanted to do exploratory brain surgery.

Oh, my God.

His headaches were every day, you know, and he couldn't. He couldn't go to school. School. So when I. We moved to San Diego, this dentist, I told him I might need some time off because my son may need some surgery on his brain. And he said, what? He said, let me take a look at him. Wow. Okay. And he said, you know, his tongue is in the wrong place. I said, I never heard of such a thing. I mean, I taught in a dental school. Nobody taught me about where your tongue should be. He said, yeah, it's supposed to be up in the roof. And he. His is down. He said, I just took a class in myofunctional therapy. I want you to do these exercises, and I'll have you see a osteopath that does the cranial work. There was only two in the country at the time. This was a long time ago.

Wow. Yeah, we have a lot more osteopaths today, thank God.

Yeah. And so I took him, her name was Viola Freiman and she was in San Diego. And we started doing the exercises and he made a little bite split for his mouth. Within three weeks, his headaches stopped.

That's amazing.

And then he started eating. He would eat like two meals at a time. He was real small. He was failure to thrive kind of thing. And he started eating like he was. Like there was no tomorrow.

Amazing.

What a great story. Tall now, but it inspired me seeing him, his headaches gone, his jaw pain stopped, his, you know, he could focus, he could go to school. Yeah, I was like, I have to learn this. And that was a long time ago. Yeah, he's all grown up now. It's very handsome somewhere.

You know, there's no coincidences in life. You were meant to be in that office so you can learn this technique.

Oh, very handsome. He went on to be a model and an actor and that's why I moved to la to be closer to him. Oh, very nice. Yeah, doing great. Very happy. And inspired me to study everything in the field and I've written a lot of stuff. I actually did grand rounds at Mayo Clinic in Rochester. But I've now written a book that you'll see out in the next few weeks.

So, yes, I'm excited about it. The name of the book is Is your tongue killing you?

Yes.

And what kind of things are you going to teach us in this book?

I'm just chewing, breathing, swallowing. I have 10 co authors that wrote chapters in the book. Like there's an orthodontist and a periodontist and just all kinds of different sleep medicines. But specialist. These are mostly my, my patients that write their story in it. So it's kind of cool. But I'm excited about it because this book was written for the layman. It's not an academic, you know, thing for, but it, we have a lot of citations, but it is written for the public. So I'm really.

Yeah, I want to go back to sleep because so many people are not sleeping properly today. And we have, you know, diagnosis of sleep apnea, of course, and it could be mild, moderate or severe. How do you work with patients with, with sleep problems and can you help all these categories?

Yeah, I would say mild to moderate, definitely. If there's severe sleep apnea, I can help them be more comfortable with the CPAP or I can reduce it down to moderate. Yeah, it works because we're dealing with the cause of sleep issues. The cause is generally if they're not breathing right and not swallowing right. This whole mechanism here Is not working right now. If they have central sleep apnea, that's. We can't really do much for that. That's more of a brain thing. And they have to wear their CPAP or sometimes MMA surgery. Maxillary mandibular advancement. Surgery helps.

Okay, so do you. When you have somebody with mild sleep apnea, can you completely get rid of it?

Yes.

That's pretty incredible. Yeah, that's by retraining. And how long does it take to kind of.

Well, it's. There's an intensive part that I would need to see the patient pretty much weekly for about three months. And then it would be. That's the intensive. And then there'd be follow up to make sure it's going to last the rest of their life. Because we have to develop a new neuroplastic pattern from the brain to all these muscles. So it becomes habit. We start with working on isolating and activating all the 16 muscles inside your tongue. And then we go into chewing and swallowing and breathing, using your diaphragm and the back of your tongue to bring more oxygen in.

Nice.

We work on swallowing in your sleep correctly. And posture. Posture is a big part of this because if you think of it logically, your head weighs as much as a bowling ball and your tongue weighs 3 ounces. So if your tongue is resting down and forward, it's just enough to cause the first three vertebrae to come forward and that puts a strain on your back.

Okay, so posture is part of your basically therapy.

I studied with Mariano Rata, who's. He's a physical therapist and an orthodontist in Chile, in Santiago. And he's written a lot of books. And he. He said that you can't really change the posture until you change the position of the tongue.

Interesting. I had no idea there was a correlation between the tongue position and your posture. Oh, fascinating.

Dealing with the cause of the problem. Your tongue is actually connected all the way to your feet with fascial tissue. And that's another thing. If that fascial tissue is restricted, we call it a tongue tie. Or if your lips are connected wrong, then sometimes we need to enlist somebody like you to help release that. Yeah.

Yes, yes, absolutely. And I know you and I have had mutual patients together and to release the tongue. And how often do you see tongue ties?

Well, it used to be very rare. When I first started, I would maybe see one or two a year. But now I would say at least half of my patients are either lip or tongue tied or both. And they don't know why they think, you know, I work with a pediatric cardiologist who's seeing almost all of the babies born with tongue ties, and he feels it's plastic, that we are plasticizing our body. And also the air quality, the blue green algae in the air. It's our environment. Something has changed. Our skulls are getting smaller, much faster than we ever hypothesized, and that's probably from not chewing, but. And our brains are getting bigger with all the information, so everything is changing and morphing. And the fascial tissue gets stuck. It's like it doesn't want to move. Stretching sometimes will allow us to get a very easy release. That's why we do myofunctional therapy first for a while before we actually do the release, and then after. Otherwise, it reattaches. So it's kind of tricky.

I see. So let's say after a tongue tie surgery. So basically, the way we trim this, depending on the tongue tie, is we try to keep it minimal with the laser. Sometimes we have to go deeper, and then you work with an ENT for that. But how soon after surgery do you have patients start therapy with their tongue?

Usually I'll see them for five or six weeks before and then completely after. I have to see them right away to make sure it doesn't reattach.

Yes. And those fibers that are underneath the tongue can be pretty aggressive, and they actually attach pretty fast. So, you know, people have to work through the pain of. Of, you know, utilizing the muscle and extending that.

Yeah, it's just exercise like anything else. If you don't use it, you lose it.

So that is so true.

What we do is we get the tongue so stretched that when the doctor finds the cord and releases it, the body knows how to react to that. So doing the therapy before is essential because if you don't do it, if you just cut it, it reattaches. And then you've got scar tissue and a tongue tie again.

Yeah, that's a problem there. Scar tissue is definitely a problem. So we covered so many different topics, but I want to talk about orthodontics, because a lot of people just basically, oh, my teeth are crowded. Let me just stand up to the orthodontist. They're going to put on some braces, force the teeth in one position, and then, sure enough, things relapse. So how can you help with this relapse, or can you help with the relapse in orthodontics?

Oh, yeah, definitely. If it was just done and you took the braces off. Yeah. We can adapt the muscles to the new structure and so we can help that orthodontist get stability. I know they put in retainers a lot of times, but people then don't wear the retainers or what are you retaining you, you're, you're fighting, your muscles are fighting your teeth. So after a while, even after a couple of years, they say, oh, you don't need your retainers anymore. But they're still tongue thrusting again, swallowing 2,000 times a day or whatever with all this pressure or their tongue is not resting. It's not just the swallow, it's the rest position of the tongue. The tongue should be resting up in the roof of the mouth. And I know you've all felt these like ridges on the roof of your mouth. They're called rug. Those are nature suction cups to hold your tongue up. Nobody knew that.

Yeah, that's a good tip.

Yeah, yeah. That's where your tongue should rest. If you say n, that's where the tip of your tongue is supposed to rest.

Yeah. And it's not like that for so many people. So with this tongue thrusting and swallowing, then the front teeth usually flare out and then you end up with spaces. Exactly. Now, in terms of starting therapy ahead of the orthodontic treatment, would you recommend that or would you prefer it after the orthodontic treatment?

It just depends on each case. Like I tell my students, everybody's like a snowflake different. You know, the ideal is if the child is thumb sucking or nail biting or has a habit, what will come in and eliminate the habit? Behavior modification. And then send them, if their palate is real narrow, we'll send them back and they'll do some expansion. Then they'll, after the expander comes out, they'll send them back to us. And then we'll do the therapy to get tongue up and get them breathing and getting their lips closed. And then we send them back to the orthodontist to maybe first some invisalign or something to gently finish the case and then they'll send them back to us. So we work back and forth to make sure that the tongue is adapted to the new structure. So that's the way it should be. I think every orthodontist should definitely have a myofunctional therapist in their office.

I agree. Because it's only going to improve their results and, and like a long term success of the treatment.

Right.

So, you know, I know some people listening to this podcast are not in California. They cannot send Patients to you. So how do they find a myofunctional therapist?

Well, most myofunctional therapists today are working with telepractice, so.

Right.

Yeah. And there's two different organizations that have listings for therapists. One is the AOMT. If you go to aomtinfo.org and then it'll say find a therapist, there's a directory. And the other one is the iaom, the International association of Oral Myology. And then you could put your. Try to find somebody in your area that way. Yeah, you want to find somebody certified. Most myofunctional therapists are either speech pathologists, a dental hygienist or dentist, or occupational therapists or physical therapists. Those four. Or sleep techs now too.

Hmm, interesting. How does somebody learn if somebody wants to train for to be a myofunctional therapist, how, how do they go about that?

Most of the people, it's a postgraduate course and my goal before I die is to find a way to get it into like a master's program of its own or a doctorate program. The doctorate program would be great because we have specialists for lungs or for heart or for orthopedics or we have so many specialists in medicine and dentistry. We need to have a tongue doctor, a specialist that specializes in the treatment specifically of the tongue and ear, nose and throat doctors, they don't really address the tongue function. Absolutely. Oral cancer or, you know, something like that. But they don't look at the whole function of swallowing and chewing and breathing. And speech therapists, a lot of times they don't look at teeth. And physical therapists are taught to stay out of the mouth. It's not your scope of practice. And the occupational therapists, they learn the cranial nerves, but they don't learn about the muscles and the functions of the tongue. So right now it's a postgraduate course. I know, I teach with the AOMT Academy of Oral Facial Myofunctional Therapy. And it's like a 58 hour postgraduate course of training and you have to do like two case studies as part of it of your certification and pass a test, so. Right.

And all those hygienists who are listening, you know, to this podcast, I think it's a great thing to learn as a hygienist to recognize issues and maybe even motivate the dentist to create a myofunctional therapy program in their practice.

You know, the American Dental association today is having a meeting with, for our children's airway and big part of it Is myofunctional therapy.

So that's exciting. Joy. We're making progress.

Yeah, we are.

So I hope to see it on a doctorate program for sure.

Yeah.

Such great information you gave us today. Thank you for your time. And before we leave, I want to see if you have one quick tip. It could be about anything for mothers or for patients in general. What can they do at home? About anything.

Okay, So I would say the goals. I. I laid out six goals of myofunctional therapy. One would be breathe through your nose. All the time. Taping your lips help when you sleep, but during the day. You can't walk around taped all day.

No, it's not a good look.

You gotta eat and talk. So breathe through your nose. Rest your tongue up to the roof of your mouth to the end spot. But not just the tip. Your whole tongue should be up. The third one would be sleep on your back. Because people who sleep on their sides, they develop a long, narrow face, and they also develop posture problems. He sleeps on his back. He sleeps on his sides or his side. And you can really see the difference now. It's really hard to sleep on your back if you're tongue tied. You'll choke on your tongue. The only way you can sleep on your back is by elevating your bed the size of a brick. You're at a slight slant, so your tongue, instead of choking, you will drop forward. Okay.

Okay.

So if you can try to sleep on your back, you could take your big pillow and hold it on top of you because people sometimes need that feeling of support.

I don't have to try that because I'm a side sleeper. But now I'm gonna focus on my back.

Sleep.

Okay.

All right.

So that was three. We got three.

Also, rest your tongue up. Did I say that? Lips sealed. You should try to get your lips closed as much as you can comfortably, except when you smile or talk or eat, but. And you have gorgeous teeth. I'm looking. So lips closed, tongue up. Breathe your nose. Sleep on your back.

Oh.

Keep your hands away from your face. That's very important. People don't realize they're always touching their face. And a lot of times they do that because they're missing the endorphins.

Interesting.

If your tongue is up, you're getting endorphins. There's a place on the roof of. That's why kids suck their thumb, because their tongue is not up there. So they get endorphins through. Incisal papilla has a lot of nerves and arteries. So when you stimulate that, you get, you feel good. So if your tongue is down, you're always like trying to touch your face. Because when a baby is born, they look to find the nipple. And so any. Your facial nerve is extremely sensitive and you get endorphins when you touch your face.

Oh, fascinating. Okay. Okay. These are amazing, great tips for everyone at home.

Six, wake your dogs. Tongue up, sleep on your back, hands away. Oh, and the last one is very important. You're going to bite when you swallow only. So a lot of people clench their teeth because they went to a dentist and they put that blue paper and they said, tap, tap, tap. So they think that they're supposed to clench. And if their jaw hurts, they have TMJ pain and they're sleeping on their side, the disc slips. So they clench to try to get their jaw in the right place. But if your tongue is up, it's going to stabilize. You don't have to clench.

Okay.

So any. Anybody with TMJ problems, We do this jaw stability exercises first to try to get things symmetrical. We teach them to chew on both sides. I use these little surgical tubing to develop facial symmetry of the muscles. And then I'll have them use this little wafer that you slide to work the lateral pterygoid muscle. Muscle. I learned that at ucla. Here it is. You can buy these from any orthodontic program.

And that's true on that.

No, you just put it in between the teeth.

Okay. And just rest.

Slide your lower jaw forward and back. Okay, that helps.

That develops your muscles.

Yeah, it helps to reposition the.

Yeah, yes. So actually this reminds me of a story. My neighbor at one time, she's like, I bought this rubber block from Amazon and I'm gonna chew on it to develop muscles for beauty. So she was chewing on one side. Do you recommend, obviously both sides at the same time? Correct. Yeah, Very, very important. Yeah. So. So this kind of brings me to another point. If you're exercising the facial muscles, see, we're going to look more lifted. We're going to age well. So. So myofunctional therapy is an anti aging therapy.

Absolutely. I know in Brazil there are myofunctional therapists that exclusively work with plastic surgeons to either prevent a lot of surgery or minimize it. And it's really powerful because your muscles are attached to the skin. So if you want a beauty technique is to get all the muscles working strong and tight.

Now I understand why you never age. Joy. I get it. Oh, yeah.

If you ever come to a convention. I know you'll see myofunctional therapist. They're 90 and they look like they're 50 or 40. It's like unbelievable.

I'm definitely coming.

Yeah, definitely.

So for everyone, we're going to post a link on the bottom where to find Joy's new book, is your tongue killing you? That's going to be on Amazon. And Joy, where can people find you?

I'm in Pacific Palisades. Joy Moeller. M O K E L L E R. And you can contact my office, 310-454-9444. And I could either find somebody in your local area if you want to see somebody in person, or if you want to do online, I can give you some names for that. Of course. I. If I'm still practicing, I'll do it as well. So thank you.

Thank you so much, Joy. Have an amazing day.

Thanks for the opportunity to educate. My pleasure.

My pleasure. It's been super informative. I've learned a lot.

Good. Okay, thank you. Bye. Bye. Bye.

Thank you so much for joining me this week. Please make sure you check out the show notes for any links mentioned in the show. If you like today's show, please invite your friends to listen as well. That was would mean a lot to me. Do you have a question you'd like me to answer? Message me on Instagram @Dr. Sanda. This is Dr. Sandha. And remember, your mouth is the gateway to your health. So take care of it in the most natural and best way possible.