Tongue Suction - Myofunctional Therapy Self-Assessment 

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Can you update me please

Update please? 😢

Update?

You are very welcome. I'm happy to hear this.

Thank you. Let me know if you have any questions!

Yes, it's definitely worth assessing and training oral posture and movement in your case to help stabilize your orthodontic results. Good luck!

I would agree with this. Though sometimes there are structural limitations to tongue elevation (tongue ties) and it's not simply muscular.

I'm 36 years old and had braces twice, close to 4 years both times. My lower jaw movement in surgery was about 32mm. I can't help but wonder, and be a little upset, that if someone had taught me proper oral posture when I was a kid that I might not have the issues I do! 🥺

@@psychadelicccc I feel for you

@@psychadelicccc I had a similar surgery in 1981, after many years of braces in preparation, before any ORIF systems (screws and stuff), mouth wired shut for months while the bones healed. Within 2 years of surgery, little bite contact. Braces back on, hideous contraption to bite into to try to move jaw. Didn't work. Taught me to clench my teeth maybe? Gave up for decades. Have straight teeth, "nice smile", very little bite contact. 40 years later, a dentist finally told me I "tongue thrust". Discovering Dr. Mew's work now. Actually, and even worse, I think we could have changed this as young adults (and even later) and avoided this brutal surgery...I was in the ICU for days while they kept the pressure of the swelling off my brain. And the months of liquid diet slurped through teeth. (Ensure, with teeth straightened, no spaces for anything thicker) , No talking as there was a splint shoved in between, no exercise (can't breathe heavily through the nose). Vomiting through the nose was a bonus. I remember asking about that...what happens if I vomit...oh, it will come out your nose! Clearly, there was and is a better way. I think we got screwed. I am worse off for this surgery. I was in grade school when the decision was made to do this and I didn't have any hideous deformity. I had many years of orthodontia prior to the surgery, which created a more open bite in preparation for surgery...no way out. Some of the newer surgical techniques to accomplish this look slightly more elegant. But doesn't the fact that the bite just opens back up quickly after surgery suggest that the structures involved are still malleable in the adult? (The bone is healed, possibly with hardware these days!) It is clear that the shape of the face, and position of the teeth, change though out life.

May I ask where you live to potentially direct you to see one of my colleagues in person?

Not a stupid question at all. The lower jaw is unlikely to widen due to putting the tongue at the roof of the mouth. One scenario I can think of that the lower dentition may widen over time by going myofunctional therapy is if a person's lips were causing much inward force on the teeth during rest and/or swallowing. If that is fixed, the lower arch may widen over time.

@@allsleepashley Thank you for your answer, i appreciate it a lot! 😄

Tongue "spilling out" means the tongue is overlapping onto the chewing surface of the molars. This often indicates the tongue has difficulty narrowing and/or the palate is too narrow for the tongue. "Difficulty getting the back of the tongue up" means the back 1/3 of the tongue is unable to reach the palate. To find/sense this location of your tongue, you can make a "kah" sound. When you do this, the back 1/3 of your tongue will touch your palate. You want to make sure this area of your tongue is also participating in your suction hold.

When you say nasal channel, what do you mean? Nostrils? Nasal valves? Nasal cavity as a whole? This will help me better answer your question. Thanks!

Can you easily narrow both sides of your tongue when it is not suctioned?

How long ago did you have the tongue tie release?

@@allsleepashley I had it during Feb/Mar’21 timeframe. Not sure how to get the tongue muscles stronger enough to be able to do the suction..

@@sampadhota3598 Did you do exercises to train the tongue suction immediately before and immediately after the surgery? Do you feel like you have more range of motion of your tongue to elevate than you did before surgery or did it end up scarring and becoming more limited? I want to rule this out, as this could be a remaining issue that is limiting your suction ability.

@@allsleepashley yeah the tongue is doing better in terms of elevation and not blocking the airway however still not ready for the suction with the back of tongue not sticking to the upper pallet yet

@@sampadhota3598 Have you worked with any therapists in-person? Have you done the entire myofunctional therapy assessment in this series? If so, are you noticing any other deficits?

I doubt mewing will widen a narrow lower jaw. It may promote the lower jaw moving more forward if the tongue is up and forward and promoting more forward growth of the upper jaw. I can't answer your question number 2 because I do not know the specifics of your mouth. If you have a cant, some form of malocclusion making your R molars heavier, or a certain neck (or ribcage, pelvis, etc) posture causing heavier R molar contact it could you to feel a heavier force on the right upper jaw. I recommend continuing to improve your oral posture as it will only help the rest of your body breathe and move better.

Practice. You should be able to increase your suction hold time with repetition. Always start here and if it's not improving then reach back out.

I’m currently facing this as well. Any advice?

Hi Leonardo, it is difficult to say how much you could influence forward growth of the upper jaw at this age. I suggest training a palatal seal posture of your tongue and training tongue coordination. If you are very diligent with this, you may see positive changes in your palate/jaw growth. There is no risk to doing this and your outcomes could be positive or no change at all... making it even more worth trying.

Shauna, have you been assessed by anyone in person? Also, what is your overall posture like? Is your head more forward or retracted? These things can affect tongue position.

Yeah I feel that, I’m trying not to strain my tongue by practicing proper tongue position too much. It does take a lot of effort and it kinda hurts while I practice.

Edges up, center down

I would start with doing tongue-narrowing exercises. I suggest you watch my video about the narrow tongue press-up to help you with this. Then combine this narrowing movement with your suction.

When you swallow, do you have a good suction (centered hollowed and edges raised) to hold the saliva? It is okay to use the buccinators slightly at the beginning of a swallow to help gather saliva onto the tongue. Buccinator muscles should be used in the initial phases of swallowing to help create negative pressure inside the mouth. We want them to coordinate with the actions of the tongue and jaw and make sure they are not doing all of the work (along with mentalis). Toned buccinator muscles will actually make the cheeks less puffy.

I have not seen the jaw structure of adults change within my clinic from doing myofunctional therapy and changing oral habits. Though, that is not to say it is not possible. Teeth are more likely to move than the jaw changing structure. Many adults I have worked with experience improvements in sleep, breathing, and pain, despite not seeing jaw structure change.

Try working your way up to a 60-second hold over the next month or so. I recommend doing suctions 3x/day and doing at least5-10 reps of your maximum hold. This will obviously vary on an individual level like any exercise would.

⁠​⁠​⁠@@allsleepashley do you mean do the suction hold with your mouth open? How many seconds to start off with? It’s easier for me to do it with my mouth open, if I close my mouth I can’t suction it and get the back of my tongue up. I do have a posterior tongue tie too.

Smile - The other way you can find your ideal tongue position is to smile really wide (we’re talking about really cheesy smile), raise your eyebrows, and try to swallow without unclenching your teeth. You should feel your tongue rise to the roof of your mouth into its ideal resting position. TONGUE THRUST CORRECTION PROGRAM

You swallow with your tongue up .

First step is to practice this regularly in front of the mirror to try to correct it by coaching yourself. There are specific exercises that may help but it's tough to give you anything specific without doing an evaluation. May I ask where you are located? It may be useful to see someone in person.

Where do you live? It may be worth seeing an airway dentist or myofunctional therapy for an in-person assessment. This sounds like more of a limited space issue than a tongue issue. Though, it is likely a combination.

Things to try: 1. Make sure the tip of your tongue is touching the back of your upper front teeth. If this doesn't work, 2. tilt your chin slightly up.

Training your tongue/oral posture would be a great place to start addressing this. It's difficult for me to go more in-depth about recommendations. May I ask where you are located? There may be someone to see in-person near you.

You can train your tongue suction so that your tongue does not overflow onto your teeth and actually fits well inside your palate. Despite a narrow palate, most of my patients are to train this. I'm unsure what you meant by your last question.

The center part of the back of the tongue drops or the center and the edges of the back of the tongue drops?

@@allsleepashley sorry i kind of worded that weird so basically i can put my whole tongue on my palate but it doesn’t have any suction so it’s hard to keep it there so i’m trying to learn how to do the suction hold the first 2/3rds of my tongue is on the palate but when i do it but my hyoid/ back third of my tounge kind of drops a little bit

@@user-kq9pi7ih4f There are some variables here... are you doing this with your mouth open and if so minimally, moderately, or maximally open?

This is not uncommon. This soreness is often due to muscles of the tongue working in a way that is new to them and/or stretching of tissues underneath the tongue. It should decrease with repetition.

A gentle suction of the tongue to the palate should be a goal for most people (there are always exceptions depending on their typical oral posture, neck posture, hyoid position, etc).

Meaning the edges are up and the center is hollowed from front to back of the tongue.

​@@allsleepashley How about when we do "mewing"? I thought that if we do not apply any pushing force at all against the palate, the suction will only bring our maxilla and face back and down? Please advise. Thank you, Al

@@tapsubscribe To create a suction, you do need an upward force of the edges of the tongue pressing into the palate. I cannot speak to "mewing", as I am not familiar with the specifics that Dr. John and Mike Mew are teaching.

​@@allsleepashley 1) Is it better to push more with the tongue against the palate or is just getting the suction enough? 2) I thought pushing more would help the maxilla stay/grow upright better, is that wrong? 3) How come the middle of the tongue isn't engaged? Isn't the *entire* tongue pressing/sucking be better for upwards growth again? Thank you so much for your help to clarify all this! And what I got about Orthotropics/mewing basically: "The ideal development of the jaws and teeth is dependent on correct oral posture with the 1) tongue resting on the palate, 2) the lips sealed and the 3) teeth in light contact for between four and eight hours a day.” So simply by adopting this, especially the teeth in contact. You force the maxilla up and forwards.

There are several different exercises you could do to improve the symmetry of your tongue here. One that often works well is tongue swipes. I don't yet have a video of this posted. You'll place your tongue between your cheek and your teeth and slowly slide it from your far left top molar all the way around to the far right top molar with your lips sealed. Then keep repeating. I can't say whether this is a great match for what you need because I haven't done an evaluation on you, but this may be worth trying. The goal would be symmetry in terms of how far you can move your tongue and that it goes both directions with ease. This is a good place to start because it can work on range of motion, strength, proprioception, and coordination all at once. I'll eventually post a video of this.

You can do both at the same time if you minimize the suction effort and push slightly more forward with the tongue.

Are you initially able to get the back of your tongue to the palate when you initiate the suction? If so, how long can you maintain this before it drops down off of the palate? Have you been practicing for this a while or just begun trying the movement?

@@allsleepashley let me tell you what i do: I say "ng", than i put the tip on the pallate and then i do the suctionhold. And exactly this moment it drops. I do this for a month rn but very unregular...

@@allsleepashley and i have another question: Sometimes, like when i wake up, my upper pallate doesnt feel like "normal", it feels different. It feels like my tongue isnt straight on the upper pallate, its much more aslant. But only because my upper pallate feels irregular, like one side is higher then the other one😂sounds strange, but i hole you understand me...

@@7thaphostlejudas319 It is possible, and not uncommon, for one side of the palate to be higher and a different shape than the other side of the palate.

Yes, try to make less of a wave than you are trying. I would suggest practicing tongue narrowing several times per day focusing on the back of the tongue. Watch my narrow tongue press-up video. This will help narrow the back over time. Always watch yourself in the narrow to make this better. To swallow, think of putting to liquid/food in the cave of the tongue, pressing the edges of the tongue up like a suction and then pressing the center of the tongue up while keeping the edges in place which will push the contents backward.

@@allsleepashley got it......will surely try this. Thanks a ton.

Where is the pressure in your head?

Can you please explain what you mean by "have some air inside the front teeth"?

@@allsleepashley idk how to explain that Like the vacuum maybe idk lol 😅🥲

@@xNINJAYT Negative pressure? :) Yes, there should be some negative pressure in the center of your tongue. It doesn't need to be extreme.

@@allsleepashley oki Tyy

Yes, but ideally, you don't want your tongue overflowing onto the upper side teeth. You may be able to change your facial structure to some degree over time with consistent posture change, repetition with exercises, and nasal breathing. This is very difficult to study in teens because the face changes in many ways during these years, but we do know that bone adapts to pressure, and changing the forces applied to your skull from within your mouth and from your facial muscles has the potential to influence your facial structure over time.

This may be coming from an asymmetrical hyoid bone or cervical spine (or anywhere else in your body). I suggest training the tongue for symmetry as you practice this in front of the mirror. It will take patients and persistence.

@@allsleepashley Are there any specific exercises or anything you would recommend I can do to try to correct it?

@@glamoroustwist7482 I will aim to get some of these exercise options up on youtube in the coming months.

It may be worth starting with the tongue exercises I have posted that will teach you how to better narrow and suction your tongue the palate. It's difficult for me to make specific suggestions without doing an evaluation on you.

@@allsleepashley thanks Ashley! to put it simply, I can't mew because of my tongie tie and my high arc palate. I cant reach to the top and the only way to do is by using the tip of my tongue, not the whole thing. is there any way you can get an evaluation on me? Im desperate, thanks!

@@FBI-bb3el Yes feel free to sign up for a consultation at sommerspt.com or a wellness assessment (since I assume you are not in the state of california).

Yes, it can promote forward movement of the teeth and depending on a person's age, forward growth of the upper jaw. This will depend on the position of your tongue, how frequently the exercise is done, a person's age, and various other factors....

@@allsleepashley felt some sore and pain in muscles around neck when i started yesterday

I mean is it normal ? And even i cant keep the position maintained

@@drsagar_25 This exercise may cause delayed soreness in the neck and tongue muscles if you are not used to holding your tongue in this position. It is very difficult to maintain, I suggest practicing daily until it becomes easy to maintain for at least a minute.

I want to make sure I understand what you are saying-- Are you saying that now that you can rest your tongue at the roof of your mouth you have difficulty breathing and feel uneasy or are you saying that you are still unable to rest your tongue at the roof of your mouth and are having difficulty breathing and you feel uneasy?

@@allsleepashley Now Iam able to rest the tongue on the roof of my mouth but when I breathe there is more hissing sound than before and Iam having difficulty breathing.. Specially while sleeping

@@Deepak-xo8pt This may be an indicator that your maxilla is limited in forward growth and thus, you don't have enough space in your palate for your tongue. It's difficult for me to fully say, though, without doing an evaluation and looking at the full picture.

It's difficult for me to say without more information. Where are these knots located under your chin? Can you please give me more details?

⁠@@allsleepashleyI also have noticed those two knots under the chin, they seem to be placed under the jaw at the two corners, I’ve been struggling with that because my tongue seems to have proper tongue posture but those two knots come out and doesn’t seem right, besides that I barely notice that in other people faces

I suggest doing certain exercises to regain tongue range of motion, ability to sense your tongue (proprioception), and symmetry. Tongue swipes are a good place to start with this, along with practicing the suction in the mirror and intentionally making it more symmetrical. I don't yet have a tongue swipes video, but intend to at some point this year.

From simply doing the assessment? There could be a variety of reasons for this.

If you don't try as hard is this still true? I often have patients who put in more effort than needed and then every muscle becomes tight.

@@allsleepashley I do light suction

@@allsleepashley so no pressure

@@FightTheMonopoly So should be light pressure around the edges of your tongue and negative pressure in the center.

It's so difficult for me to give you specific advice without seeing you. It may be a tongue coordination or range of motion issue that is resulting in you over-straining all of these other muscles.

It depends on why it's happening. This is a similar answer to your question about scalloping. In addition, training your tongue on what to do during the first 2 phases of swallowing would be the third piece.

If your tongue is spilling out onto the teeth, I suggest doing regular exercises to improve your ability to narrow your tongue. From there, it will depend on if you're able to elevate the sides of your tongue as you hollow out the center. This is a foundational movement for a suction. You can practice this in the mirror-- elevate the sides of your tongue as your center moves downward. Your lips can help guide this and your tongue can be slightly out of your mouth. There can be several reasons why you are unable to suction. Begining to address this by improving posture and movement of the tongue is the least invasive/cheapest way to start! If you want more detailed suggestions, it may be useful to see a local myofunctional therapist for an in-depth assessment.

@@allsleepashley Thank you so much for the quick and detailed answer! I am 18, female and my "mew indicator line" and intermolar width are a few millimetres off the normal spectrum. I am going to make an appointment with a local myofunctional therapist. Is there a chance that this can be corrected without surgical intervention?

@@blancheharris2457 At your age, you may be able to make some good changes by changing your oral habits. It's difficult for me to comment on surgery since I have not evaluated you and don't know your personal goals.

Potentially that you have difficulty narrowing the back of your tongue (more than the front or middle) or your palate is too narrow in the back. Or potentially a combination of these two things.

@@allsleepashley Thank you so much for your immediate response! Is there anything I can do to improve this?

@@minealvabveb782 It's difficult to give you specific advice when I have not seen you. In general, it's helpful to start with exercises that help you learn how to narrow the back of your tongue. The narrow tongue press-up video I have posted may help you with this.

@@allsleepashley Thank you!

you want the edges up and the center down/hollow

It's difficult for me to give specific advice in your case without doing an evaluation. It is likely a combination of poor tongue coordination and range of motion, along with a high palate. The tongue portion is the easiest to change, so I suggest starting here.

@@allsleepashley thank you, it's been 2 weeks and now I am able to get most of my tongue on thr palate

Train symmetry persistently in front of a mirror.

And practice narrowing your tongue.

Depending on your goals, it may be helpful to talk with a myofunctional therapist and/or an airway dentist.

@@allsleepashleyBasically I want to try mewing but my tongue tie won't allow me

@@MrGTAVModstoSA Where are you located?

@@allsleepashley Uruguay, South America

@@MrGTAVModstoSA I suggest trying to find a myofunctional therapist in your area. I know in Brazil there are many. I am not sure if this is true of Uruguay. If you have a hard time finding someone, I'd be happy to do an online consultation to help you out. You can find me at sommerspt.com.

Not everyone can sense this, but yes, you want the tongue elevated from the front just behind the top front teeth to the soft palate.

@@allsleepashley Thanks, also is having your tongue exactly at the center of the roof of the mouth a requirement or not? (By that I mean that the center of the tongue touches the center of the roof) Since my tongue is either small or my palate is too Wide and It seems to be more comfortable placing my tongue on one side of the roof and not the center

@@FatMonkeySexMonkey There is no "requirement". It depends on what your goals are.

@@allsleepashley well by doing that what I wanted to achieve is fixing my facial assymetry so in that case I would need to put it on the center? Although right now I just noticed that one side of my palate (roof of the mouth) is wider than the other one (possibly caused because I used to put my tongue on that side more than the other one). So what im doing right now is trying to engage my tongue more on the less developed side in order to get a "symmetrical palate". Should I keep going this way or stick to putting my tongue on the center? (I do feel it would be better keep going this way since later on It would be easier to engage my tongue on the center)

@@allsleepashley my tongue is flat on the roof I just apply more pressure to a specific side

May I ask in which country (or state if in the US) you live so I can help you find someone in-person to help?

@@allsleepashley hmm m from india in person is not possible

I also have deep bite

@@sunlight5106 Your age may affect my recommendation. In what age range are you in?

@@allsleepashley 25

Make the sound "kah" and you'll feel the back, center part of your tongue press up to the roof of the mouth. Use this spot as a reference to find the back of your tongue when you suction. You want the edges of your tongue at this location to be pressed to the palate during your full tongue suction.

@@allsleepashley if I say Kah and chin tuck will I be good?

@@chasegainsovahoes663 No need to bias a chin tuck. Just say "kah" in your normal head and neck posture. This should allow to you feel the back of your tongue.

@@allsleepashley bett thank you 🙏🏾

@@chasegainsovahoes663 You're welcome!

Omar, you have good questions. I suggest doing your version of sucking the tongue to the palate. I have not seen this make the lower teeth crooked, but you bring a valid point. Because lip position varies between people and dental occlusion varies from person to person, this is difficult to study. Typically the upper teeth should overlap the lower teeth slightly and thus the lips would contact the upper teeth before the lower teeth... maybe this is what prevents the lower teeth from becoming crooked. If it is very difficult to elevate the back of your tongue and suction... this could be an issue with soft tissue restriction under your tongue, tongue coordination, or high/narrow palate. Or some combination of the three.

So you should suck your tongue on the roof of the mouth but not thrust it on the palate? Because They say that the muscles between your chin and throat should be lifted up when you are mewing, and the only way i can do that is by thrusting all my tongue on the roof of my mouth, but sucking it on the other hand does not lift up my throat muscles (maybe just a little bit but not like thrusting it) also thrusting it will make the tongue push forward and sucking make it feels like its pushing backwards. Thanks for replying

@@omarafifi4560 Hi Omar, who is "They"? What is your goal with the exercise? This will determine my answer to your questions.

Everybody who is talking about this technique "mewing" (I dont if its the same as your practice or maybe similar to it) on youtube they say that the muscles under the jaw should be lifted up, and also dr.mike mew says the same in one of his videos. My goal was to enhance my facial features.

@@omarafifi4560 The tongue should have the ability to both suck to the palate and to press into the palate. I like to train the suction as it prepares you for a proper swallow. If you goal is to elevate the bottom of the chin maximally, then you should press the entire tongue up.

Can you explain what you mean by making the bottom of your mouth flat?

@@allsleepashley the fat under the chin is increasing

@@vex7830 Are you tucking your chin while doing this? If so, try to avoid this.

@@allsleepashley no I’m not

@@vex7830 If you press your entire tongue up to the palate (front to back) does it eliminate this issue?

Where do you live? There are ways to expand the lower teeth. Does your orthodontist not have access to or not have experience with these expanders?

@@allsleepashley I’m not sure if she has experience. I’m from EU. I’ll definitely ask her on friday and maybe we can find a solution.

Your front teeth or side teeth? Or both?

@@allsleepashley side teeth

@@AbdulRahman-hy4wk Are you able to narrow your tongue? Is there scalloping (ridges) on the edge of your tongue?

That may mean it's worth practicing :)