Orthodontic Relapse and Myofunctional Disorders

Orthodontic Relapse and Myofunctional Disorders

Aug 08, 2018

Imagine this situation: A teenager spends several months wearing braces or Invisalign to correct misaligned teeth. Roughly a year after the orthodontic treatment ends, the teeth begin to shift back into their problematic spaces.

This sort of relapse often occurs when the underlying causes of the original misalignment are never fully addressed. Under constant pressure from a myofunctional disorder, the teeth will become crooked again, and the patient is back to where he or she started.

Cause of Relapse

Many people believe that orthodontic relapse is the result of tongue thrust – routinely thrusting the tongue between the top and bottom front teeth when swallowing. However, the shift in teeth can be also related to the tongue’s resting position, rather than its movements. The same applies to the resting positions of the mandible and the lips.

Unresolved myofunctional conditions, such as tongue-tie, lip-tie, airway obstruction, and unusual swallowing patterns, can all indicate that the tongue, lips, and mandible aren’t resting properly. In addition to reversing the effects of previous orthodontic treatments, these disorders also come with other unpleasant symptoms that a patient might want to reduce. For example, obstructed airways often lead to sleep apnea, which is characterized by difficulty breathing when sleeping. So the patient will find multiple health benefits to resolving the issue.

Dr. Korous recently met with a teen who was experiencing orthodontic relapse. The spacing returned to his upper teeth, and on the bottom his front teeth shifted forward creating spaces behind the canines on either side. Dr. Korous recognized this was due to an unresolved myofunctional disorder. His tongue was pushing his teeth forward.

He also experienced snoring and teeth grinding – signs of a breathing obstruction. Another indication was that when he was younger, his tonsils and adenoids were removed. Many children have their tonsils and adenoids removed, but no one asks why they got enlarged to being with and what is the underlying cause? A breathing issue, most often an obstruction in airway, can lead to the enlargement.

Dr. Korous confirmed an airway blockage by observing a Mallampati score of 4 in the patient.


Myofunctional therapy is typically the key to changing the resting position of the tongue and other parts of the mouth. In some cases, such as with tongue-tie, minor surgery is required, but even that step should be followed up with therapy. The exercises a patient performs during myofunctional therapy will train the structures of the oral cavity to not only move correctly, but to rest properly when not in use.

For the teen mentioned above, Dr, Korous will propose a multi-step treatment plan that could include:

  • Sleep test to diagnose sleep apnea,
  • Myofunctional therapy with Myobrace
  • Laser tongue-tie procedure
  • Myofunctional therapy after the procedure
  • Second-phase orthodontic treatment to realign teeth.

A patient should only consider braces, Invisalign, or other orthodontic treatment after all underlying conditions have been corrected. Otherwise, he or she risks having to spend more time and money trying to fix the orthodontic relapse.

If you are living in Frisco or Little Elm, and think you’re experiencing orthodontic relapse or may have an myofunctional disorder, call Millennium Smiles today to schedule a consultation with Dr. Korous.

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