Spotlight Series

Topic: Orofacial Myology with Laura Colmenares

Guest Name: Laura Colmenares

Guest Credentials: BSDH, COM

Discussion Details:

Laura Colmenares, founder of LC Orofacial Myology, is a Certified Orofacial Myologist (BS, COMs, QOM) and certified Buteyko breathing instructor. She specializes in airway-centered care, oral muscle function, and breathing re-education, using a holistic, individualized approach to guide the body back toward optimal function.

Benefits of Watching:

1. Uncovering Root-Cause Connections: Learn how common issues like mouth breathing, poor sleep, tongue ties, and jaw pain (TMJ) are often linked to underlying oral and airway muscle dysfunction rather than isolated symptoms.

2. Understanding Whole-Body Healing: Discover how retraining oral muscles and restoring proper nasal breathing improves lifelong posture, sleep quality, facial development, and overall well-being.

3. Actionable Management for All Ages: Gain practical insights on how both children and adults can retrain daily habits to manage chronic symptoms, avoid structural issues, and achieve long-term, functional balance.

Address of Guests’ Business: https://www.orofacialmyologylc.com/ 

Hi, I’m Viraj Chang. I’m a physical therapist and owner of Accelerate Physical Therapy, and this is my professional spotlight series. Today, I am featuring Laura Colmenares from LC Oral Myology.

How are you? Nice to meet you. Nice to meet you. I’m so excited to be here.

Thank you for having me in your spotlight. Yes, I’m so excited. Let’s do a little intro about Laura.

Today, we’re thrilled to sit down with Laura Colmenares, a certified orofacial myologist and an airway-centered specialist who is changing the way we think about oral function and whole body wellness. Through her practice, LC Orofacial Myology, Laura works with children and adults to identify the root cause behind everyday struggles, ranging from mouth breathing, tongue ties, to poor sleep posture, to TMJ pain, clenching, and orthodontic issues. Rather than simply managing symptoms, her holistic and gentle approach retrains facial and airway muscles to guide the body back to optimal function.

Excited to talk to you about all of that. I just wanted to share a unique fact about you, which is very cool, that you love to travel, and that you’ve been to 30 countries, which is amazing. Do you have a favorite? Tell me about it.

Oh my gosh. I feel like with my husband, that’s been our life passion. We want to see the world, and we want to just visit as many places, learn about different cultures, and that’s the one thing that is our go-to, our must.

So far, we will say our favorite place is Portugal. We just love the feel of the people. There’s so many things to see, from castles to the wineries in the north, and the amazing and unique beaches in the south.

So I think every place is so unique, but Portugal has a special place in our heart. So I feel like that’s always our go-to. That sounds wonderful.

I’ve never been to Portugal, but I heard great things, and I know it’s a quick commute from here, right? Yeah. I feel like that’s why we’re so drawn to it, because you get a little bit of everything. It is only a seven-hour flight, which is not bad, because if you think about going to California, it’s what, like six hours or five hours? So it’s really not bad, and yeah, we love it.

We love the culture, the food, the weather. Yeah, I feel like that’s our favorite place. We have a lot of favorite places, but that’s our go-to.

Awesome. Sorry, the note-taker popped up really quick. So that sounds amazing.

Thanks for sharing that with me. I’m just going to get right to it, and kind of ask you how you got into this field, and what made you start your own business? Yeah. So my background is in dental hiking, and I was practicing for a while.

Where I practiced, it was mainly adults, but we were very whole, like whole care, like whole body care. We’re looking at how the mouth is connected to the rest of the body, and I was aware of how to check airway for adults, but I wasn’t really sure what the things to look for in kids, and then my son came around, and he was dealing with a lot of digestive issues. He was dealing with a lot of sleep issues, where I didn’t know if it was something that, you know, as the sleep related, if it was a problem, or if I should look into it further, but you know, when you start thinking, and writing, I think social media just starts bringing you all of these things about airways.

So I decided to take him to an airway-centric dentist when he was around two and a half, three, and we had gone years with, you know, issues, mainly digestive and skin-related, and then some sleep concerns, but it wasn’t terrible. It was just like positional things that I noticed that when I started looking, I’m like, oh, I didn’t know that this was not normal. Like if your baby is sleeping with their booty up, that means that they’re trying to open their airway or weird positions.

So when I took him to the airway dentist, it was mind-blowing because they were asking me, you know, how is his digestive system? How is his, you know, does he have any skin issues? And I’m like, wait, I’ve been in the dental field for, at this time, like 15 or 20, maybe 18 years by then. And I have never asked me, like anybody asked about other things than teeth or, you know, the normal health-related. And then they were like, what is, does he have any constipation? Does he have any like eczema? And I was like, yes, yes, he has all of these things.

And then they were like, well, you know, we noticed that he has a restriction in his tongue that is not allowing that tongue to do what it’s supposed to do. And you know, the first step of digestion happens in the mouth. If that first step doesn’t happen correctly, then that could affect the digestive system.

And also allergies and eczema are from, you know, digestive-related. And I was connecting the dots. They were talking about how his mouth wasn’t growing, you know, wide enough, or it wasn’t having the right trajectory of growth and how this was also impacting his airway and sleep.

And at that point, I’m like, no one has ever said this to me. And I’ve been struggling with, you know, all of these things for years. You know, doctors were like, just give him Miralax for the constipation.

And I felt so guilty doing that because in the bottle itself, it says not to give for under 18, not to give for longer than, you know, than a week. And here I am months in trying to find answers and just not going anywhere. So when I found that, I was like, okay, we’re going to look more into it.

I took my first course. And once you see airway, once you see, you know, dysfunction, oral ties, you just cannot look back. So after that first course, I, you know, started connecting with other families that were going through the same path and just didn’t know where to go or what route to take.

So I started being more of that middle person of, you know, connecting them to like different providers and then evaluating their kids and, you know, helping them with the therapy. And, you know, little by little, it started becoming of, you know, my full-time profession, but I started LCR Facial Myology in like 2023, end of 2022. But I mean, it was really 2023 when I started like seeing more clients.

And at the beginning, it was just once a week where I was renting like a little space and I will see families and then it started being like twice a week. And then now I’m seeing families full-time in my office in Ashburn Road. So it’s been an amazing journey into starting my own business.

And I’m so grateful that I get to help so many, you know, families and, you know, kids, adults deal with some of these issues and connect the dots where they’ve maybe haven’t felt heard or they’ve been dismissed of some of the symptoms that they’re noticing and really getting them to that end point to like, okay, now we know what to do and seeing the results on the changes. It’s so rewarding. Yes.

A hundred percent. And you mentioned some of the symptoms you’re like, what does GI stuff and what does skin stuff have to do with breathing? And I think also just educating other practitioners out there and healthcare providers like gastroenterologists and maybe dermatologists to start thinking a little bit more outside of the box. I had a similar situation with my kids as well, where I was, we did take Marilax because of the issues and we did have to put topical steroids on because this is our first line and it literally, it takes years to get to the root cause.

And so maybe as we educate more providers and specialists out there to kind of think outside of the box, that might be a little helpful as well. And, you know, and sometimes it’s, it’s also to the point of, I mean, obviously the medicine is there and you need to, you need it when, when you need it, but digging deeper, like when did this start? Why is it happening? Let’s look at other things. Let’s make other connections.

Right. Because parents want that. Parents ask for, you know, some people come to me and they’re like, I’m going to three different people asking for this.

And everybody tells me they’ll grow out of it or it’s fine or take this. But even one of those persons saying, you know what, why don’t you go see a neurofacial biologist or, you know, PT if you have postural, like anything, just go see them and let’s see, you know, it doesn’t hurt to find. And people are looking for those, for, for those root cause changes.

And a lot of times they come to me and it might not be me, but I, I’ll guide, I’ll guide them to who they need to see because of what I noticed. Yes. Referral is like the first line of, you know, if it, if you don’t know, just refer, yes.

Get it evaluated. And then at least that way you can figure things out. Exactly.

Well, what kind of people or what kind of customers do you serve? You mentioned you’re working with little kids. Yes. So I usually, the youngest I see for myofunctional therapy is around four.

So myofunctional therapy is exercise phase. So we’re almost like personal trainers for the muscles of the face and the airway muscles. But kids have to be, you know, they have to have the ability to do repetitions of exercises.

So mimicking is important. So usually around four, some, you know, kids are more mature and they’ll be able to follow through some of the exercises, but we need them to have some type of cognition and repetition because it’s all about the exercises that they perform that is going to make those changes or that, or that neuromuscular re-education that we’re looking for. A lot of times we start with faces.

So like younger kids, I started with like, you know, phase one where we’re just starting to activate the muscles, increase the tone and create the, increase the posture, increase awareness because awareness is everything. A lot of people don’t know where their tongue needs to be, how they should be breathing, why this is important. And then from then we go into, you know, therapy, you know, whatever they are progressing later on.

I do have like a little breathers program, but it’s more of a like play based program for, for little kids, where it’s mainly just, you know, breathing, how we breathe through our nose. We have a little like a friendly character that, you know, kind of goes through that with, with everything with them. And then also I think it’s identifying what needs to be in their field, right? Do they need to see an OT because I’m noticing, you know, some sensory or gross motor challenges? Do they need to see a feeling specialist or do they need to see a speech therapist for oral motor at the younger age? Right.

But typically for true myofunctional therapy, we need that, like being able to do repeated exercises. So around four is, you know, when we start. How about, do you see any adults and what kind of issues would you see adults? Yes.

So I see adults, you know, I think all this patient I’ve had is a seven-year-old woman that was dealing with sleep issues. So for, for myofunctional therapy, a lot of the patients come from like tension. They have jaw pain.

So a lot of TMD, headaches, migraines. They also have a hard time sleeping. And that’s because, you know, especially for women after a certain age, we, we lose that tone because of our hormonal change.

So working on breathing, you know, breathing, tongue posture, exercising the muscles of the throat, exercising the muscles of the, of the tone of the tongue. And then obviously collaborating with other people, you know, like you for like breath work, diaphragmatic breathing, engaging the right muscles, pelvic floor, all of that. So usually adults I see mainly for sleep related.

So sometimes patients that have sleep apnea and they cannot tolerate a CPAP. So we work on strengthening the oropharyngeal muscles. There has been studies that show that myofunctionally can reduce apnea events up to 50% in adults and 70% in kids.

Obviously it’s not a replacement for treatment. You still need to collaborate with your sleep doctor, but we’re, we’re helping patients tolerate some of this other tools or fix the problem by doing other modalities of treatment and guiding them through those options, because there’s not only one option. There’s usually a different variety.

There’s the common ones, but then there’s other things that could also help then also just surgical patients. Yeah. So you mentioned tone and with women, cause I deal with a lot of women in perimenopause and I I’m always, you know, there is a relationship with the feet, the pelvis, the rib cage, then the airway.

And so I’m curious, I do see tone like shifts at the joints with the estrogen declining and the joint moving a little bit more, but I’m curious. I know that there is this component up here. And sometimes if I’m stuck at the pelvis, this is kind of where I go, but I’m curious to see what you see as far as tone, you mean the tone in, in the tongue and, and the tone in the muscles of the face, neck and jaw? And also so the way they’re breathing, right? The pace of the breathing.

So I’m certified in Buteyko breathing, which is a modality of breath work. And we know that breathing is very multifactorial. So there is, you know, issues structural, like, you know, is there anything in the structure that’s making it harder? And now before you were able to maybe keep your tongue up or breathe better, but now everything, the tone is decreasing and now you cannot keep the tongue up, let’s say, or your soft palate is a little weaker and you cannot, you know, lift it up to keep that airway pattern.

Or it could be, you know, like soft tissue, usually see them more for younger kids, but also some of those like enlarged turbinates, tonsils, I don’t know. It’s, it’s also mechanical, right? Where we’re breathing from. So that’s when diaphragm pelvic floor coming into place, but it’s also chemical.

How is our sensitivity to our breathing, our CO2? So that’s where Buteyko comes into place, which is usually what I do a lot when I’m having, you know, older women that, you know, that receptor of breathing changes when our estrogen drops and we have more of that progesterone. So it’s really figuring out what their tolerance is for CO2, because we have like a sensor in our brain that has that signal of, you know, relaxation. And sometimes that signal cannot be activated if the body’s not comfortable with a higher tolerance of CO2.

So I do like breathing tests when they come in and I’m trying to see what their CO2 sensitivity is. And if it’s really low, that means that their body’s on that heightened, you know, like alert alertness, let’s say, and then they cannot get to those deep stages of sleep. So then they’re not able to, to fully have those deep restorative sleep cycles.

And then their tone is weaker because that tone, that tongue is not, you know, firmly resting in the roof of the mouth or the muscles are weaker. We need to work on strengthening those. So it’s muscular and breathing more of the chemical approach and the mechanical approach.

Love that. So I never knew that. That’s really good to know.

But for people who are in that age range to know, like if they’re starting to have sleep issues, it could be because of this issue as well. And you know, a lot of people don’t realize how the importance of CO2 in our breathing. So CO2 is the driver of our breathing.

Oxygen travels in our blood with hemoglobin, right? They’re traveling together. Whenever that CO2 is present, that’s when that oxygen actually comes out and it goes into our muscles, into our organs, into our brain. So that full oxygenation happens when we have that buildup.

Now, if you’re breathing more through your mouth, so the muscles are relaxing more or you’re breathing faster, if you’re breathing from your upper chest instead of your diaphragm, then you have, you don’t, you’re not able to tolerate that. So then when I do breath work, we’re working on the sensitizing, that tolerance, so making it a higher level so you can tolerate it more. And then you can actually get that, that oxygenation everywhere that it needs to, to go so that you have proper tone and stability.

Yes. Yes. Breathing is very underrated.

It’s so complex. Yes. I think of the book Breath.

Yes. I forget who’s, Nestor. I can’t remember his birth name, but last name is like Nestor.

Yeah. It’s, it’s, it’s sending, Oh, I have it. James Nestor.

I have it right here. I just, I just took a little quick peek. But yeah, it talks about how breathing through your mouth can change so much like mental, the way your face grows.

It’s, it’s really, like you said, it’s overlooked. Very overlooked. And it can, and it can really shift and help you level up.

If you practice this type of breathing or you get this type of evaluation, it can cause a huge shift in your wellbeing. I think. Oh, absolutely.

Yeah. I have a lot of patients where, you know, they’re not fatiguing as much because they are actually able to tolerate their body is oxygenating better, right? They’re, they don’t have that oxygenation. So if I have someone they’re like, I’m fatiguing so much, you know, with my workouts and we look, let’s check your breathing.

Let’s do some scores. Let’s see. There’s so many things obstruct, obstructive.

If it’s soft tissue, structural habit, chemical, mechanical. And then from then we come up with a plan. But a lot of times I see them with like a blood oxygen level that is low, meaning that they’re, they cannot tolerate CO2.

And we, we work on getting them up to a higher tolerance and they’re like, wow, I can walk up a flight of stairs and I don’t feel winded anymore. And it was just working on that desensitizing. Now their body’s able to oxygenate better.

Amazing. Yeah, I know if you take was it’s still cool. What’s so you mentioned some things already.

But what’s a common problem that you help people solve? You said, you know, with restoring all this, you can help them to oxygenate, oxygenate better. Their workouts are going to be better. They’re going to get better sleep.

Digestion I’m thinking is going to be better. They’re going to be able to renew their skin health and restore. Just talk a little bit about some problems that you help people solve.

The most common problem that people come to me is usually mouth breathing or like TMD jaw pain. And I feel like that’s the one thing that, you know, most people are probably from that book, like people are more aware of how they’re breathing and how it’s not good for their kids to breathe through their mouth. So that’s one of the things, but whenever they come to me for mouth breathing, I’m not just looking at the referral.

I’m looking at everything because something is connected, right? We cannot just, okay, we’re going to work on mouth breathing. And then this is the exercises because we’re a system. We’re all, you know, we’re all one unit.

So even though I work here, I need to see what else is happening everywhere else. Because again, and I tell this to, you know, when we schedule an evaluation, I’m like, I want to be the most comprehensive I can during the evaluation so that we can really connect the dots and come up with a reason and come up with a plan, right? And then what’s your goal? What’s the ultimate goal? Because, you know, I can give you different recommendations, but I want to know what do you want to get out of this? But I will say the most common thing that people come to me would be the mouth breathing or, you know, jaw pain. Those are usually the referrals that I get from, you know, other people too.

Okay. And then as a physical therapist, like, what do you think that, you know, I’m looking at the body similar to the way that you do. Like I’m looking at, you know, the head and neck, the rib cage, the pelvis, the feet, and movement and breathing is the core of what I do with postural restoration.

But to like, for me, and maybe some of the other PTs that are out there, what are some things that we should be looking at where we should be maybe referring to you? Where would, what would our patients kind of show that would require an evaluation with you? You know, if one, I think screening, like if they have like their mouth open, you know, that, you know, obviously they’re not breathing. So that’s an easy clue, right? Mouth breathing. And then when you’re trying to engage the right muscles, but they’re continuing to mouth breathe and they tell you, I can’t breathe through my nose.

Obviously we probably need to see an ENT or we need something else. But we’re just trying to connect what’s happening there. Then, you know, I don’t know how comfortable some of the PTs are about going intraorally, looking at their mouth, right? If they have this forward head posture, a lot of times that’s a compensation to open the airway.

So when they’re, when they’re walking like this or they’re sitting like this, yes, we’re working on, you know, strength, your work on strengthening the core and looking at the posture, but they’re opening the airway, asking more questions like, you know, how do you sleep at night? Do you feel rested? Has anyone told you that you grind your teeth or you clench your teeth? If they have had an actual retention, hey, can you open up and let, you know, can you move your tongue around? You might have a restriction that it’s not allowing for those muscles to move freely because of that frontline fascia, that connection from the tongue to the tip of the toes. And, you know, just trying to, I guess, dig deeper into what is happening as far as their mobility. Why are they having some of these issues? When did it start? You know, just curious, did you, were you able to breastfeed when you’re an infant? I mean, some adults don’t know that, but connecting like, oh wow, this started, or how long have you been, if you’ve been mouth breathing, how long have you been doing it for? Did you have ortho? Did you have braces? And then looking at their mouth when they’re smiling, their arch looks small, do you see spaces in between? So I think it’s almost like a detective of, okay, they’re coming from postural, they’re coming from breathing.

What other symptoms do they have or what other signs do they have that there’s also, that could be a functional connection? And our tongue is such an essential muscle for our framework and our body because it has 16 muscles. So it’s eight on each side and its role is to support our structure. And if that tongue is resting low all the time, then you know that that tongue is going, so like I have, I always show this one, that tongue is going into the airway.

So they’re sleeping and the tongue is lazy and relaxed and it’s going in there. So it’s going to make them, you know, grind forward, or they’re going to compensate. And then during the day they are not going to grind, but they’re probably going to walk like this or sit like this.

So it’s really looking at, you know, what you’re noticing and then digging a little bit deeper as far as, okay, you know, we’re having this things that you’re presenting with. Do you have any, you know, what is the history as far as your sleep? I don’t know if that’s something that you go over when you’re seeing your patients, but just having like a quick sleep screening. Do you wake up at night? Where’s your tongue? I feel like that would be an easy one.

Where’s your tongue resting right now? I have that weird question all the time. I’m like, listen, I’m going to ask you weird questions. I want to know if your tongue is sitting low, middle or a high.

And people don’t realize the normal resting posture should be right behind your front two teeth at the top right there. And you know, just, yeah. And then I have to educate, but yes, that’s a, that’s an easy one.

I feel like they’re like, Oh, so like one, they come in and their mouth is open. You’re like, okay, that’s one clue. Then maybe that posture is always forward and then be like, Hey, where’s your tongue resting right now? Yeah.

Okay. Then we need to work on that posture of the tongue. And then that’s when you can tell them, you know, you would benefit from, from an evaluation, you know, with my functional therapy, because I’m noticing some things that could be affecting the way you’re, you know, your muscles are compensating.

Yes. Yes, absolutely. It’s eye-opening when I tell them that, but I like that.

Thank you. So that that’s again, a way that we can, like, if we see some things we can refer to you, the more that we know, the better. I think that, that, that patient is going to be.

Yeah, absolutely. So tell me a little bit about why airway health is important in adolescence and what are some steps that patient parents can take to learn more? So, you know, adolescence is so important because they’re still growing and, you know, their, their structures are developing. The sooner that you can start looking into the growth and development of the face and the airway is the most important part, because we can really change the trajectory of that person’s life.

Truly, you know, the sooner, even, you know, younger, the better. So if parents start noticing that their kids are constantly with their mouth open, so they have that open mouth posture, which already just talk about the tongue being up in the roof of the mouth, which is where it should always be. If their mouth is open, you know, that their tongue is resting low.

That’s going to affect how that face grows. The face is going to grow long and that jaw is going to grow back. And if the jaw grows back, then that jaw is blocking the airway.

So, you know, that those are, are, are people that are probably not going to be sleeping well at night. And our body compensates to the point, to a point, and then we start having issues or pain, right? So those kids that are mouth breathing, they might be more hyperactive because they’re, they’re not sleeping well. And kids are different than adults.

When we don’t sleep, we’re just tired. Kids just have more energy and, you know, could be some mixed diagnosis because we didn’t look at the airway in the sleep. So, you know, if we start noticing mouth breathing, if we start noticing weird postures, you know, postures when they’re sleeping, a lot of parents, when I ask how, you know, how do you, the kids sleep, they’re like, oh, perfect from, you know, seven to seven.

But how’s the quality of that sleep? Are they moving? Are they tossing and turning? Are their sheets looking like they had a fight with, you know, the pillow? Is, sleep should be always silent, dry, and still. So if they’re moving, that’s a sign of sleep, sort of breathing. If, you know, they’re having accidents at night, bedwetting, or they’re waking up to go to the bathroom, that’s a sign that they’re not getting to those deep stages of sleep either, and they’re waking up, or they’re not waking up, and that’s why they’re having accidents.

And then silent, if they’re snoring, if there’s loud breathing, if there’s grinding, those things are not normal. And it’s so overlooked. And it’s so, you know, it’s okay, they’ll grow out of it, they’re fine.

Or, you know, let’s jump into like a surgical intervention. But the sooner that we can look at this changes, especially when they’re growing, the better, because this is going to affect their performance, you know, athletic performance too. When you’re not sleeping well, you could perform, you’re going to compensate.

But what if you could just do it even better, because you’re actually sleeping well? You know, same thing with anxiety, all of those things are affected with how that happens. And I have so many families and kids that come to me, and, you know, they’ve been dealing with some of these issues. And, you know, they’re almost like going from one place to another without really finding, again, the connection.

And like I said, it might not always be Mayo first, it might be a referral somewhere else, but at least coming to the common ground and asking and not stopping. Most of the parents that come to me, they’re like, I’ve asked three doctors already or three, you know, the ENTs or, and a lot of times it’s, they don’t refer just because they’re, what they know is, it’s what they know. And it’s not, not that it’s wrong, it’s just that they are not, they don’t know that there’s other options, that there’s other things that you can do and be looking at.

Recently I had someone that they had tonsils and adenoids removed, and they’re still like snoring, not sleeping well, they have really bad posture, they’re sick. And then, you know, the ENT after like, you know, third time, they were like, okay, let’s maybe go see a dentist or an orthodontist. And then they went and they’re like, well, you’re still too little, you know, to do any expansion.

So we’ll just kind of wait. But that’s not, the orthodontist just doesn’t know that there’s, there’s other things that you can do for those little kids. There’s other expansion routes, and there’s other things that you can do early on.

You just have to kind of look around and keep asking. For parents, I’m like, advocate, advocate, advocate. You know your child more than anybody.

And, you know, if you’re, if an answer doesn’t sit well, then get another opinion and keep looking. Keep asking. Talk about it. If you have something that has helped, tell other parents. Tell, because that’s how we learn.

We learn from each other, and we learn from the communications, from the things that we see out there. So I think just advocating, looking for the signs of sleep or how they’re breathing during the day, what’s their posture like, and then trying to get more into the bottom and addressing the issue.

That was helpful. What are some symptoms that might require a consult with an airway dentist? I think you touched on a few already.

Yeah. Tell me if we missed any. So open mouth posture, grinding at night. Me being in the dental field for the time that I was, we always talked about, “Okay, if you’re grinding your teeth, we don’t want your teeth to wear down. We have to give you something to protect them.” Which is a solution, or it’s a Band-Aid to the problem, but it’s not really solving the solution. Grinding is your body trying to open its airway.

When you’re grinding and you’re sleeping, so if you’re like this, your tongue is falling back and your body’s going to be like, “Oh, I need to do something to open that airway.” So you’re not getting to those deep stages of sleep, so you always feel tired and groggy. You’re grinding.

Instead of just using an appliance, try to figure out why you’re grinding. Is it tension in the tongue? Is it the muscles that are weaker? What is it?

Is it that there’s no space in your mouth? Is it that you’re not breathing from the right muscles? So I think grinding is a big one that I’m seeing more pediatric dentists, which is amazing, looking to, “Okay, let’s figure out why you’re grinding,” instead of just putting something to protect. And some parents might be okay with that solution, and that’s okay, but you want to know more. You always want to ask about why. I feel like that’s my biggest thing.

But usually they come to see me for tongue thrust. A lot of orthodontists, that’s what I work with them for, some of those tricky cases where the mouth is open, and they’re thrusting the tongue. Usually it’s from habit. So patients that thumb suck or use a pacifier long term, they usually come to see me, too, for habit elimination. Patients that have jaw pain, headaches, migraines. All of our muscles are connected, and if you are breathing wrong, or if your tongue is not where it needs to be, or if your tongue is resting, you’re going to have more tension in your head and neck, and then you’re going to have that jaw pain. You’re going to have those tension headaches. So trying to figure out what is happening, and then again, trying to get the root cause. Also asymmetry, so bell palsy, when you have weaker facial muscles. I feel like that’s something else that I see, and just overall muscle function.

Okay. So can you tell me what an initial consultation and a follow-up session looks like with you? Yes. So I love my evaluations. I feel like they’re one of my favorite things because I love connecting the dots. Yeah. The evaluation is about 90 minutes to two hours, and I am really comprehensive about everything that I look at.

First, we start with a pretty complete questionnaire where I’m looking about everything down to how was your birth and feeding. A lot of adults, I’m like, “You might not know that answer, but if you can figure it out, that would be great,” because that can help me start figuring out when some of these issues started when I’m evaluating them. I’m always looking at posture because, again, we’re connected, and I want to see if there’s something where I need to collaborate with someone else. Are they compensating for their airway? And also to track changes.

Is what we’re doing helping? Is it improving? I’m also doing a breathing assessment, so again, how are you breathing?

How is the output of air? Where are you breathing from? What is the sensitivity to your breathing, like your CO2?

And then looking at the facial muscles, so I’m evaluating how the facial muscles move, how the tongue is moving, where the tongue is resting.

I’m assessing if there’s any restrictions. Oh, that’s something that I didn’t mention. Tongue tie is something that people come to see me for as well. So I’m assessing if there’s any restrictions under the lip, some restrictions on the tongue, how that tongue is elevating. Is it able to reach up? Do we compensate? Do we have any jaw tension?

Again, how are our TMD muscles work, our jaw muscles working. And I also evaluate their swallowing, so I have them check, bring some different types of food. I have them swallow in here and also drink. I always tell them, “Bring the water bottle that you normally use,” because I want to see how that is. Because our habits always play a role. It’s not just how the muscle working, but what are our natural habits.

And I usually have them bring photos of sleeping and just watching shows, just so that I can see how they are in a natural environment.

So that’s typically an evaluation. From then, I come up with a treatment plan. I do have some assessments, like primitive reflex, just assess for screening, just to see if they will benefit from seeing someone else, like OT. And then we talk about what the next step would be.

Should we collaborate with a PT? Should we collaborate with a neurocentric dentist, orthodontist, ENT? Who could be on the team from what I notice?

I give them a quick recap of things I notice, and then usually they get a report in their portal afterwards. From then, we talk about what therapy would look like from what their symptoms are and what their goals are. And therapy sessions are usually 30 to 45 minutes. We meet in person or virtual, because I do also virtual therapy and virtual evaluations. And then it’s usually we look at the muscles, we start strengthening them. But myofunctional therapy, and this is something that I always tell them, it is a commitment. It is exercises that you have to do every day because we’re doing what’s called neuromuscular reeducation. We’re changing the pattern of movement of your muscles.

And I always say, I don’t know if it’s ever happened to you, but let’s say sometimes you drive home and you’re like, “Oh my gosh, I don’t even know how I got home.” It’s just automatic. This is how your muscles are working, and now we’re going to change the muscles to work in a more ideal way and in a more harmonious way. So you have to do the repetition so that it becomes now automatic and habituated. So each program is different depending, again, on the goals, on the age, what are we working on, and then we come up with also a habituation plan afterwards. Because we do the therapy, we do the active phases, but then we want to make sure that you’re able to actually habituate those changes, and not just get really good at doing exercises, but actually implement them so that you’re functioning this way. Ah, yeah. So that seems like a very comprehensive evaluation. You probably get a lot of information out of that eval.

Yes. And sometimes it’s very collaborative. It takes a village- Yes … to help everyone. So what would you say is your dream integrative team?

Yes, and I say this all the time. I’m like, “It is not just my home.” We’re a part of the puzzle, but the true magic happens when we’re collaborating with people that understand and are aware of all of these things and how they’re connected. So, I feel like each case is different, so it’s not always a cookie-cutter approach like, oh, you’re always going to see this person, or you’re always going to see someone. But let’s say I have a kid that is not sleeping well.

I look at them, and then they come for mouth breathing. I’m like, “Okay, why are you mouth breathing? Is it structural? Is it soft tissue?

Is it a restriction?” And most of the time, I’m referring them to an airway-centric dentist or orthodontist that is going to look at how that facial growth is developing. They usually do a CBCT scan to look at the airway, and then we come up with a plan. Okay, because we can also see the soft tissues from those screenings, and then do we need to collaborate with an ENT, or should we just start expanding and then looking at the symptoms, and then maybe we can still see the ENT afterwards if the issues are still there. A release provider, now PTs are looking at postural issues or tension.

If their diaphragm is really weak, if I notice in my posture photos that they have that anterior pelvic tilt or they have posterior tilt, they’re compensating, their head is forward, their diaphragm is really weak, we’re like, okay, we need to have someone else that is looking at posture because obviously we need to have those specialties to help in that collaboration.

Someone that has a restriction on their tongue, I always want to see cranio-sacral therapy to release the fascial tension of the mouth, the body.

Anybody that has trauma too, like a fall, I’m like, you want to see cranio-sacral therapy or surgical just to release tension.

So I think it’s different, and I always tell them, I’m like, “Okay, we’re going to come up with a plan. We’re going to see what we need to do, what our goals are, and this is who’s going to be in your team.” But I will say in my plan, there’s always an airway dentist, orthodontist, physical therapist, cranio-sacral therapist, release provider if we need to have someone to release the tongue. Sometimes also I collaborate with chiropractors. There are some that do primitive reflex integration.

Or speech therapists, feeding therapists, obviously, if there’s speech issues, I don’t do any speech therapy. So we work on strengthening the muscles, and then they see speech after or at the same time when we’re doing the treatment. Yeah. Mm-hmm. So definitely, it takes a village.

Yes. And I have to say, as a mom of two, who, because of my background with postural restoration, I was able to see these shifts and changes when my kids started having issues. And so when I started the journey, and I’ve worked with myofunctional therapists, we did Buteyko breathing, we did postural restoration- Mm-hmm … we worked with airway dentists, body cranio-sacral therapists. It’s a journey, but I can say when we’re on the other side of that journey, I think that my kids are in such a better position- Absolutely … having that intervention. And I think that their lives would’ve been very different had I not taken that time and invested. It is some time as a parent.

Yeah. It is an investment. But the knowledge- It’s worth it … that I’ve got from it and the shifts that I’ve seen, and in some of my patients too, it’s amazing. It’s going to help you in the future too. It’s going to help the kids in the future, and it’s going to help the adults age better, longevity-wise.

And it’s also everybody is different, and I always tell them, “Be honest with me. Tell me if there’s any barriers, because I want to make this work for you.” So let’s say I’m like, “Okay, I cannot do all the things.” And I tell them, “Look, I’m telling you what I see because it is your right to know what I’m seeing, and I don’t want to hide anything because I want to tell you what I notice, right?” And obviously everything is different. You don’t have to see all of those people.

Sometimes you just see some. But making it work for them to be like, okay, this is what we do first, and then we do this afterwards, and then we do that.

Just having a roadmap, right, of what we need to do, to get to where we need to be. Because it can be overwhelming sometimes.

And I tell them, “Look, I’m telling you everything. I don’t want to overwhelm you, but it is your right to know.”

And I was like, the last thing I want is for us to do something, and they’re like, “Oh, and now you need to see this other person because of this.” Why didn’t you tell me this from the beginning, right? I’m always upfront. I’m like, “This is what I see. This is the things that I recommend. Tell me where you’re at, and then we’ll come up with a plan, right? We’ll make it work for you.” Because my goal is to help, and I feel like that’s why I wanted to create my own business so that I could do how I want. I commit to the people that come to see me. I’m like, “I’m here for you. You’re not alone in this, and I know it’s a lot, and we’ll just talk it out.

We’ll come up with a different solution. If this doesn’t work, we have another option.” There’s always options. And I always tell them, “Please tell me, because if you don’t tell me, I don’t know, and I think everything’s clicking. So we’ll see what we need to do. We’ll pace it at the pace that you need to.

And then we’ll go from there.” But it’s not fair for someone to say, “Oh, this is all you need, and then you’ll be fine” when you know that there might not be. Or if I have the tools to evaluate you to the best of my ability, I want to do that for you because that’s what I would want for myself.

That’s what I always want for my family and for my son. And sometimes you cannot just have that almost wall or block of like, oh, maybe they don’t want to hear this or I just say it and I’m like, “We’ll come up with a plan.

We’ll see what works for you, what doesn’t work.” And then a lot of people are very holistic. They really want to stay away from surgical intervention, so they want more homeopathy. And I work with homeopaths too, so I’m like, we’ll find a middle ground, right? There’s things where we’re like, we’ll try to where we need to be, but this might still be what you need to do. So, I feel like every case is different. Every family is different.

Every story is different. And you just have to check in with them and meet them where they’re at because- Yeah … you don’t want to stop doing something because you’re like, “Oh my gosh, it’s too overwhelming.” No, let’s talk about it.

Let’s figure it out so that it works for you and for your family. Well, you seem like you have a very empathetic approach, and I think that’s essential for this patient population because it is a lot and they do need some guidance. Yes. And I always say I’m almost like the quarterback on the team.

I’m like, I talk to this person, and I’ll talk to that person, and I really love collaboration, truly. Just messaging them like, “Hey, this is what I noticed. Tell me what you think. What should I work for?” Or, “Let’s pause here because now you’re going to do that.” And again, making it work for each family and trying to do the best. I’m probably the worst salesperson.

I’m like, I have all of these plans, so just make it work for everybody. But I truly do care, and I want to make a difference.

And I feel like that’s where I’m like, let’s make a family plan. Let’s make a deal so that you can get everyone in without it being too stretched out. But yeah, that’s just me. Well, thank you so much, Laura. This was great. I think that your interview really gives everyone some good information about what myofunctional therapy is, what symptoms to look out for, and how they can start the journey and make some shifts for their kids who might be having some of those symptoms. So thank you so much for coming on with me today. Thank you for having me. This was wonderful.

I really appreciate the time to be here and really educate and talk more about what we do to support our kids.

Yeah, of course.