Some dental and jaw problems aren’t really about the teeth. They’re about habits: where your tongue rests, how you swallow, and whether you breathe through your nose or your mouth. Those patterns push on your teeth and jaw all day, every day, and they can shape your bite for years before anyone connects the problem back to them.
Myofunctional therapy retrains those habits, and Dr. Lee-Mirzayan, a dentist and a certified myofunctional therapist, leads the program herself.
Prefer it on paper? Here’s a one-page printable summary, with a QR code that brings you back to this page.
What it is
Think of it as physical therapy for your tongue, lips and face. There’s no appliance, no surgery and nothing to wear. It’s a set of exercises that build strength and coordination and teach your tongue and lips a new resting position, one you may not have had for decades.
What it’s used for
- Tongue thrust. A tongue that pushes forward when you swallow can open gaps between the front teeth and push them out of line.
- Mouth breathing. Breathing through your mouth, especially at night, dries out your teeth and gums and changes where your tongue and jaw sit. Here’s what chronic mouth breathing does.
- A low resting tongue. When the tongue doesn’t rest against the roof of the mouth, the muscles around the teeth and jaw work differently.
- Teeth that keep shifting after braces or Invisalign. A retainer holds teeth for part of the day, but your tongue is pushing on them the rest of the time. Why teeth keep moving.
- Jaw muscle tension, as part of TMJ treatment.
- Before and after a tongue-tie release. Releasing a tie without training the tongue can let it reattach or fall further back.
The Airway & Function Assessment
Every patient starts with the same in-person exam, which we call the Airway & Function Assessment. Dr. Lee-Mirzayan looks at the whole system, not just the teeth:
- How you breathe at rest: through your nose, your mouth or both, and how your head and shoulders sit.
- Lips, cheeks and tongue: where your tongue rests, whether it pushes forward when you swallow, and whether a tongue-tie or lip-tie limits how it moves.
- Your bite and palate: crowding, open or deep bites, and whether the palate is narrow or high.
- The airway itself: tonsils, the back of the throat, and signs of a blocked nose.
- Sleep: snoring, waking up tired or with a dry mouth, and a short sleep apnea screening questionnaire. It’s a screen, not a diagnosis. If it flags a risk, we’ll refer you to a physician for a sleep study.
- How it all works together: lip seal, swallowing, chewing and speech.
From there you get a plan. For many people that’s myofunctional therapy, sometimes with a tongue-tie release partway through, and an orthodontic re-check afterward if it’s needed.
What the program looks like
A typical program runs about 8 weeks, with a check-in every other week. At each check-in, Dr. Lee-Mirzayan looks at your progress and moves you on to the next set of exercises. The work in between happens at home, about 5 to 10 minutes a day.
That home practice is what makes it work. The sessions show you what to do, but the change comes from doing it every day. At the start, we measure things like how long you can hold your lips closed comfortably, so we can compare later instead of guessing how it’s going.
If you’re having a tongue tie released, the timing is a little different: usually 6 to 8 weeks of therapy before the release and about 8 weeks after.
Why repetition is the part that matters
The exercises work because the tongue and lips are muscles under the control of the brain, and repeated, structured movement changes how the brain drives them, a process called neuroplasticity. Foundational research on tongue training found that structured tongue exercises produce measurable changes in the brain’s own motor control of the tongue, not just a change in the muscle itself.
Svensson P, Romaniello A, Arendt-Nielsen L, Sessle BJ. Plasticity in corticomotor control of the human tongue musculature induced by tongue-task training. Exp Brain Res. 2003;152:42-51.
A more recent study using the same measurement technique found that a single 40-minute session of tongue exercises measurably increased the brain’s motor response to the tongue in healthy adults, while a parallel session of breathing exercises alone did not produce the same change. The researchers were careful to note what this does and doesn’t show: a single session produces early, short-term adaptation, not the kind of lasting reorganization that comes from training repeated over weeks, and measurable gains in strength or function typically lag behind these early changes rather than appearing immediately. The study was also done in healthy adults rather than myofunctional therapy patients, so it’s evidence for the mechanism, not a claim about outcomes in any specific condition.
Mi D, Castrillon E, Kothari M, Arima T, Svensson P. Effects of oropharyngeal exercises on orofacial function and corticomotor excitability in healthy individuals. Sci Rep. 2026;16:26208.
Age on its own isn’t a reason to expect this not to work. A meta-analysis pooling 12 randomized trials of tongue-strengthening exercise found strength gains across every age group tested, and the largest gains were in adults 65 and older, not the smallest. A separate trial using the same kind of daily exercise, in a group with a median age of 84.5, found significant gains in tongue strength and endurance after 8 weeks, the same span our program runs.
Lin CJ, Lee YS, Hsu CF, Liu SJ, Li JY, Ho YL, Chen HH. Effects of tongue strengthening exercises on tongue muscle strength: a systematic review and meta-analysis of randomized controlled trials. Sci Rep. 2022;12:10438. Yano J, Nagami S, Yokoyama T, et al. Effects of tongue-strengthening self-exercises in healthy older adults: a non-randomized controlled trial. Dysphagia. 2021;36(5):925-935.
Separately, research comparing brain-level motor plasticity directly between younger and older adults after a comparable training task found both groups adapted at a similar rate. That particular study used a hand task rather than a tongue task, so it speaks to how the aging brain responds to training in general rather than to tongue training specifically, but it points the same direction.
Cirillo J, Todd G, Semmler JG. Corticomotor excitability and plasticity following complex visuomotor training in young and old adults. Eur J Neurosci. 2011;34(11):1847-1856.
That’s consistent with what we see clinically, and it’s part of why the program runs in weeks rather than a single visit: the daily home exercises are what drive the retraining, and it takes sustained repetition, not just correct technique on the day of a session, before a new resting pattern holds on its own.
What the research shows
We want to be clear about where the evidence is strong and where it isn’t.
The best research is on sleep. Two recent reviews of randomized trials found myofunctional therapy improved daytime sleepiness, sleep quality and snoring. They disagreed on whether it reliably lowers the apnea index itself, though one found the improvement did reach significance when people trained for more than thirty minutes a day. We go through both reviews on our sleep apnea page.
Saba ES, Kim H, Huynh P, Jiang N. Orofacial myofunctional therapy for obstructive sleep apnea: a systematic review and meta-analysis. Laryngoscope. 2024;134(1):480-495. Xu Y, Yang R, Yu M, Gao X. Efficacy of myofunctional therapy for obstructive sleep apnea: a systematic review and network meta-analysis. J Evid Based Dent Pract. 2025;25(3):102137.
For tongue ties, a randomized trial in children and adults found that therapy combined with a release did better than therapy alone for tongue movement, swallowing, breathing and resting posture.
Lichnowska A et al. J Clin Med. 2024;13(18):5354.
It isn’t a treatment for sleep apnea on its own, and it isn’t a substitute for a diagnosis. Myofunctional therapy doesn’t diagnose or cure apnea, and some people respond much more than others. That’s why we measure at the start and track progress.
How it fits with the rest of your care
Myofunctional therapy usually works alongside other treatment, not instead of it. A tongue thrust might be the reason Invisalign keeps fighting to close the same gaps. Tight jaw muscles often respond best when therapy is paired with buccal massage: in the largest trial of that hands-on work, patients who also did retraining exercises did better at one year. And sometimes a tongue tie physically stops the tongue from reaching where it needs to go.
One patient was referred to us just to bond the spaces between her front teeth. A full exam found a tongue thrust habit that had been pushing those gaps open. Treating the habit first meant Invisalign could close her spaces for good, with no bonding needed.
See how we solved J.L.’s case →
Where it happens
Your first exam and intake always happen here in the office, in person. After that, sessions can take place in our Zen Room, the same room where Dr. Lee-Mirzayan does buccal massage, or remotely over Zoom if coming in is hard to fit around work, school or the drive.
Is this right for you?
That depends on what’s actually causing your symptoms, which is what the exam is for. Call 702-734-0776 or tell us what’s going on, and we’ll help you figure out whether myofunctional therapy belongs in your plan.
Not sure yet? Start with our ten-question self-assessment. It takes under a minute, nothing you check is sent anywhere, and you can print your answers to bring in.