Ten Years In: Are We Winning the War on Orofacial Dysfunction? 

By Sarah K. Hornsby 

Ten years ago, when I began teaching orofacial myofunctional therapy, I spent a lot of my time explaining what it even was.

I got lots of questions like:

“What exactly is that?”

“Is that like speech therapy?”

“Is that evidence-based?”

Most professionals hadn’t heard of it. Some dismissed it politely. And some even openly challenged it.

So many airway conversations felt fringe.

Tongue posture was considered insignificant, and mouth breathing was brushed off as a harmless habit children would “grow out of.”

If you talked about nasal breathing, oral rest posture, or the long-term impact of dysfunctional habits, you were often met with raised eyebrows.

A New Orofacial Myofunctional Therapy Landscape

Today, there’s a lot to be optimistic about because the landscape feels totally different.

Breathing is now a common lecture topic at major dental conferences.
Orthodontists are openly questioning relapse patterns.
Pediatric dentists are screening for airway risk.
Speech-language pathologists are collaborating more intentionally with dental teams.

 Are all the collaborative specialties fully aligned? No, not yet, but awareness has shifted dramatically.

Ten years ago, we were trying to justify why oral rest posture even mattered. But today, entire practices are being built around airway-centered care.

Parents are so much more informed. They come into appointments asking about tongue-ties, expansion, sleep quality, and nasal breathing. 

Research is expanding. Interdisciplinary study groups are forming. Conversations that once happened in small corners of the internet are now happening on conference stages.

And yet…

Oral dysfunction is still everywhere.

Children are still mouth breathing.

Expansion without habit change still relapses.

Adults are still living with dysfunctional patterns that affect their sleep, their posture, their jaw health, and long-term stability.

The New Airway Paradigm

So, the question is: are we winning the war?

I believe we are winning the awareness battle, but awareness alone is not transformation.

The real shift will come when myofunctional therapy is no longer viewed as supplemental, as something you “add on” after expansion, after surgery, after relapse.

The real shift happens when it is seen as foundational.

Because function drives form, habits shape growth, and stability requires neuromuscular change.

Over the last decade, I’ve watched more than two thousand clinicians step into this field. 

I’ve seen hygienists become airway advocates within their practices. I’ve seen orthodontists rethink retention protocols. I’ve watched SLPs widen their lens to include craniofacial growth and breathing. I’ve seen professionals who once felt isolated now find community and confidence.

The field is maturing and expanding so quickly.

And what excites me most isn’t how far we’ve come, it’s how collaborative the future feels.

We’re moving from siloed conversations to shared responsibility. 

From defensive explanations to integrated treatment planning, and from “alternative” to interdisciplinary.

The next ten years won’t be about defending myofunctional therapy. Instead, they’ll be about integrating it into dental curricula, orthodontic planning, pediatric screenings, and everyday conversations about health.

That’s when we stop fighting for legitimacy.

That’s when we start building a new standard.

And that’s when the real transformation begins.