Why Myofunctional Therapy and Bodywork During Airway Expansion Are Essential for Kids

If you’ve been around here awhile, you know I’m a big believer in both-and solutions. For us, airway expansion wasn’t about one magic appliance—it was a team sport. Two of my kiddos are going through airway expansion and both did/are doing consistent myofunctional therapy and bodywork during airway expansion; one also added feeding therapy. We saw calmer bodies, easier nasal breathing, more “lips together, tongue up” moments, and better follow-through on expansion—all the tiny wins that add up to a healthier airway and happier kid.

This post is the guide I wish I’d had on day one: what airway expansion does, why pairing it with myofunctional therapy and bodywork during airway expansion can maximize benefits, what the evidence actually says, and how to build a support team without burning out. And, most importantly, how they are all connected. 

Airway Expansion 101 (in plain English)

Airway expansion most commonly means widening a too-narrow upper jaw (maxilla) so there’s more room for the tongue and nasal passages. In growing kids, rapid palatal expansion (RPE/RME) can increase nasal airflow and reduce resistance—translating to easier nose breathing and (for some children) improvements in sleep-disordered breathing.

What we DID NOT know in the beginning of our journey, was that most, if not all, of our symptoms that we were experiencing with our kiddos were all related to needing their airways expanded. For us, that looked like picky eating, sensory issues, obstructive sleep apnea (OSA), sickness induced asthma, frequent emergency room visits for closed airways, ADHD and behavior issues, bed wetting, mouth breathing and snoring, consistent chapped/dry lips, exhaustion during the day, and more. We were treating all of these symptoms individually/separately for many years before discovering our root cause. 

What we noticed at home: expansion appointments went more smoothly when our kids’ bodies were regulated and their oral-facial muscles knew what to do with the new space. That’s why myofunctional therapy and bodywork during airway expansion made such a difference.

Why Myofunctional Therapy Is the “How” Behind the “What”

Expansion can create space; Orofacial Myofunctional Therapy (OMT) helps the tongue, lips, cheeks, and soft palate use that space correctly—day and night. Think of it as physical therapy for the mouth and airway.

OMT can be provided by different professionals:

• Speech-Language Pathologists (SLPs), often called speech therapists, who are trained in speech, swallowing, and sometimes feeding.

• Occupational Therapists (OTs), who support functional skills for daily life, and some have advanced training in feeding and oral-motor therapy.

• Dental professionals (like hygienists or dentists) who complete additional OMT certifications.

What the research says:

• A systematic review and meta-analysis found that myofunctional therapy decreased the apnea–hypopnea index (AHI) by about 50% in adults and ~62% in children, along with improved oxygen saturation and reduced snoring.

• More recent meta-analyses continue to support OMT’s positive effects on AHI, daytime sleepiness, and airway muscle tone in OSA patients.

• Broad consensus in pediatric dental policy is a team-based approach that includes habit retraining, airways, and oral-facial muscle support. The American Academy of Pediatric Dentistry (AAPD) policy on obstructive sleep apnea encourages screening, collaboration, and non-surgical interventions (including expansion) as part of a holistic plan.

What we did at home: daily, bite-sized OMT exercises—nothing fancy, just consistent. We got “homework” from our guided experts, and practiced these at home often. We celebrated “tongue to spot” and “lips together, teeth apart” like they’d won a trophy. The payoff was better nasal breathing habits and less mouth-open fatigue by late afternoon.

Where Feeding Therapy Fits

If swallowing is inefficient, picky eating is rooted in mechanics, or your child has a history of airway issues, feeding therapy may be part of the puzzle. When feeding therapy and OMT collaborate, you get both function and carryover into real life—meals, school, sports—where habits stick.

What we saw: fewer gaggy moments, less crying and anxiety around food, improved texture tolerance, and less mealtime fatigue. Progress wasn’t always linear, but the synergy was real. And, the real progress with feeding therapy happened after the expander was placed. We had been going to feeding therapy for months beforehand, and progress felt slow. This was truly a light bulb moment when we realized it was all connected. 

What changed: We know that the opening of the airway, including the nose passage, made textures and smells change, affecting the sensory aspect of the experience for our kiddo. It also made it easier to swallow food, and things started to slowly fit in place. What we thought was a super picky kiddo who was never going to change, ended up being the root cause of an actual anatomy issue that was truly impacting his ability to smell, eat, and swallow. 

Gentle Bodywork: Regulated Bodies Learn Better

Why we layered in chiropractic + gentle bodywork: regulated, comfortable bodies make it easier for kids to do OMT, chew/swallow efficiently, sit through adjustments, and sleep. The connection between myofunctional therapy and bodywork during airway expansion is that bodywork supports posture, neural regulation, and muscular release—so new breathing + oral posture patterns have a freer “playground.”

What the evidence says (and where we’re still exploring):

• The literature on bodywork (chiropractic, myofascial release, craniosacral-style work) in airway/expansion settings is more limited and heterogeneous—these modalities are often adjunctive rather than stand-alone airway therapies.

• In orthodontics and airway medicine, practitioners increasingly acknowledge that musculoskeletal and myofascial balance (neck, ribs, tongue posture) influence airway mechanics and therapy tolerance.

• Clinically, we noticed: after bodywork days, OMT felt smoother, jaw/neck tension dropped, and sleep was less restless. That “settled” feeling helped our kids accept the new oral posture OMT was building.

What we noticed: after bodywork days, OMT was smoother, jaw/neck tension dropped, and sleep was less restless.

Timing Matters: Before, During, and After Expansion

• Before: establish nasal breathing habits and tongue-to-palate rest posture.

• During: keep OMT frequent and short; check that gains in space are matched by gains in function.

• After: don’t skip the “maintenance” phase—muscles need repetition to make the new airway posture automatic.

This is where myofunctional therapy and bodywork during airway expansion create long-term stability instead of short-term gains.

What the Research Honestly Says

• Expansion & airway: Multiple studies and reviews show that RPE (rapid palatal expansion) can increase nasal airway volume, reduce resistance, and influence upper airway dimensions—but results vary, and long-term controlled trials remain limited.

• OMT & sleep-disordered breathing: Meta-analyses show consistent reductions in AHI, improvements in oxygen saturation, and reduced snoring when OMT is used as an adjunct therapy.

• Guidelines & policy: The AAPD policy emphasizes screening for pediatric OSA, integrating non-surgical airway tools (like expansion), and collaborating across specialties.

As a parent, I hold two truths: 1) the scientific evidence is growing but not perfect, and 2) our lived experience matters. When our kids’ bodies were regulated and their mouths knew what to do with the space we created, everything else worked better. One of my favorite books that I have read on this whole topic that has really opened my eyes to so much is Breathe Sleep Thrive, by Dr. Shreen Lim. I highly recommend this if you want to dig deep into the mechanics of sleep, airway expansion, and all of the long-term side-effects of not treating this in your kiddo. 

Our Personal Routine (Real Life, Not Pinterest-Perfect)

• Morning: two quick OMT drills after toothbrushing.

• Afternoon: movement break + “tongue to spot” check-ins.

• Evening: calmer nervous system = better sleep. On bodywork days, evenings were easier.

Progress tracker on the fridge. Stickers. Lots of grace.

Local Resources We’ve Used (Customize This Section)

• Airway-savvy orthodontist/ Dr. Edward Lipskis, TMJ Sleep Centre and Centre for Integrative Orthodontics

• Airway-saavy dentist (did our Oral Tie Releases): Dr. Milton Geivelis

• Myofunctional therapist, Feeding Therapy, and OT: We absolutely adore the team at Turning Wheels Pediatric Therapy. They have seen all three of our kiddos for all of the things, and I cannot recommend them enough.

• Chiropractic/bodywork: Dr. Jessica Leighton is unfortunately not local to us anymore, but she is a master at her craft, and has all of the certifications you would want in a chiropractor, IBCLC, and body work pro for your kiddos. 

For our family, myofunctional therapy and bodywork during airway expansion weren’t extras—they were the glue that held everything together. Expansion gave our kids the space, but OMT and bodywork taught their bodies what to do with it. If you’re just starting this journey, I hope our story shows that building a supportive team is worth every ounce of effort.