Practice Alert Regarding Oral Myofunctional Therapy and Registered Dental Hygienists
Published in the January 2025 issue of the ISHA Voice.
By Susannah F. York and Danila L. McAsey, members of the Billing and Reimbursement Committee
Per ASHA, “Orofacial myofunctional disorders (OMDs) are patterns involving oral and orofacial musculature that interfere with normal growth, development, or function of orofacial structures, or call attention to themselves.” These disorders affect infants, children and adults and can have a negative impact on feeding, swallowing, chewing and speech, whose treatment falls within the scope of practice and expertise of speech-language pathologists. OMDs are an area in which involvement is also multidisciplinary, and may also include dentists, lactation consultants, and registered dental hygienists (RDHs), with respect to jaw and dental alignments, facial-skeletal growth, oral hygiene, breast feeding, sleep, and upper airway patency.
Myofunctional Therapy (MT) is a type of treatment in which specific exercises are used to improve the muscle function of the face, mouth and neck. Speech-language pathologists are likely aware of this sub-specialty as it applies to their scope of practice, as well as the additional training and certification involved for assessment and treatment in these areas. Because of the wide-ranging impact of OMDs members of varied disciplines may be trained and certified in MT to be applied within their scope of practice.
Presently, there are concerns in surrounding states about Registered Dental Hygienists (RHDs) employing this treatment technique to assess and treat complex dysphagia cases, for which they lack the qualifications. This may lead to the risk of inadequate and ineffective treatment and potential patient harm. SLPs are uniquely trained, qualified and licensed to evaluate and treat dysphagia. While RDHs can be trained in orofacial myofunctional disorders, in most states aspects of their practice are restricted by state legislation and licensing requirements. In Illinois, RDHs can operate independent practices. As such they may operate outside of their legislated scope of practice. Further medical billing codes assigned to speech pathology may be being used to obtain reimbursement.
At this time, there is no pending legislation in Illinois that would allow RDHs to provide MT for the purposes of treating dysphagia or speech disorders. However, as a profession we must be alert to this encroachment on our professional practice. Due to pending state compacts and telehealth capabilities, ISHA is monitoring RDH involvement in dysphagia, via the use of MT assessment and treatment. If you have questions or concerns, please contact:
- Janet Olson, Chairperson of the Legislative and Regulatory Committee: janet@niu.edu
- Kim Pritikin, vice president for the Division of Legislative and Regulatory Affairs: kim.pritikin@gmail.com
Resources:
https://www.asha.org/practice-portal/clinical-topics/orofacial-myofunctional-disorders/
https://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1325
https://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1296
