Certified Orofacial Myologist Practice Test Video Answers

1. B
Orofacial myofunctional therapy aims to establish proper patterns of muscle function and rest posture of the tongue, lips, and jaw. While it may positively impact dental relationships, it does not directly correct malocclusions or replace orthodontic treatment but works synergistically with other modalities.

2. C
The genioglossus muscle is the primary protruder of the tongue. It originates from the mandible and fans into the tongue body, pulling it forward when contracted. The styloglossus retracts and elevates, the hyoglossus depresses, and the palatoglossus elevates the posterior tongue.

3. B
The correct resting position of the tongue is on the hard palate with the tongue tip behind the incisive papilla (alveolar ridge) and the dorsum gently contacting the palate. This position supports proper craniofacial growth and airway maintenance.

4. B
The typical freeway space (interocclusal rest space) is 2-4 mm, representing the vertical distance between maxillary and mandibary teeth when the mandible is at physiologic rest position. This space allows for muscle relaxation and proper TMJ positioning.

5. B
Tongue thrust swallow is characterized by anterior tongue movement with interdental or interdental-approximating positioning during swallowing, often accompanied by excessive lip and perioral muscle activity. This differs from the mature swallow pattern.

6. D
The hypoglossal nerve (cranial nerve XII) innervates the intrinsic muscles of the tongue and all extrinsic muscles except the palatoglossus. The trigeminal nerve provides sensory innervation, while the facial nerve innervates facial muscles.

7. B
Ankyloglossia, commonly called “tongue tie,” is a condition where a short or tight lingual frenulum restricts tongue mobility. Macroglossia refers to an enlarged tongue, microglossia to an abnormally small tongue, and glossoptosis to posterior tongue displacement.

8. C
The orbicularis oris is the primary muscle responsible for closing and protracting (puckering) the lips. It encircles the mouth and is essential for lip seal, facial expression, and articulation of bilabial speech sounds.

9. D
The spot exercise, where the tongue tip maintains contact with the alveolar ridge behind the upper incisors, should typically be held for 30-60 seconds to build endurance and establish muscle memory for proper resting posture.

10. C
Mouth breathing typically leads to a high, narrow palatal vault (increased height), not decreased. Other sequelae include elongated facial proportions, anterior open bite, and forward head posture as compensatory mechanisms for maintaining airway patency.

11. C
The masseter muscle, a primary muscle of mastication, is innervated by the mandibular division (V3) of the trigeminal nerve, which also innervates the temporalis, medial and lateral pterygoid muscles.

12. B
During a normal mature swallow, the teeth should be in light contact or close proximity (within freeway space). This provides stability for the mandible while the tongue elevates against the palate to propel the bolus posteriorly.

13. C
While cephalometric analysis may be valuable supplementary information, it is a radiographic technique performed by dentists or orthodontists, not a component of the OMD assessment performed by myofunctional therapists. Assessment focuses on clinical evaluation of rest postures, function, and habits.

14. B
Hyperactivity of the mentalis muscle (creating a “puckered chin” or “cobblestoning”) typically indicates inadequate lip seal competence, requiring excessive strain to achieve lip closure. This often correlates with short upper lip, incompetent lips, or mouth breathing patterns.

15. C
While prolonged pacifier use can affect speech, the primary concern is the development of dental and skeletal malocclusions including anterior open bite, posterior crossbite, and altered maxillary development due to sustained abnormal oral pressures.

16. B
The buccinator muscle forms the muscular component of the cheek and functions to keep food between the occlusal surfaces during mastication, preventing food from accumulating in the buccal vestibule. It also assists in facial expression and lip function.

17. B
Habituation in myofunctional therapy refers to the stage where newly learned correct orofacial patterns become automatic and unconscious, occurring without conscious effort. This represents successful integration of therapeutic goals into daily function.

18. C
Anterior open bite is most commonly associated with tongue thrust patterns, as persistent anterior or interdental tongue posturing during function and rest prevents normal vertical development and eruption of anterior teeth, creating or maintaining the open bite.

19. B
The incisive papilla, located on the hard palate immediately behind the upper central incisors, serves as the primary landmark for proper tongue tip placement (the “spot”) during rest, swallowing, and certain speech sounds.

20. B
Orofacial myofunctional therapy can typically begin around ages 4-5 for cooperative children who can understand and follow instructions. Treatment should be individualized based on cognitive development, motivation, and ability to participate, not solely on chronological age.

21. B
The Garliner swallowing sequence typically begins with swallowing with teeth together (or in close proximity) and tongue on the spot, establishing the foundational mature swallow pattern before progressing to more complex exercises and variations.

22. D
Nasal breathing actually increases nitric oxide production (which is produced in the paranasal sinuses), not decreases it. Nitric oxide has antimicrobial properties and enhances oxygen uptake. All other options are correct benefits of nasal breathing.

23. B
The levator veli palatini is the primary muscle responsible for elevating the soft palate during swallowing, speech, and blowing. The tensor veli palatini tenses the palate and opens the Eustachian tube, while the palatoglossus and palatopharyngeus assist in velopharyngeal closure.

24. C
A lateral lisp (air escaping laterally during sibilant production) is often associated with inadequate buccal muscle tone or coordination, allowing air to flow over the sides of the tongue rather than through the central groove. It may also relate to dental or occlusal issues.

25. B
The butterfly or clucking exercise (clicking the tongue against the palate) is designed to stretch and increase mobility of the lingual frenulum while also strengthening tongue elevation and promoting awareness of palatal contact.

26. C
Interdental tongue posture at rest is classified as forward tongue posture or tongue thrust tendency. It represents a significant orofacial myofunctional disorder that can impact dental development, stability of orthodontic treatment, and overall orofacial function.

27. B
Research has established that orofacial myofunctional disorders can contribute to sleep-disordered breathing by affecting tongue posture, airway patency, and craniofacial development. OMT is increasingly recognized as an adjunctive treatment for some SDB conditions, particularly in children.

28. B
Optimal lip seal should be achieved with minimal muscle activity, allowing the lips to rest together comfortably without strain. Excessive muscle contraction indicates lip incompetence or inadequate lip length requiring compensatory muscle activity.

29. C
Only licensed healthcare providers such as physicians, dentists, or oral surgeons have the legal scope of practice to diagnose structural anomalies like ankyloglossia. Orofacial myologists and SLPs can identify functional implications and make referrals but cannot provide medical diagnoses.

30. B
Orthodontic relapse is significantly more likely when underlying orofacial myofunctional disorders are not addressed, as persistent abnormal muscle patterns and tongue thrust continue to exert forces on dentition that counteract orthodontic correction.

31. B
The “spot” is the specific area on the anterior hard palate, approximately 4-6mm posterior to the maxillary incisors (at or just behind the incisive papilla), where the tongue tip should habitually rest. This is the foundational concept in myofunctional therapy.

32. A
Incompetent lips are defined as lips that cannot achieve a seal without excessive muscle strain or conscious effort. This is distinct from lips that are habitually open but can seal easily (lip apart posture) and requires assessment both at rest and with attempted closure.

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