i'm dr amanda orthodontist at straightsmile solutions we help dentists launch and scale
orthodontics in their practice today we'll be sharing some content from a webinar
that was co-hosted with ms tamara thomas a facial physique oral myofunctional therapy
to connect with ms thomas please use this qr code or visit www.facialphysique.com
if you want to help with an orthodontics case please
contact dr amanda with at straight smile solutions www.straightsmilesolutions.com
or click on her qr code i was going to go over a little bit of bringing it into your office
so you can either refer out which is what i i have my own business doing this i've been doing
it for almost six years now my virtual i've always been virtual even before covet i've been virtual
and i'm lucky enough to have figured out how to assess patients i have a whole platform that
i've um built out for myself it's hipaa compliant it's very user-friendly for the
patients and i see patients throughout the world so i've made lots of connections with
orthodontists ear nose and throat physicians in different parts of the country and the world and
working a lot in the uk actually with a lot of myofunctional therapists even over there
but you can refer out or you can bring in so some of us love to have our own business
and others prefer to work with somebody the one main thing i'd like to caution is that it's not
like bringing a hygienist on board it's like a whole department so hygienists and speech
and language pathologists are able to take these courses you have to be one of those in order to
take or dentist i'm sorry i should say that take these courses to become a myofunctional therapist
but uh where was i going with that uh you're talking about implementation in an office like
like it's not that smooth just to you know just to bring one in it's not like hiring a regular staff
yes it's not like hiring regular staff where you're gonna bring us in and we
can do a profit cleaning and then the last 20 minutes we can give exercises that's
a little much it's more like if you were to bring a speech and language pathologist into your
practice to teach speech you wouldn't do that in a hygiene setting too it's just a little
too much for that that that appointed time um so you do it would be good to have in your office
you just want to make sure that it's something that's separate from a hygiene appointment so how
do you book it if somebody if if you do go into an office how do how do you how do they schedule it
what type of chair would you want like how would that work so you don't need too many things for an
assessment um we're taking photos for assessing function so you know a sterilizer definitely
need that because you're going to be using cheek protectors but you don't need a full on dental
chair with suctioning and water and all of that as well so it's pretty minimal the overhead in
the sense if it was just myofunctional therapy you just need a room for the patient to be in
good lighting mirrors it's very simple that way um and then you would for me so i'll tell you how
i do my virtual a little bit because it would be the same as if you're in person i see them online
i send over photos that they need to take and upload into my portal the photos that they take
aren't diagnosing anything they're not it's just a way to start what i'm really assessing
is function so i want to see the way everything moves and if there's compensations so that just
gives us a baseline so we can see what they look like afterwards and the progress that they made
that usually is about an hour some therapists will do an hour and a half it's very in-depth
we're going over sleep or going over um from when they were an infant you know did they breastfeed
if they couldn't breastfeed why couldn't they breastfeed so there's all these little red flags
that go over where they are today um then if they decide they want to move forward then we do about
minute sessions some therapists like 45 minutes um selena sometimes will do 45 because she's um
this is my associate celina because she's learning and i oversee her a little bit with all of that
as you get a little bit faster a little bit should be good to do 30 minutes i meet every two weeks
and then after um we get there's three phases right of therapy there's the intensive phase
which usually is about four sessions the habituation phase which is where we're getting
rid of those old habits and giving those new ones and then the retention phase so they have to get
through all of those phases usually to have it be successful usually about 12 sessions it's usually
12 sessions or more and i tell patients that only because they have to know how much of a commitment
it is you're eliminating a habit and that takes a really long to eliminate that and get yourself
a new one if someone has obstructed sleep apnea a lot of times that will be more if they're not
compliant with doing the exercises as prescribed they're they won't do well either because every
exercise we give is a building block so if we meet and they haven't done the exercises really just
give the same ones until they get those down and then we can move forward so do you like test them
before they move on to the next step or yeah oh wow that's so cool yep so we have them do specific
things we explain to them what we're looking for you know do this exercise but we don't want
you activating them tell us so look at yourself in the mirror try to relax at the best you can
we're giving exercises if they can't do it after so many sessions then we know that there might be
a restriction there that we need to roof route to provide evaluate that a little bit more i see so
if they can't get around it then they might have to have a surgical release or something like that
yeah and that's where either the dentist or the innocent throw physician whoever is performing
that release comes into the integrative approach of everything cool yeah so uh
usually about 12 sessions it's usually about at least six months of therapy which seems like a
really long time but it does go by pretty fast um and then the end goal is to have those four goals
um you know nasal breathing lips closed tongue on the roof through the mouth and proper swelling
not pushing against the teeth at all or using any muscles that are compensating um anything
else amanda any other questions about the way i do things so putting that into like a an actual place
would be pretty similar can you go over a little bit about i think you mentioned briefly that you
could be a dentist slp or a hygienist in order to become an omt but can you go over just real
briefly like what the classes are like i know you told me about it but just so we can share
with our viewers how they could get maybe their hygienist in their office or the dentist certified
yeah so it does you don't have to be certified that's where it's kind of going the field is going
it's not a licensed field it's that you have a license before you move on to go
into myofunctional therapy and that license is either a hygiene license an slp license a dentist
some places are even letting pts and ots in just depends on where you go so there's a lot
and i have a whole class that i've given um for anybody that's wanting to explore this field
um and to see the different ways you can go so there's the international association of oral
facial myology that's the iaom that one you have to be an slp or a hygienist or a dentist
in order to take that one it does take a long time and you get certified once you finish that one
i believe you have to take a 24-hour course and then they have to have a test an on-site test you
have to fly the instructor out to watch you wow yeah and it's so many hours and usually that's
pretty legit you can be certified wow okay so there's the cost what's the cost approximately
you know that one it because you have to pay for the instructor to fly out usually i'm not
sure if that's the same with covid that might be a little changed now but um they may start
to be coming out now now that we're kind of a little out of the um the woods with that tiny bit
um but you have to pay for the instructor to fly to you you have to put the instructor up in
a hotel um so those costs vary right um but the 24 or the 24 hour course that i was just saying
you have to take before all that um i believe is most classes are about 2500 24 25. okay it seems
pretty reasonable yeah yeah same with the one i went through was called my mentor that used to
only be open to hygienist now it's um through the breath institute which is that photo that i was
showing you right that one is a 12-week program and it's all online her name is sarah hornsby
she's uh she's awesome she was my mentor for many years i was her associate for a little while there
at the beginning learned a ton of stuff from her uh so yeah that's 12 weeks and that one i believe
is 22 to 24 or 2500 around there that one's not certified but it's a great education the one
that i went through certified specialist in oral facial biology was taught through a behavioral
school back east it's no longer available and it's been taken out of there and it's through sandra
coulson institute and she's located in um colorado and that one also i believe was like an eight or
twelve week course i believe that one was three thousand dollars again she has a lot of knowledge
she's been doing it for over 40 years so i really wanted to learn a lot from her um that's why i
took that course i wasn't too concerned about being the certified part because it's not really
recognized per se yet there's no standardization within each association there is but not overall
um and there's no licensure within state it's not like you have to apply through
your dcca or something like that at the moment right no so at the moment yeah so hygiene and
myofunctional therapy wear different hats so you need hygiene to get into my functional therapy but
you don't you can practice you're basically you're working off your hygiene license
or you're working off your slp license or you're working off your dentist's license
credit and um but i'm not i'm not doing hygiene if that means right right right but you are yeah
but you're you're licensed for that so yeah got it uh and then there was one more so i went to io the
aont academy of oro facial myofunctional therapy and that's aomt info.org i believe i can give you
all this information is there a place they can go to get this information or is it on your website
it's uh i have a link that i haven't put on the website yet my website's being revamped but um i
can provide that i can they can they can you can either give it to me um or they can contact you
either way yeah i'll give it to you um and that one is it used to be a four-day course i've taken
that one as well they didn't have certification at that time now it's a 12-week course and they do
have certification at the end you take the 12-week course and then you have to do a test and then you
have to apply for the certification then i believe in to keep the certification is similar similar
with iaom aomt you have to pay yearly fee and do so many units in order to continue to have your
certification with them got it got it and then um i don't know if you're going to go over this but
um billing i know you and i talked about this i want to make sure everyone else knows billing
insurance does it happen does it not really happen how do people pay for it how do patients pay for
it tell me a little bit more about how that works sure so uh the billing portion um is pretty simple
um i usually do fee for service if they're in california um i usually will give a super bill
and that's because that's where my hygiene license does come into play and since i'm licensed as a
hygienist and my mpi is through there that's why i only give it for then um but they do
have to have it's usually through medical insurance right so it's not through dental
insurance it's not a covered benefit so it can be a little hairy it can take a lot of time
and usually most patients don't even deal you know i just tell them up front this is how much
it is i usually have them pay for 12 sessions up front if they want to do that i get 10 off or they
can do six payments and the reason why i do it that way is because i want them to know it's not
a one or two session thing and you're going to be fixed and it takes a commitment um and then
at the end if they want that super bill i can send it to them if they have a medical diagnosis for
you otherwise it's not usually a covered benefit because there's no um documentation so they'd
probably have to have an md diagnose it and then they would be the ones that could so
i know some dentists do do medical billing but it's a huge pain from what i've heard so yeah
unless you're already doing medical billing um i think they have some agencies you can use for that
correct yeah outsourcing yeah all right that's that's really good to know an approximate price
point i mean you can talk about what you charge or what the average kind of fee is i know probably
california is a slightly different price than maybe some parts of the country but you know just
an estimate of what people charge for perception so i charge um well the package for 12 sessions i
do 2400 10 off if they pay in full and so on um i've had most there are some therapists that do
per session but they're finding that patients aren't staying as committed so mostly we're
going through the packaged pricing i would say um i have some friends uh my functional therapist in
like georgia and they're more like 100 150 a session depending um the other thing is i
do free 30-minute informational consultations that is just for them to get to know me and
make sure that we're a good fit and even see like you know this is i've heard of this what is this
just to get an idea and i can do a little mini assessment and then i charge 99 for the full
hour of consultation and i've had people other therapists say oh my gosh that's so cheap that's
so much work i can't believe you charged so little and i was like well most people don't
know what it is and i want them to understand how this can impact their health so for me
i think most charge between 150 to 350 for their consultation and then i've had
some therapists especially in california that i know up to six thousand dollars
for wow it's very broad i would say i'm pretty average especially not just california because i
have patients or fellow myofunctional therapists in nebraska utah georgia and they're all about
about the same no just like orthodontics we often give the full assessment um treatment
plan for free records you know we don't always charge for that or really really low
you know um you know but it's the right thing to do giving the patient the information from there
they can decide if they want treatment or not so you know we don't always make money off that
but you know i i enjoy it's my favorite part of treatment so yeah that's good perfect yeah that's
why i do the 30 minutes just so they don't feel like they're committed financially and because
a lot of them like i said just go what what yeah is your specialty i don't even know how to say it
yeah yeah yeah i got it so um are most of the doctors that that bring you in um do some
patients find you and then you just work with them out and there's no like doctor referral or
most of the time do doctors bring you in for a particular patient so usually doctors bring me
in but i've had many i've had people like across the united states somehow found me um so they're
not particularly referred from a dentist or an or any physician um they have knowledge but then i
always reach out to their physicians and dentists oh that's good okay because that's really good
it like i said it's a team approach i i'm not gonna i don't do orthodontics and that's a
lot of things necessary right reason for in some cases and then obviously in your nose and throat
physician if there's something going on with the nose i'm just working with the muscles but
the muscles aren't individualized either they're connected to right and so and there's a reason
why they're not working properly and we've got to figure out why and i got to find those specialties
um so the patient can be best supported so speaking of orthodontics since you brought
that up and everyone knows i am an orthodontist i just had a consultation session with one
of my doctors about an hour two ago he was showing me this open bite patient that he had
i was looking at it um and i go oh there's some type of habit look at the face look at this look
at that you know um and i said i would not treat this patient is what i told them unless they were
doing some type of first of all we got to find the root cause everything you were saying is what i
said and he's like what what i didn't know about this you know so and i said it it is going to
even if you can he goes well i know i can cl i can close this with brackets you know um it'll
it'll close i said but will it stay because i mean i've seen them relapse so many times i said
you don't know you know so how would that work if you were trying to implement it let's say you had
that kind of mild to moderate open by patient we know we need something like omt to come in would
they do it before they started the ortho is it during the ortho how do you kind of integrate that
so some patients will come to me where they're already in ortho so
and everybody's so different so i if it's the only time i really will wait for my functional
therapy is if there's a palatal expander because we can't get that tongue to the roof of the mouth
because it fits the tongue right so what if it's a removable power expander and how long it depends
on how long they'd have to wear it which is often correct oh 24 hours a day for six months yeah yeah
so even though they remove it they still can't get contact yeah yeah yeah yeah yeah because
there's because it take there's a thickness to it so okay so better to wait till the expansion is
done before you start that but otherwise as long as there's no appliance on the roof of the mouth
um you should be good to go do you so they can start at any time or do you want to hit
so many sessions before they actually start their ortho or does it really not matter
it usually doesn't matter in that sense if there is no expander then we just want to
make sure my functional therapy and all those compensations are done before ortho comes off
right because we don't want that thrusting or any other issues that they're having to relapse
got it got it awesome that was just super super helpful thank you so much tamara for all the
information anything else that you wanted to add for doctors out there they can contact you through
the email through the website anything like that if you have any other last minute thoughts
oh yeah they can contact me at tamara facialphysique.com selena
is my associate she's been with me for a couple years now she's been doing excellent
and then the qr code goes to facial physique.com there'll be more information up there right now
it's my older website but i'm revamping it a lot of more resources on there for doctors
and hygienists and patients so perfect thank you so much tamara for meeting with us today really
appreciate you guys should definitely reach out to her if you have any questions thank you thanks