[YOUR COMPANY NAME]

Date: March 20, 2050

Patient's Information:

Introduction: The enclosed document provides a structured template for an Orofacial Myofunctional Evaluation. This tool is designed for integral evaluation purposes.

Overview: This evaluation is focused on assessing the function of orofacial muscles and oral habits. The results can be used to guide therapeutic planning and monitor improvement.

Evaluation Criteria:

1. Lip Function: Assessing lip strength, range of motion, and coordination.

2. Tongue Function: Evaluating tongue strength, mobility, and positioning during rest and movement.

3. Oral Rest Posture: Examining the resting position of the tongue, lips, and jaw.

4. Swallowing Function: Assessing the swallow pattern, including any signs of dysfunction or deviations.

5. Speech Function: Evaluating articulation, phonation, and resonance.

6. Oral Habits: Identifying any deleterious oral habits such as thumb sucking, tongue thrust, or bruxism.

Instructions:

1. Criteria: Review each criterion listed below to assess various aspects of orofacial myofunctional function.

2. Description: Familiarize yourself with the description provided for each criterion to understand what aspects of orofacial myofunctional function they cover.

3. Score: Assign a score to each criterion based on the individual's performance. Utilize the provided score scale to indicate the level of achievement observed.

4. Comments: Provide any additional comments or observations related to the individual's performance in each criterion. Offer specific feedback to support the assigned score.

Score Scale:

• 1: Poor

• 2: Below Average

• 3: Average

• 4: Above Average

• 5: Excellent

Evaluation Table:

Additional Notes and Comments:

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