How to Measure MIO
Posted by Sarah Schuman, M.S. CCC-SLP on 11/11/2021 to
General Medical and Dental Information
Mouth opening is measured as a MIO or ROM distance. MIO (maximal interincisal
opening) is the distance between the central incisors when the mouth is fully open.
Average MIO for adults is approx. 50mm. By measuring MIO, a therapist can determine
if a patient is WNL or has trismus. ROM (Range-of-Motion) is the maximum distance
the mandible moves. ROM and MIO may be different, e.g. patients with an open bite.
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Dysphagia and the Tongue
Posted by Sarah Schuman, M.S. CCC-SLP on 6/10/2021 to
Dysphagia & Oral Motor Control
Trismus in HNC Patients - 2020 Update
Posted by Sarah Schuman, M.S. CCC-SLP on 11/18/2020 to
Dysphagia & Oral Motor Control
80-90% of patients with radiation to the pterygoid and/or masseter muscles will develop trismus. Learn how to diagnose and treat including therapy with the OraStretch press jaw motion rehab system.
Tongueometer Bluetooth Device Now Available!
Posted by Sarah Schuman, M.S. CCC-SLP on 9/16/2020 to
Dysphagia & Oral Motor Control
BIG NEWS! Tongueometer Bluetooth device now available for iOS and Android devices. Increase tongue strength and endurance with an easy to use, affordable device.
Support Organizations for Head & Neck Cancer & Craniofacial Patients
Posted by Sarah Schuman, M.S. CCC-SLP on 9/9/2020 to
Cleft Lip & Palate
A review of a few of the wonderful nonprofit organizations within the HNC, dysphagia and craniofacial communities to support patients as they face these challenges.
Oral Mucositis in HNC Patients
Posted by Sarah Schuman, M.S. CCC-SLP on 6/2/2020 to
General Medical and Dental Information
Spring 2020 Newsletter ORAL MUCOSITIS IN HEAD & NECK CANCER PATIENTS Oral Mucositis occurs in up to 80% of HNC irradiated patients! What is oral mucositis (OM)? Mucositis is the inflammation,
How Strong Is Your Tongue? and Other Fun Facts...
Posted by Sarah Schuman, M.S. CCC-SLP on 5/11/2020 to
Dysphagia & Oral Motor Control
FUN TONGUE FACTS How long is the tongue? The average tongue is approximately 3 inches in length. According to the Guinness World Records, as of May 2020, the longest tongue record goes to Nick Stoeberl whose tongue measures 3.97
LEARN & EARN!!! SLP CMH REMOTE IN-SERVICE: Oral Complications of Head & Neck Cancer Care -- Trismus, Xerostomia, Mucositis & Dysphagia
Posted by Sarah Schuman, M.S. CCC-SLP on 3/16/2020 to
Dysphagia & Oral Motor Control
Earn .1 CMH (1 hour) towards ASHA requirements with a remote live in-service. Speech pathologist, Sarah Schuman, is providing a free in-service on trismus, xerostomia, mucositis and dysphagia in HNC cancer patients. The in-service takes approximately 1-hour and you will have the ability to ask all of your HNC rehab questions!
Please contact us via email to [email protected]hab.com or call us at 1-800-206-8381 ext 86 for scheduling.
Saliva and Xerostomia in the HNC Patient
Posted by Sarah Schuman, M.S. CCC-SLP on 3/12/2020 to
Dysphagia & Oral Motor Control
Head & neck cancer patients often develop acute and chronic xerostomia and dry mouth. 
Learn more about the causes, diagnosis, and treatment of xerostomia and dry mouth.
Learn more about the causes, diagnosis, and treatment of xerostomia and dry mouth. The Psychological Burden of HNC Survivorship on Patients and Caregivers
Posted by Sarah Schuman, M.S. CCC-SLP on 12/10/2019 to
Dysphagia & Oral Motor Control
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New Research! When is it best to start trismus therapy?
Posted by Sarah Schuman, M.S. CCC-SLP on 10/10/2019 to
Head & Neck Cancer, Radiation Therapy
When is it best to start trismus therapy? Treatment for head and neck cancer may cause trismus, xerostomia and dysphagia negatively impacting a patient's quality of life (QOL). A new study, Effects of jaw exercise intervention timing on outcomes following oral and oralpharyngeal cancer surgery: Pilot study (, , , et al, 2019), looks at the optimal timing for exercise initiation post-operatively in HNC patients. Initial findings suggest early exercise intervention has a positive effect on some QOL measures!
Radiation Fibrosis - Development & Impact in HNC Patients
Posted by Sarah Schuman, M.S. CCC-SLP on 8/21/2019 to
General Medical and Dental Information
Radiation, commonly used in the treatment of head and neck cancer, may negatively affect healthy cells by increasing the production of the protein, fibrin which damages soft tissues in the treatment field potentially leading to trismus, or limited mouth opening. Trismus affects patients negatively by making it difficult to speak, eat, maintain good oral hygiene, receive dental procedures and it even has the potential to complicate intubation. In patients that receive radiation treatments, approximately 30% will develop trismus. If the treatment field includes the pterygoid or masseter muscles incidence rises to above 80%. Loss of maximal interincisal opening (MIO) is continual and progressive in these patients. Therapeutic exercises will need to continue for the rest of the patient's life! The good news is that trismus is preventable and treatable with exercise therapy using jaw motion rehab systems such as the OraStretch press.
New Research Reinforces Prevalence of Trismus in HNC Patients up to 10 Years Post Treatment
Posted by Sarah Schuman, MS, CCC-SLP on 7/23/2019 to
Head & Neck Cancer, Radiation Therapy
New Research! Systematic review and meta-analysis reinforces the significant prevalence of trismus (equal to or less than 35 mm MIO) in HNC patients up to 10 years post treatment.
HPV Vaccine is Key in Fight Against Cancer
Posted by Sarah Schuman, MS, CCC-SLP on 7/1/2019 to
General Medical and Dental Information
HPV Vaccine In The News!!!!
In June 2019, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices approved the use of the HPV vaccine in some people through the age of 45. By expanding the pool of approved people, more insurance providers may cover the vaccine.
CranioRehab Update and Research Refresh
Posted by Sarah Schuman, M.S. CCC-SLP on 6/17/2019 to
Cleft Lip & Palate
CranioRehab Update & Research Refresh. Review "Correlation Between Radiation Dose to Pterygoid and Masseter Muscles with Trismus" and "Successful Rehab of Facial Burns Using Jaw Motion Rehab Systems Including the OraStretch Press". Learn about CranioRehab products.
Actress Aims to Destigmatize HPV- Related Cancers
Posted by Sarah Schuman, M.S. CCC-SLP on 6/11/2019 to
General Medical and Dental Information
In an effort to end the shame surrounding cancers caused by the human papillomavirus (HPV), actress Marcia Cross shares her personal story with anal cancer as well as her husband's with throat cancer.
New Research Correlates Radiation Dose to the Masseter and Pterygoid Muscles with the Development of Trismus (Article Review)
Posted by Sarah Schuman, MS, CCC-SLP on 5/21/2019 to
Head & Neck Cancer, Radiation Therapy
Reconfirmed!! New research reinforces the correlation between radiation dose to the masseter and pterygoid muscles with the development of trismus.
The study “Radiation dose to the masseter and medial pterygoid muscle in relation to trismus after chemoradiotherapy for advanced head and neck cancer” stresses the impact of radiation dose on the ipsilateral masseter muscle and the ipsilateral medial pterygoid muscle in head and neck cancer patients. A meaningful analysis of data was conducted across 83 patients treated for advanced squamous cell carcinoma of the head and neck. These patients participated in a preventive exercise program for mouth opening and MIO measurements were compared. The study concluded that radiation dose on the ipsilateral masseter muscle and ipsilateral medial pterygoid muscle is predictive for trismus.
Xerostomia in HNC Patients
Posted by Sarah Schuman, MS, CCC-SLP on 2/5/2019 to
Dysphagia & Oral Motor Control
Xerostomia, "dry mouth" is due to reduced or absent saliva production. It may affect a patient's quality of life and can lead to serious health problems! Learn about the signs, symptoms and managing xerostomia.
Living with Xerostomia - Mouth Care and Gum Health
Posted by Sarah Schuman, MS, CCC-SLP on 1/16/2019 to
Dysphagia & Oral Motor Control
Living with Xerostomia? Tried and true tips from cancer survivor Speech Pathologist, Marcy Maksail, for Saliva Substitutes, Mouth and Gum Health.
IMPORTANT HPV VACCINATION UPDATE!!!
Posted by Sarah Schuman, MS, CCC-SLP on 12/17/2018 to
General Medical and Dental Information
On October 5, 2018, the U.S. Food and Drug Administration (FDA) approved the administration of the Gardasil 9 vaccine for women and men between the ages of 28-45 years. Previously the vaccine was indicated for individuals up to the age of 27 years. "Gardasil 9 prevents certain cancers and diseases caused by the nine HPV types covered by the vaccine". Human Papilloma Virus (HPV) can cause head and neck cancer in men and women. It is the cause of most oropharyngeal cancers in United States. These cancers and their treatment may lead to trismus (limited mouth opening) and dysphagia (difficulty swallowing).
The expansion in vaccination ages follows a study in which 3,2000 women between the ages 27-45 years were followed for approximately 3.5 years and it was found that Gardasil was 88% effective in preventing certain HPV related infections and cancers. The results were inferred to apply to men as well.
For further information, please see the complete FDA News Release at: https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm622715.htm
Swallowing Difficulties and the Holidays
Posted by Sarah Schuman on 12/14/2018 to
Dysphagia & Oral Motor Control
Difficulty swallowing, dysphagia, may cause the sufferer to feel embarrassment eating and drinking around friends and family. This may lead to lack of participation during holiday celebrations. With some adjustments it is possible to make celebrations inclusive and enjoyable for all. We, at CMR, wish you and yours a very happy holiday season.
When to order a Jaw Motion Rehab System for Trismus Prevention from Radiation Therapy.
Posted by Rob Christensen on 11/1/2018 to
Dysphagia & Oral Motor Control
When should you recommend using a jaw motion rehab system like the OraStretch press to prevent trismus after radiation therapy? Who is most at risk for developing trismus from radiation treatment? We provide research and a decision tree to help you prevent trismus in head & neck cancer patients.
Trismus in Head & Neck Cancer
Posted by Sarah Schuman, MS, CCC-SLP on 5/25/2018 to
Head & Neck Cancer, Radiation Therapy
Trismus, or restriction to mouth opening, has many implications including difficulty speaking, eating, maintaining oral hygiene, receiving dental procedures and may even affect intubation. Typical measure of mouth opening is 50 mm and highly correlated to body size. An opening of 35mm or less is considered trismus. Trismus is preventable and treatable by engaging in exercise therapy and treatment using jaw motion rehab systems such as the OraStretch® press.
HPV and Oral Cancer - Signs and Symptoms
Posted by Sarah Schuman, MS, CCC-SLP on 2/12/2018 to
General Medical and Dental Information
HPV is the most prevalent sexually transmitted virus. The best screening for HPV related oral cancer is by a medical or dental professional. However there are signs and symptoms that the individual can monitor.
Article Review on Trismus incidence and impact on quality of life in head and neck cancer patients (2013)
Posted by Sarah Schuman, MS, CCC-SLP on 2/5/2018 to
Head & Neck Cancer, Radiation Therapy
This study assesses the negative impact of trismus (restricted mouth opening) on head and neck cancer patients daily life activities. 6-12 months post-treatment trismus was found to impact quality of life with decreased mouth opening, jaw related problems, eating limitations, muscular tension, dry mouth, swallowing and pain as well as anxiety and depression both pre- and post-treatment.