Vulnerable populations—cancer survivors, TMJ patients, post-surgical patients—are suffering unnecessarily due to a critical care gap. Research-based orofacial massage, orofacial rehabilitation, and orofacial recovery therapies can prevent and relieve this suffering, yet lack of regulations, billing codes, and insurance coverage creates barriers to access. This resource advocates for interprofessional training, clear guidelines, and equitable access to these safe, holistic, non-invasive orofacial health therapies.
Vulnerable populations are suffering unnecessarily. Cancer survivors experience radiation-induced trismus and pain. TMJ patients endure chronic dysfunction affecting eating, speaking, and quality of life. Post-surgical patients struggle with scarring and limited mobility. Research proves orofacial massage can relieve this suffering—yet patients cannot access it.
The barrier? Lack of regulations, billing codes, and insurance coverage. Without clear practice act guidelines, qualified healthcare professionals cannot provide this therapy. Without billing codes, insurance won't cover it. Patients who need it most—those facing cancer treatment, chronic pain, surgical recovery—cannot afford out-of-pocket costs.
The solution: Interprofessional training and clear guidelines. Multiple healthcare professions can safely provide this therapy with proper training. Dental providers (dental hygienists, dentists, dental therapists) are excellent candidates because they are already licensed to perform oral health assessments—a critical safety requirement before intraoral massage. When non-dental providers perform orofacial massage, interprofessional collaboration with dental professionals is essential to ensure proper screening and prevent complications.
This website advocates for: (1) Clear guidelines in interprofessional practice acts, (2) Standardized training and certification pathways, (3) CPT/CDT billing codes for insurance reimbursement, (4) Broad provider access to ensure geographic and economic equity. Every patient deserves access to this research-based, safe, holistic, non-invasive therapy.
Patients need access to orofacial massage where they live, when they need it, covered by insurance. Training multiple healthcare professions ensures geographic reach, reduces wait times, and creates competition that improves quality and affordability. Each profession brings unique expertise—oral health assessment, musculoskeletal rehabilitation, functional therapy—creating a comprehensive care network. With standardized training and clear guidelines, we can close the care gap and serve vulnerable populations effectively.
Many of these providers are already trained in orofacial myofunctional therapy (OMT), which provides the foundational knowledge needed for orofacial massage: orofacial anatomy, muscle function, assessment protocols, and therapeutic techniques. Speech-language pathologists, occupational therapists, dental hygienists, and dentists commonly receive OMT training as part of their practice. This existing competency makes additional training in intraoral and extraoral orofacial massage efficient and cost-effective—building on established skills rather than starting from scratch.
Critically, any intraoral work requires thorough assessment of the health and condition of the teeth, gingiva, bone, tongue, and surrounding structures. This intraoral assessment must be performed before massage therapy begins to identify contraindications such as active infections, lesions, loose teeth, periodontal disease, or other conditions that could be aggravated by manual therapy. Performing intraoral manual therapy without proper training, certification, or legal authorization exposes practitioners to significant professional liability, malpractice claims, and potential regulatory sanctions. This is where interprofessional collaboration becomes essential—and why dental providers (dental hygienists, dentists, dental therapists) are uniquely positioned to provide comprehensive, safe orofacial massage services within their established scope of practice.
Certificate/Diploma (500-1000 hours)
Direct provider of orofacial massage with specialized training
Associate's or Bachelor's degree
Direct provider with oral health assessment capability
Doctoral degree (DDS/DMD)
May perform directly or refer; comprehensive oral diagnosis
Bachelor's or Master's degree
Limited scope; may refer to other providers
Associate's to Doctoral degree
Assessment and referral; specialized NPs may treat
Doctoral degree (DPT)
Direct provider for TMJ/myofascial work; intraoral unclear
Master's degree minimum
Direct provider of orofacial myofunctional therapy (OMT)
Master's or Doctoral degree (OTD)
Direct provider for oral-motor therapy and TMJ treatment
Medical degree (MD/DO) + Residency
Diagnosis and referral; coordinates interprofessional care
Why we urgently need standardized certification for orofacial massage and rehabilitation
Rebecka Clark, founder of orofacial massage and rehabilitation techniques, exemplifies the extensive training journey providers must undertake because no formal certification exists. To feel prepared to safely offer these life-changing therapies, she obtained:
The 28-hour OMT certification does NOT cover orofacial massage and rehabilitation techniques. OMT focuses on muscle function, tongue posture, and swallowing patterns. Orofacial massage and rehabilitation—the manual therapy techniques Rebecka Clark teaches—require entirely separate, specialized training in intraoral and extraoral massage, pain management protocols, contraindication screening, and clinical application for TMJ, cancer recovery, and post-surgical rehabilitation. These are distinct fields with different scopes, techniques, and safety requirements.
This patchwork approach creates massive barriers. Most providers cannot afford the time, cost, and complexity of obtaining multiple licenses and certifications. Patients suffer because too few providers can offer these therapies. Without standardized certification, regulatory boards don't know how to authorize the practice, insurance companies won't create billing codes, and providers face legal uncertainty.
Rebecka Clark created comprehensive training in orofacial massage and rehabilitation to prepare providers to safely perform these therapies. Her vision: train enough qualified providers to demonstrate clinical efficacy and safety, then establish formal certification standards recognized by regulatory boards and insurance companies.
This is why this website exists. We need governing boards to recognize orofacial massage and rehabilitation as a distinct field requiring specialized training and certification. We need billing codes so insurance covers these medically necessary therapies. We need clear practice act guidelines so providers can legally offer these services without fear of regulatory sanctions. The training exists. The research proves efficacy. Now we need the regulatory framework to match the clinical reality.
These vulnerable populations face unnecessary pain, dysfunction, and reduced quality of life—not because treatment doesn't exist, but because they cannot access it.
80% experience orofacial pain after radiation therapy. Trismus (jaw tightness) prevents eating, speaking, and dental care.
Without insurance coverage, many cannot afford treatment and suffer in silence.
Chronic jaw pain affects eating, sleeping, working, and social interactions. Many face years of suffering before finding relief.
Limited provider availability means long wait times and geographic barriers to care.
Scarring, lymphedema, and restricted mobility after oral, head, or neck surgery impair function and appearance. Orofacial rehabilitation and orofacial recovery support is critical.
Lack of billing codes means insurance won't cover orofacial rehabilitation, forcing patients to pay thousands out-of-pocket.
Without CPT or CDT billing codes, insurance companies classify orofacial massage as "not covered" or "experimental."Patients must pay $100-300 per session out-of-pocket. For cancer survivors needing 8-12 sessions, this totals $800-3,600—an impossible burden for those already facing medical bills.
Compare this to physical therapy: Clear billing codes (CPT 97140, 97530) enable insurance coverage for myofascial release. The same therapy applied to orofacial structures should have the same coverage. The only difference? Billing codes and practice act clarity.
This suffering is preventable. Peer-reviewed research from MD Anderson Cancer Center, Memorial Sloan Kettering, and leading universities proves orofacial massage and orofacial manual therapy significantly reduce pain, restore function, and improve quality of life for cancer survivors, TMJ patients, and post-surgical patients. These orofacial health interventions are not experimental—they're evidence-based medicine. Yet patients cannot access them because of regulatory gaps, lack of billing codes, and insurance exclusions. We can end this preventable suffering by establishing clear guidelines, training qualified providers, and ensuring insurance coverage.
Orofacial massage demonstrates significant effectiveness for TMJ disorders, with multiple systematic reviews showing consistent benefits.
Research from leading cancer centers (MD Anderson, MSKCC) shows manual therapy effectively manages cancer treatment side effects.
Manual therapy accelerates recovery and prevents complications following oral, dental, and head/neck surgeries.
Comprehensive benefits extend beyond physical symptoms to improve overall well-being and social participation.
Orofacial massage is supported by robust peer-reviewed research from prestigious institutions including MD Anderson Cancer Center, published in journals such as JAMA Otolaryngology–Head & Neck Surgery. The evidence demonstrates measurable improvements in pain, function, and quality of life.
Systematic review demonstrating that manual therapy is an effective treatment for temporomandibular disorders in the medium term.
Multiple institutions - Systematic Review
Systematic review providing evidence that manual therapy is effective for TMD treatment.
Multiple institutions - Systematic Review
Randomized clinical trial comparing intraoral myofascial therapy to education and self-care for chronic myogenous temporomandibular disorder.
Multiple institutions - RCT
Survey study examining patient satisfaction with massage therapy for TMD.
Survey Study
Study comparing massage alone versus massage with post-isometric relaxation for temporomandibular disorders.
Clinical Study
This research compilation includes 10 peer-reviewed studies with over 344 combined citations. Research institutions include MD Anderson Cancer Center, Memorial Sloan Kettering, and multiple international universities. Publications appear in JAMA, MDPI journals, BMJ Open, and other high-impact medical literature.
Comprehensive state-by-state and province-by-province analysis of orofacial massage regulations across 9 healthcare professions. Use the search and filters below to find your jurisdiction.
Explicitly permits massage inside mouth/oral cavity. TMJ treatment requires written referral.
Source: Ohio Administrative Code Rule 4731-1-05
Last Updated: 2023-02-28
Permitted with specialized training in internal cavity massage, safety protocols, and informed consent.
Source: Oregon Administrative Rule (OAR) 334-010-0029
Last Updated: 2024-01-01
Must obtain special intraoral massage endorsement on massage therapy license.
Source: RCW 18.108.250 (2016)
Last Updated: 2016-01-01
State regulations address internal cavity massage including oral cavities.
Source: 21 N.C. Admin. Code 30 .0516; NC PT Board Position Statement
Last Updated: 2024-06-05
Intraoral treatment recognized in MTAM Standards based on national NHPC standards.
OMT permitted with CDHM-approved training (minimum 28 hours), continuing competency, collaboration with healthcare providers.
Source: MTAM Standards 2023; CDHM Interpretation Guideline Sept 2024
Last Updated: 2024-09-01
Intraoral treatment likely within scope based on national NHPC standards.
NBCDH recognizes OMT as part of scope (2016). Requires adequate education (4-5 day advanced course recommended).
Source: NBCDH Position Paper 2017
Last Updated: 2017-01-01
Intraoral treatment recognized in MTAA Standards. Informed consent required.
Certification required for myofunctional therapy practice.
Source: MTAA Standards; AOMT information
Last Updated: 2024-01-01
BC massage therapists offer TMJ and buccal massage services. Provincial guidelines exist.
Source: BC Personal Service Guidelines; Practice observations
Last Updated: 2024-01-01
TMJ massage including intraoral techniques advertised by practitioners. CMTO regulates profession.
Source: Practice observations; CMTO regulation
Last Updated: 2024-01-01
We call on governing boards, insurance companies, and healthcare organizations to act:
Define orofacial massage and orofacial manual therapy scope for dental hygienists, dentists, physical therapists, speech-language pathologists, occupational therapists, and other qualified professionals with orofacial health expertise.
Develop interprofessional training programs building on existing orofacial myofunctional therapy (OMT) competencies. Many providers already have foundational knowledge—they need specialized training in massage techniques, safety protocols, and clinical applications. Establish minimum hour requirements, competency standards, and continuing education.
Work with AMA and ADA to create specific billing codes for orofacial massage therapy, enabling insurance reimbursement and removing financial barriers for vulnerable populations.
Require health insurance plans to cover evidence-based orofacial massage, orofacial manual therapy, and orofacial rehabilitation for medically necessary conditions including TMJ disorders, cancer treatment complications, and post-surgical recovery.
Authentic experiences from those who have received or provided orofacial massage and rehabilitation care.
"I have been in chronic pain for TMJ. I had my second appointment with Rebecca today and I'm starting to feel relief. I feel like I'm finally on track with a more wholistic approach to my situation. I can't wait for more bodywork next week."
Source: Allimeden - Integrative Orofacial Functional Medicine & Recovery, Seattle, WA
"I had Orthognathic Surgery (DJS) December 2023 and I started therapy about 8 weeks later. Meeting Rebecka and seeing her as my therapist has been a positive experience. I learn something at each visit and the massage session feels FABULOUS. I highly recommend investing in this type of care. I have more knowledge of my surgery outcomes, greater range of motion, and I have a plan moving forward."
Outcome: Greater range of motion, improved knowledge of surgery outcomes, comprehensive recovery plan
"Amazing care, holistic approach with very detailed examination to determine real root cause of your pain. If you have any issues with teeth, jaw, nerve pain this is THE care for you, don't look any further."
Focus: Root cause determination through detailed examination and holistic approach
"Taking a workshop through the Orofacial Recovery Institute has had a profound impact on my confidence when it comes to assessment and treatment skills. I have been able to expand the demographics that I can serve, as well as my modalities, to better treat my current clients. The course material was top notch with many study aides. Rebecka is happy to take on any question. Leaning into the knowledge and guidance offered by The Orofacial Recovery Institute is the best investment I have made in the future of my practice."
Impact: Expanded practice capabilities, improved assessment skills, enhanced client treatment options
Every patient deserves access to evidence-based orofacial massage when they need it, where they live, covered by insurance. Clear regulations, standardized training, billing codes, and insurance coverage will make these outcomes accessible to all.
Help spread awareness about the need for orofacial massage regulations and insurance coverage. Share this comprehensive guide with colleagues, boards, and professional organizations.
Expand your practice and help vulnerable populations access life-changing orofacial massage and rehabilitation therapies. Learn from the founder of the field through comprehensive certificate programs.
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