Lessons from Local Leaders:

Angela Richwine

The Answer Nobody Gave Her: How Angela Richwine Built Renew Myo From a Mother’s Gut Feeling and Three Decades of Hard-Won Knowledge

She was a dental hygienist for over 30 years. She had the training, the credentials, and the clinical eye. And still, nobody — not her doctors, not her specialists — could tell her what was wrong with her son. That gap became her life’s work.

A Question That Wouldn’t Go Away

Angela Richwine didn’t plan to become a myofunctional therapist. She planned to clean teeth.

She came to dentistry the way a lot of people come to their calling — sideways, through a chance encounter. At 19, working weekends at TGI Fridays while figuring out her next move, she kept cornering a coworker who happened to be a dental assistant. The woman finally told her to stop asking questions and just come apply. Angela did. Four years later, a hygienist told her she had the instincts for the job and pushed her toward hygiene school. She went, graduated, married a Marine, took her boards in California, worked on and off base, moved across the country and back, and built a career that would span more than three decades.

Then her oldest son was born.

He had trouble latching from the start. Nursing was so painful that Angela says she “saw stars.” He was a mouth breather, had repeated ear infections. He had clogged tear ducts. Before he turned three, he went under general anesthesia twice — once for ear tubes, once to probe the tear ducts that kept blocking. Doctors offered medications and procedures. None of them offered a reason.

“I knew something wasn’t right,” Angela says. “I just went to doctor after doctor, and they’re like, ‘No, let’s put him on this medication and that medication.'”

She was a new mom, working part-time, with a husband on deployment. She was, in her own words, in survival mode. So she stopped pushing.

She regrets that. And it became the reason she never stopped pushing again.

The Continuing Education Class That Changed Everything

When her youngest was still under three, Angela drove from North Carolina to Virginia for a continuing education course. What she heard in that room felt, she says, like it was written specifically for her.

The course introduced her to orofacial myofunctional therapy — a field she had never been taught in dental hygiene school, despite spending decades looking inside people’s mouths. Everything she heard connected to her son’s history in ways that made her want to go back and do it all over again.

“His life has just been an awakening for me,” she says.

She has now been learning about myofunctional therapy for 19 years. She has watched the research expand, watched the field gain traction in dental and medical communities, and watched other parents arrive at her door carrying the same exhausted look she once wore — the look of someone who has been told to wait and see one too many times.

Her practice, originally called Central Virginia OMT, recently rebranded to Renew Myo. The new name carries everything she has been through. Divorce, a new home, a new office, a rebuilt sense of self. The word “renew” was not chosen lightly.

“It was a renewing of myself,” she says. “Finding myself again.”

What Myofunctional Therapy Actually Is

The word is a mouthful. Angela acknowledges this with a laugh.

Orofacial myofunctional therapy — OMT — focuses on the muscles of the mouth and face, specifically how they function in relation to breathing, sleeping, eating, and overall development. Myo means muscle. Orofacial means the mouth and face. Together, the field addresses what happens when those muscles aren’t working the way they’re supposed to — and what that dysfunction costs the rest of the body.

The most common issue Angela sees is mouth breathing. It sounds minor. It isn’t.

The nose is the body’s built-in filtration system. It warms, filters, and humidifies the air before it reaches the lungs. When someone breathes through their mouth instead — whether because of a structural obstruction, a habit formed in infancy, or an untreated tongue tie — they bypass all of that. Over time, the consequences compound. Poor sleep. Reduced oxygen quality. Reduced attention span. Altered facial development. A cascade of compensations that show up in the neck, the back, the posture, the gut.

“If you have gut health problems, it’s going to show up in your mouth somewhere,” Angela says. “Or somewhere in your body.”

She has spent enough time studying fascia — the connective tissue webbing that links every part of the body — to understand how deeply interconnected these systems are. Sprain an ankle and you start compensating on the other side. Breathe through your mouth for years and your facial muscles elongate to accommodate it. The body always adapts. The question is whether that adaptation is helping or quietly accumulating damage.

The Signs That Are Common But Not Normal

Angela has a phrase she returns to often: common but not normal.

A child who snores is common. It is not normal. A child who sleeps with an arched back and a tilted head — what looks like a cute sleeping position — may be repositioning to open their airway. Tossing and turning through the night. Bedwetting at ten, eleven, twelve years old. Thumb sucking that persists past the age it should. Dry, cracked lips in a teenager. Repeated ear infections in an infant. Spitting up constantly after nursing. All of these are signals, and most of them are dismissed or medicated rather than investigated.

She knows because she lived it. She knows because she sees it every single day.

“I just took a really deep breath,” she says, when asked how often patients arrive having been told there’s nothing to be done. “Because that is what we see every single day.”

The parents who find her are usually the ones who didn’t accept the answer they were given. They’re the ones who went home, searched online, asked questions at playdates, found a social media group, and eventually ended up in her office with a file full of dead ends and one more question: is there anyone who can actually help?

The answer, she tells them, is yes. And she means it.

Tongue Ties, Palate Expansion, and the Architecture of the Airway

Angela’s own mouth is currently home to her sixth orthodontic appliance. She mentions this with a kind of wry self-awareness — she spent decades helping other people’s teeth, she says, while always putting her own care last.

The device she’s wearing now is a palatal expander. It’s fixed in place, bands cemented onto her back molars, anchored into the palate with small titanium screws called TADs. When she turns it, the two bones of the upper jaw — the maxilla — slowly separate along the midline suture that runs from the nose down between the front teeth. The roof of the mouth and the floor of the nose share one thin piece of bone. As the jaw widens, that bone shifts, the nasal passage opens, and the tongue gains the space it needs to rest properly against the palate.

That last part matters more than most people realize. The tongue, at rest, should sit fully against the roof of the mouth. When the palate is too narrow — whether from a tongue tie, a pacifier used too long, soft foods that never demanded chewing, or simply genetics — the tongue can’t get there. It drops. It pushes against the teeth or retreats toward the airway. And the problems follow from there.

Tongue ties are a significant part of this picture, but Angela is careful about the order of operations. You don’t release a tongue tie until there is enough space in the palate for the tongue to actually go afterward. Release it too soon and the tongue has nowhere to land. The myofunctional therapist’s job is to prepare the mouth before the release and to retrain the muscles after it, ensuring the tongue heals correctly and learns to function in its new freedom.

“After the tongue is released, it’s like a carnival ride,” she says. “We need to make sure it’s functioning and healing the right way.”

A Collaborative Practice at the Center of a Circle

Myofunctional therapy does not operate in isolation. Angela is emphatic about this.

Her referral network includes orthodontists, ENTs, dentists trained in palate expansion, speech and language pathologists, occupational therapists, physical therapists, and craniosacral therapists. A patient who comes to her may leave with a referral to three other providers. A patient referred to her from an orthodontist may need airway imaging, a palate expander, and six months of muscle retraining before any other treatment begins.

She describes her role as sitting at the center of a circle — connected by tethers to every other specialty that touches the airway and the face. The goal isn’t to keep patients in her office. It’s to get them to the right people in the right order.

Her oldest palate expansion patient is 70 years old. Her youngest patients are under five. The work is never cookie cutter, she says, borrowing a phrase she loves: there is no such thing in healthcare. Every body compensates differently. Every patient arrived at their dysfunction through a different combination of anatomy, habit, environment, and neglect — their own or their providers’.

What they all share is a history of being told to wait, medicate, or accept.

Why the Gap in Awareness Exists

Angela is not angry at the providers who missed these signs. She is frustrated with the system that never trained them to look.

“Airway awareness is just not taught in healthcare curriculum,” she says. “We can’t really put blame on the physicians. But when they attend their annual conferences, more and more professionals are getting up on the podium and delivering this information.”

Whether those professionals choose to absorb it is a different question. Angela has knocked on enough closed doors to know that the resistance is real. She has been told, in various ways, that what she does is pseudoscience. She pushes back on that calmly and with evidence — the research is there, she says, and it is growing. The question is whether people are willing to encounter it with an open mind.

Angela believes the tide is turning. She sees it in the conferences she attends, where more orthodontists are discussing airway, more pediatricians are asking about sleep, more dentists are training in palate expansion. She sees it in the parents who arrive in her office already knowing what they’re looking for — who found her not through a doctor’s referral but through a Facebook group or an Instagram story or a conversation at a school pickup line.

The parents, she says, are often more informed than the providers now. That’s not an indictment. It’s an opportunity.

Renew Myo: A Practice Built From the Ground Up

The rebrand from Central Virginia OMT to Renew Myo was not just a name change. It was a marker of everything that had shifted.

Angela started her practice just before COVID, working from home, newly navigating a divorce and a fresh start. She bought a new house. She opened a new office. Opportunities arrived that she doesn’t think would have found her otherwise. And as her reputation grew, so did the requests for mentorship — other therapists asking to shadow her, to learn from her, to understand how she structured her cases and guided her patients.

She took them on. Two are now based in Northern Virginia. One is in Alabama, having found Angela through her educational content online. Together, they operate under the Renew Myo umbrella, with Angela still leading assessments, mentoring through cases, and ensuring the standard of care she has spent nearly two decades building.

Her grand reopening earlier this year drew local officials, referring providers, and the community she has cultivated through years of showing up consistently and knocking on those doors. A state senator spoke. The mayor offered kind words. Her youngest son brought a friend. Her other sons sent good luck from afar.

“The love, the support, the smiles on everybody’s faces,” she says. “It just reignites the passion.”

What’s Coming: Sprout

Angela is writing a book. It’s called Sprout.

She co-developed it with a Long Island dentist who has spent decades working in airway — a collaboration that began at the World Dental Sleep Society conference in Baltimore, where the two of them sat with a laptop open while everyone else was dancing. Sleep surgeons looked over and asked what they were doing. They were building something.

Sprout will be part of a nonprofit Angela is developing to bring airway screening into public schools. The tools already exist — validated screening instruments that any teacher or healthcare assistant can learn to use. The barrier isn’t knowledge. It’s access, curriculum, and institutional will.

“Let’s start screening for airway for these children,” she says. “Let’s give them the opportunity to breathe and sleep and thrive and grow.”

She knows she may not see this fully realized in her lifetime. She says so with honesty and without self-pity. But she also knows that seeds take time, and she has been planting them for a long time.

One family at a time. One provider at a time. One conversation at a time.

Connect with Angela Richwine and Renew Myo

Website: renewmyo.com

Instagram: @renewmyo

Facebook: Renew Myo

Renew Myo serves patients of all ages in Fredericksburg, Virginia and beyond, with team members also based in Northern Virginia and Alabama. If you’ve been told to wait and see — or if you’ve just had the feeling that something isn’t right — reach out. Jen, their patient coordinator, has a medical background and will help you figure out the right next step.

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