Tethered Oral Tissue:
Tongue, Lip and Buccal Ties
What is Tethered Oral Tissue?
Let's talk about common signs and symptoms of tethered oral tissues. Tethered oral tissues (TOTs) is another name for tongue, lip and buccal ties. TOTs or ankyloglossia, is a condition that occurs when the frenulum (the band of tissue that connects the tongue to the floor of the mouth, cheeks to the gums, or lips to the gums), is too tight and restricts range of motion.
Signs and Symptoms of TOTs:
Infant Issues:
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Noisy suckling/clicking
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Inability to latch to the breast
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Popping on and off the breast
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Leaking milk out of sides of mouth (breast or bottle)
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Poor weight gain
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Coughing or gagging
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Lip Blisters
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Gas Pain
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Noisy breathing/snoring sounds when sleeping
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Mouth breathing
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Sleeping with mouth open
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Reflux or colic symptoms
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Chomping at the breast
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Body tensions
Child Issues:
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Coughing or gagging when eating
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Messy eating
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Noisy breathing/snoring sounds when sleeping
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Mouth breathing
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Sleeping with mouth open
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Body tension
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Speech issues
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Teeth grinding
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Dental problems
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Picky eating
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Behavioral concerns
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Jaw pain
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Limited tongue movement
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Narrow palate
How can our therapies help with TOTs?
Adult Issues:
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Limited tongue movement
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Mouth breathing
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Poor oral health
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Snoring/Sleep apnea
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Neck tension/headaches
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Difficulty speaking
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Heart-shaped tongue
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Dysphagia
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Recessed jaw
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Teeth grinding
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Digestive issues
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Tongue thrust
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TMJ
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Narrow palate
How does our therapist help with TOTs?
Our therapist can help by doing a full functional assessment to check for tethered oral tissue. She will assess tongue range of motion such as lift, lateralization and extension of the tongue, the palate, teeth placement, and other areas of the face, mouth, jaw and nose to diagnose the condition and recommend a treatment plan. That treatment plan may consist of: Myofunctional or oral motor therapy, feeding therapy, bodywork including Feldenkrais Method, Craniosacral therapy techniques, and more. When she and you feel as though you’re ready, she will refer you to a trusted release provider if releasing the tethered oral tissue is necessary.
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Body tensions are a side effect of TOTs. This can be in the neck, shoulders, jaw or elsewhere in the body. The tongue is connected down to the toes through the deep front line. If the tongue is tight, most likely there is tightness elsewhere. We suggest bodywork to help relieve the tension BEFORE seeing a release provider with continuation of therapy afterwards.
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The procedure to release the tethered oral tissues is called a frenectomy or frenotomy. This severs and releases the tight frenum allowing it freedom of movement. Usually this is done with laser or scissors by a dentist, ENT or other medical professional. We refer to specific release providers based on good outcomes and experience. Some medical professionals say that they can release the tissue but do not release completely and another procedure is necessary to alleviate symptoms. Our therapist also takes into consideration patient location and financial situation when choosing the best release provider for them.
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The goal is to achieve function to set our patients up for good oral function for a lifetime! Remember that when dealing with TOTs, it's a journey and not a magic fix.
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We provide specific pre-procedure and post-procedure appointments to help ensure good healing during the critical window of wound healing.
