Tethered Oral Tissues

Tethered oral tissues (TOTs), otherwise known as tongue/lip/buccal ties, affect appropriate movements of oral structures for adequate food management, swallowing, natural oral cleansing, and speech.

These are the main symptoms associated with tongue/lip/buccal ties:

• In breastfeeding, unsustained and/or shallow latch, colic and/or irritability, gassiness, falling asleep at the breast, extended feedings, frequent short feeds, poor weight gain, clicking, anterior breastmilk loss, gagging; maternal nipple pain/trauma, recurrent thrush/ mastitis, combative behaviors;
• Gastrointestinal tract issues including gassiness, hiccups, vomiting, and acid reflux-like symptoms;

• During bottle feedings, clicking, anterior liquid spillage, extended feedings, poor weight gain, GI symptoms (GER, gas, hiccups), frequent short feeds, collapsing bottle nipple, combative behaviors, and gagging;
• During solid feedings, difficulty transitioning to purees and table foods; poor intake and weight gain, gagging, refusals and negative mealtime behaviors, packing, expulsion, difficulties with fibrous, multi-textured foods;
• In speech production, speech related issues with difficulty articulating “t, d, z, s, th, n, and l” sounds.

Following the most advanced recent medical research, we now provide comprehensive:

• Evaluation for presence and impact of tethered oral tissues on your child’s oral function, including proper oral exam and necessary referrals to outside preferred providers to obtain surgical intervention when appropriate;
• Execution of a treatment plan for optimizing oral function in the presence of tethered oral tissues, including active wound management and specific treatment techniques;
• Education and communication with caregivers and other medical professionals regarding identification and treatment of tethered oral tissues, including educational tools and resources.