Tethered Oral Tissues

The tongue is one of the most critical organs in our bodies. It has the ability to regulate and shape orofacial structures and associated musculature. Unrestricted mobility of the tongue and lip are required for optimal speech, chewing, swallowing, oral hygiene, and breathing functions. Lingual range of motion, coordination, and strength impact the development of the skeletal structures of the jaw and the airway.

Children with a restricted labial or lingual frenulum may have difficulties including:

  • Inability to chew solid foods

  • Gagging, choking or vomiting foods

  • Picky eating

  • Difficulties related to dental hygiene

  • Excessive and persistent drooling

  • Delayed development or regression of speech

  • Behavior problems

  • Incorrect habits of compensation being acquired

For adults, the areas of difficulty spread to include social situations, self-esteem, the work environment, and dental health. Challenges an adult with a tongue-tie may include:

  • TMJ pain, clicks, pops

  • Headaches/migraines

  • Neck tension, pain, and postural dysfunction

  • Protrusion or retraction of the lower jaw

  • Effects on social situations, eating out, kissing, relationships, stress

  • Dental health; tendency to have inflamed gums; increased need for fillings and

  • extractions

Without proper intervention, a child can grow to experience issues with inflamed tissues (e.g., tonsils, adenoids), sleep and airway issues, dental issues, depression, anxiety, ADD, ADHD, bedwetting, irritable bowel syndrome, and headaches.

Assessments of tethered oral tissues, such as tongue tie or lip tie, typically involve a comprehensive evaluation by a healthcare professional trained in identifying and managing these conditions. The assessment may include:

1. Physical Examination: A visual inspection and palpation of the tongue, lips, and surrounding tissues to assess for signs of restriction or limitations in movement.

2. Functional Assessment: Evaluating the functional impact of the tethered oral tissues on activities such as breastfeeding, bottle-feeding, speech development, and oral motor skills.

3. Symptoms Assessment: Inquiring about symptoms that may be associated with tethered oral tissues, such as difficulty latching during breastfeeding, speech difficulties, dental issues, or feeding challenges.

4. Collaboration with Other Healthcare Providers: Collaboration with other healthcare professionals, such as lactation consultants, speech therapists, pediatric dentists, or otolaryngologists, may be necessary to provide a comprehensive assessment and develop a multidisciplinary treatment plan.

Ultimately, the assessment of tethered oral tissues aims to determine the functional impact of the condition on an individual's oral and overall health and guide appropriate management, which may include conservative measures, such as oral exercises or stretches, or surgical intervention, such as a frenectomy. It is important for individuals experiencing symptoms or concerns related to tethered oral tissues to seek evaluation and guidance from a qualified healthcare provider.