PHONE 402-484-0326
Defined
According to the International Affiliation of Tongue-Tie Professionals (IATP), tongue tie can be defined as,
“An embryological remnant of tissue in the midline between the undersurface of the tongue and the floor of the mouth that restricts normal tongue movement.”
The Impact
The negative impact of tongue-tie varies from person to person. Tongue tie can hold the base of the tongue down instead of allowing it to assume its normal resting position on the palate.
Results could include:
+ Dental crowding
+ Narrow palate
+ Tongue that can no longer fit into palate for appropriate rest posture, speech, and swallowing
+ As the muscles of the body relax during sleep, the tongue can fall backward and obstruct the airway.
+ Inappropriate feeding behaviors (gagging, packing, expelling, vomiting, swallowing whole, refusing)
+ Mouth breathing
+ Impacts on craniofacial development ("long face")
+ Increased cavities due an inability to effectively clear the food particles
+ Mumbling or speech errors
In breastfed infants:
Inability to latch/ unsustained latch/ shallow latch
Maternal nipple pain/trauma
Recurrent mastitis/thrush
Penetration/aspiration
Poor endurance
Increased respirations
Falls asleep nursing
Poor weight gain
GER
Combative behaviors
Extensive gas/hiccups
Lipstick-shaped nipples
Constant nursing
Lip blister
Anterior loss
Gagging
Poor milk supply
Extended feedings
Munching at breast
Overly strong suction
In bottle-fed infants:
Anterior loss
Gagging
Penetration/aspiration
Increased respiration
Clicking
Poor weight gain
Combative behaviors
Poor endurance
Lip blister
GER
Excessive gas/hiccups
Constant feeding
Falls asleep feeding
Extended feedings
Collapsing bottle nipple
At Link to Communication, LLC, a functional assessment is key to appropriate treatment.
It is not a linear process.
It is team-based.
Function is KEY.
Structure and function have a dynamic relationship.
Client must be symptomatic (not cosmetic or preventative).
Release decision is up to client/parent.
.
Function
Symptoms
Appearance
Looking at Function:
“Normal” Range of Motion
+ Lift the tongue to the palate with a wide open mouth .
+ Swing the tongue side to side.
+ Touch the maxillary molars with ease.
+ Lay the tongue on the roof of the mouth without excessive jaw movement or restriction.
+ Look at the other structures – palate, occlusion, etc.
+ Check for compensations - activation of neck muscles, jaw shifting, even eyebrows try to assist in supporting the tongue.
Different classifications
If the client's team recommends a lingual and/or labial release (tongue tie and/or lip tie release), the client will be referred to a trained provider. Myofunctional therapy must happen prior to and after the release for the best results. Research on the benefits of myofunctional therapy:
Lingual Frenuloplasty With Myofunctional Therapy
Manual Therapy Prior to and After Frenectomy
Functional
Evaluation
Find the best treatment specifically tailored to the client.
Myofunctional Therapy
Initiate neuromuscular reeducation to maximize the success of the therapy after surgical revision.
Release
We only refer to providers who have had additional education in lingual and labial releases.
Post-Release Therapy
Post operative myofunctional therapy provides individualized care for the client to optimize recovery and healing after surgery, as well as strength training and pattern retraining exercises for the tongue and orofacial muscles.