Doctor Staci Whitman
@doctor_staci·7.2K subscribers·103 videos
What is all this talk about tethered oral tissues (TOT’s)?
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August 7, 2023
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0:24Now PlayingWhat is all this talk about tethered oral tissues (TOT’s)? A tongue tie (ankyloglossia) or a lip tie is when the string of tissue (frenum or frenulum) under your tongue or above your upper front teeth is tight and restricts normal movement and proper function.
Sadly, I received close to ZERO education in dental school or pediatric residency on TOT’s. I always thought...”if you can stick your tongue out, you’re good.” Wrong!
Some signs of TOT’s: Pain or difficulty with nursing, picky eating or grazing, speech issues, open mouth/mouth breathing/low tongue posture, crowded teeth or narrow palate, inability to touch back sides of upper molars with tongue, blanching of gingiva when lifting the upper lip or an excessive space after permanent have erupted, heavy plaque and food accumulation under upper lip, and other issues.
Possible effects of untreated TOT’s: (it’s not all about breast feeding!!): Nursing issues, failure to thrive, improper jaw and palate growth, speech issues, increased cavity risk, improper swallowing patterns, open mouth posture and/or mouth breathing, sleep disordered breathing/sleep apnea, neck/back pain, headaches, TMJ issues, airway and sleep concerns, orthodontic relapse, and more!
It is always best to see an IBCLC, an ENT, an airway-focused dentist or another properly trained provider to be screened for TOT’s. It often takes a team to get the proper diagnosis, treatments, and therapies for ideal outcomes.
Fun fact: releasing a tongue tie can be dated back to the 1600’s and even
the Bible! “His ears were opened, his tongue was released.” Mark 7:35 (ESV). Midwives would keep one fingernail sharp so they could address a tongue tie immediately after birth. King Louis XIII was said to have had the procedure done in 1610!
Excellent books to read if you want to know more about TOT’s are “Tongue-Tied” by Dr. Richard Baxter and “SOS 4 TOTs” by Dr. Larry Kotlow, both leaders in the field. @breathe_institute is working endlessly to get new research out, too, so stay tuned!
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