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Tethered Oral Tissues Speciality (TOTS)
The term “tongue-tie”, or ankyloglossia, is commonly used to describe a congenital condition in which the lingual frenulum (the small portion of tissue under the tongue) restricts or “tethers” the tongue from underneath. This largely undetected and undertreated disorder occurs when tissues do not completely recede as they should during gestation. Like tongue-tie, lip ties (labial frenula) and buccal (cheek) ties may also occur, for a total of seven possible frenula, or ties, in the mouth.
What are the Potential Impacts of Tethered Oral Tissues?
Not all tethered oral tissues present difficulties. For some individuals there appears to be no adverse implications for the observed ties. For others, tongue, lip and/or cheek ties may have a significant impact on their ability to eat/chew/swallow, breastfeed or speak clearly. Tethered oral tissues have also been correlated with TMJ pain, sleep, and airway conditions.
How can a Speech-Language Pathologist help?
It is important to select a speech-language pathologist (SLP) who is trained in identifying and treating individuals who present with tethered oral tissues. Working with children who present with functional deficits resulting from these is often a team approach that may also include an otolaryngologist (ENT), dentist, orthodontist, sleep specialist, orofacial myologist, body workers, and more! The speech-language pathologist will complete a functional assessment and determine whether additional referrals are needed. If a functional deficit is suspected, a referral will be made to a release provider in addition to beginning the corrective therapeutic process. Once a release occurs (if warranted), the SLP will continue to work with the child to increase functionality of the oral structures for improved eating/chewing/swallowing, nursing, speaking, breathing and/or sleep!
If you feel tethered oral tissues may be impacting your child's speech and language skills, please reach out to your local school district or county's early intervention system to request a free evaluation.