Tethered Oral Issues
(TOTs & Their Role in Growth and Development
Tethered oral tissues (often referred to as tongue ties, lip ties, or buccal ties) occur when the soft tissues in the mouth are restricted in their natural range of motion. These restrictions can impact how the tongue, lips, and cheeks function during breathing, swallowing, speaking, chewing, and facial growth.When oral tissues are restricted, the tongue may not rest properly against the palate, which can influence jaw development, airway size, dental alignment, sleep quality, and overall facial growth patterns. In some individuals, tethered tissues may also contribute to mouth breathing, poor oral posture, orthodontic relapse, or feeding and speech concerns.
How We Assess Tethered Oral Tissues
As part of our comprehensive evaluation, we carefully assess tongue, lip, and cheek mobility to determine whether tethered tissues may be affecting:
- Growth and development
- Airway and breathing patterns
- Swallowing and oral function
- Orthodontic stablility
Release in Combination with Myofunctional Therapy
If a release is indicated, it is not performed as a stand-alone procedure. Instead, it is completed in coordination with our Myofunctional Therapy Program, typically around week 4–5 of therapy when strength, awareness, and coordination have been established.
- This combined approach is critical because:
- Myofunctional therapy prepares the muscles for optimal healing and function
- The release allows improved mobility
- Therapy then retrains the tongue and oral muscles to function correctly
- This ensures true neuromuscular integration, not just increased movement
- When properly integrated, this approach can significantly enhance:
- Facial and airway development
- Breathing and sleep quality
- Orthodontic outcomes and stability
- Overall oral function
Our goal is always to support healthy growth, balanced development, and long-term airway health in the most conservative and effective way possible.
