Shari Green, COM
Orofacial Myologist

(847) 641-4444
Tongue and Lip Tie Information

Tethered Oral Tissues-TOTs rehabilitative therapy
Pre and Post TOTs care
Tongue Tie and Lip Tie release, along with rehabilitative orofacial myofunctional therapy, can often result in a profound change to an individual's comfort, oral and facial structure, and quality of life experience. In the photo above, note that a lip tie was present on the upper photo, and then was later released in the bottom photo. Orofacial myofunctional therapy was provided. The patient no longer had the upward force of the upper lip, and the teeth were free to move into a more appropriate position, free of abnormal forces.
Note the inability in photo above of the tongue to lift easily. The tongue appears very rounded and tethered in the floor of the mouth;Tongues should be able to point straight up to the roof and thin. The tip should be able to touch the hard palate while fairly open. Sometimes tongues are restricted in the back also.
Heart shaped tongue above, head tilt in effort to move below.
Tethered oral tissues, or TOTs may be one of the most commonly missed issues in practice today. And for some reason, I feel it is becoming more prevalent. New research and techniques in this area have expanded our knowledge of tongue and lip tie, and have resulted in easier, less invasive techniques by dentists and physicians to address TOTs in small children and adults. It's significance is becoming more evident as time passes. And because newer techniques have become more mainstream, it is being addressed more often, as well.

It is crucial a tongue be able to lift to rest and swallow within the hard palate. An OMD or myofunctional disorder is almost always the result. When someone comes to see me on an initial visit, I will assess the mobility and muscle patterns to observe any concerns so I can work with your physician, dentist, or other health providers as a team.

Ask yourself...does your child have sloshy speech, cannot stick their tongue out from side to side or straight forward without stress and strain, do they have a heart shaped tip, do they seem to have difficulty chewing in the back or chewing food without moving the head? If so, they would benefit from an orofacial myofunctional assessment.
Hint: TOTs is believed to have a hereditary component. Have others in your family had this issue?...Ask. You may be surprised!
Pull up that upper lip and look to see if that space between your front teeth has a sneaky reason it is there...It may be tied.
Note the child to the left has a very heart shaped tip. When they try to move the tongue to the side, they end up using their head and tilting it to compensate for a lack of tongue mobility. Issues with chewing, speech, gagging, and the bite are quite common in TOTs. Often when a child sees a Certified Orofacial Myologist for an assessment for tongue thrust, the restriction is observed.
Shari is trained in Pre and Post Tongue and Lip Tie care. She works with children 3 and up and adults to prepare them for frenectomy, and then assists them along with their dentist, ENT, or oral surgeon in post wound care, stretches, and Orofacial Myofunctional rehabilitative exercises. A tongue tie release alone does not provide the necessary care to rehabilitate the tongue, and Ms. Green is an expert in this area, having had a release herself.
Often an individual with a tongue tie can still lift the tongue, but at a cost. The body will recruit other muscles from the face, head, neck, jaw, and the floor of the mouth may pull up in order to maximize mobility. It is common for someone with tongue tie to experience sloshy speech, or fatigue from speaking for extended periods of time as they try to accommodate for a lack of full tongue elevation or mobility. In addition, I have seen patients experience mid face tremors prior to release. Since the mid tongue has not been able to fully lift, one must be trained to lift the tongue after the procedure. In addition, exercises are required as well as stretches to maximize healing and mobility post procedure.