Treatment
Treatment of ties in kids (ages 4+) and adults is a relatively quick and easy process, though it does require a bit more pre-op work to ensure a positive outcome.
MYOFUNCTIONAL THERAPY
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Facial skeletal growth (maxillofacial development)
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Sleep-disordered breathing (including snoring and sleep apnea)
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Nasal obstruction
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Oral hygiene and dental problems
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Teeth grinding (bruxism)
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Temporomandibular joint dysfunction
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Neck and shoulder tension
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Speech problems
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Facial esthetics
Myofunctional therapy is a program used to correct the improper function of the tongue and facial muscles. It involves strengthening of the tongue and orofacial muscles by teaching individuals how to engage the muscles to the appropriate position.
Individuals with predominant mouth breathing (or insufficient habitual nasal breathing) often develop maladaptive habits and patterns of orofacial function that may impact various conditions including:
Proper diagnosis allows for targeted and effective physical therapy exercises for oral posture retraining to promote better health with goals to improve breathing, reduce pain, and enhance quality of life. Please refer to Academy of Orofacial Myofunctional Therapy for a more detailed explanation on the impact of maladapative orofacial posturing on maxillofacial growth and development: https://aomtinfo.org/myofunctional-therapy.
Our office requires that all patients undergoing tongue tie release work with a myofunctional therapist prior to their frenectomy. This ensures proper preparation of the muscles and their surrounding fascia, a complete release of restrictive tissues, and allows for ideal tongue posture and function after the procedures is complete. Patients who are not committed to proper preparation will not see their desired outcomes and
INITIAL VISIT
We ask that all patients interested in becoming a patient fill out the proper intake form on our website (click here) and we will reach out and schedule a 30-minute consultation. At this initial visit, we will discuss any signs and symptoms you or your child may be experiencing, and we will complete a thorough evaluation of the head, neck, jaw, and airway to see if there may be any other concerns in addition to TOTs that may need to be addressed.
Dr. Heidi will take measurements to help assess how much restriction there is in and around the tongue. She will then discuss treatment options. If you are not already working with a myofunctional therapist, she will provide some referrals. Some patients may also need to work with a bodyworker, such as a physical therapist, chiropractor, etc. in order to optimize the preparedness of the whole body for release of the fascia that has been restricting proper movement throughout the body, from head to toe.
TREATMENT
On the day of the procedure, we will review all risks and benefits of surgery and will have you sign an informed consent form. The procedure itself takes only a few minutes from start to finish.
We first anesthetize the underside of the tongue with a topical anesthetic, which creates enough numbness to minimize discomfort as the local anesthetic is injected under the tongue. Dr. Heidi checks to make sure everything is profoundly numb before beginning the release.
Once your tongue is numb, Dr. Heidi uses a CO2 laser to release the tension on the fascia under the tongue. She will release a little bit at a time to ensure a complete release that removes all restrictions that prevent proper tongue movement. She will then take measurements again to see how much movement you have gained.
Whenever possible, Dr. Heidi will place stitches to close up the wound. This helps reduce the amount of scarring, as well as post-op pain. In some cases (especially younger children), they are unable to sit still for the suturing, so the wound may be left open to heal with a scab, which does not have a significant impact on healing, though post-op pain may be slightly greater in some patients.
POST-OP INSTRUCTIONS
It is important to continue myofunctional therapy after a tongue tie release. There are exercises and stretches that will help the new tissue form with as little restriction as possible. Your myofunctional therapist will review these exercises before the procedure, and will also follow up afterwards to ensure everything is moving properly.
Please click here for the post-op packet that covers all the information needed for proper healing.
