About Pre and Post Tongue and Lip Tie Release

A diagnosis of a tongue tie or lip tie (Tethered oral Tissues- TOTS) is made by a combination of; a hands-on structural oral assessment, hands-on oral function assessment as well as a feeding history and current symptoms. The diagnosis is made by a trained specialist (usually a dentist or ENT specialising in this field).  

So what is our role, as the Speech Pathologists in the assessment phase?
Our role is to complete the functional assessment, to determine the impact any potential restriction is having on the way the oral and facial muscles are being used.

What are the symptoms?
Depending on the persons age their can be a variety of symptoms (you do not need to have all of these in order to be diagnosed with a tie), such as;

Infants
- Shallow or difficulty maintaining a good latch 
- milk leaking out the corners of the lips
- clicking sounds
- air intake 
- increased gas, tummy discomfort, reflux
- difficulty keeping a pacifier in their mouth
- frequent small feeds
- falling asleep during the feed
- poor weight gain
- lip blister, two toned lips 
- open mouth posture 
- tented upper lip shape
- white coating on the tongue
- double chin appearance
- high narrow palate
- head turn preference/Torticollis

Mothers symptoms if breastfeeding
- Pain during feed
- cracked, blanched or lipstick shaped nipples after a feed
- poor drainage of milk
- what appears to be poor milk supply

Children
- difficulty transitioning to solids
- increased gagging on food
- messy eating 
- noisy eating
- difficulty with oral hygiene 
- open mouth posture
- mouth breathing 
- picky eating
- sleep issues (e.g. snoring, restlessness, apnea, teeth grinding)
- persistent bed wetting
- unresolved speech issues
- Dental occlusion problems (e.g. teeth crowding, gap in upper central incisors, high narrow palate, open bite)

Adults
- sleep issues (e.g. snoring, apnea, teeth grinding)
- persistent headaches
- neck/shoulder tension
- forward head posture
- mouth breathing
- TMJ pain
- orthodontic relapse

What do we do as Speech Pathologists?
At HaMakor we are specialised in the functional component of the assessment as well as making sure you are ready BEFORE a release is done AND AFTER the release is done, by working on the oral muscles in therapy.

Therapy pre and post tongue/lip tie release is imperative for the best possible results. The therapy program is built based on the individuals specific functional needs.
A physical release of the ties on their own is not enough to restore optimal function. Therapy works to reeducate the muscles to function optimally for eating, resting, breathing and speaking (when age appropriate).