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The information provided here is based on research and clinical experience of those working in this area. There is research on the impact of Tongue Tie (ankyloglossia) and other oral ties on speech, but the studies are not conclusive. More studies have been completed investigating the effect of Oral Ties on breastfeeding and demonstrate a causal link.
Is this a Fad? What Does the Research Say?
The clinical and research information regarding Tongue, Lip, and Buccal (Cheek) Ties within the last five to seven years show that it IS more of an issue than previously indicated and it is STILL largely ignored as a medical condition.
While a causal link has been established with breastfeeding, research in this area regarding speech and OVERALL facial/dental development is lacking.
Those working in the field of Orofacial Myology or other related professions have extensive clinical experience which shows improvement in outcomes after release for both speech and feeding.
"Clinical experience is a part of Evidence-Based Practice (EBP) and is necessary when the research has not caught up to the needs of the patient."
What Do We Do?
For older children (4 years and up) and adults
If you are concerned about Oral Ties, a FULL FUNCTIONAL evaluation, typically lasting 1-2 hours, should be completed by a highly trained Certified Orofacial Myologist or Myofunctional Therapist before any recommendations are made to medical doctors regarding tie impact and the need for release (surgery). Additionally, myofunctional therapy should begin before and continue after release for full benefit!
For breastfeeding infants and toddlers
A Speech-Language Pathologist specializing in infant feeding and/or an IBCLC (lactation consultant) will complete a functional assessment.
For non-nursing toddlers and children under 4
Children this age are too young for a traditional myofunctional therapy program, but they still need a functional assessment to improve future outcomes. A Certified Orofacial Myologist or Myofunctional Therapist will design a treatment plan to encourage normal facial growth and development and work with the parent to implement the plan.
I've Been Told I Have a Tongue Tie!
Some patients first find out they may have Oral Ties by a dentist who offer to release them during the visit.
Please do NOT do this!
An Oral Tie CANNOT be diagnosed through a simple exam, by sticking your tongue out, or from a picture!
Children and especially adult patients need a full functional assessment to determine if there is an Oral Tie AND if there is an impact.
For some patients, a more serious issue of (lack of) Tongue Space, an airway/small upper jaw problem, makes them appear as if they have a Tongue Tie and some may have both!
If you have a small upper jaw and have a tongue tie released, it may actually cause MORE problems due to lack of TONGUE SPACE!
Having a FULL FUNCTIONAL assessment ahead of any Oral Tie release will give you the baseline and functional information you need to more forward with therapy and release (if needed).
Your therapist can guide you in the process and get you to TRAINED medical professionals in this area who can help you without wasting time and money.
“Tongue tie patients live in a state of stress”
Mukai, Mukai & Asaoka (1993)
Additional Sites for Research and Information:
Dr. Soroush Zaghi, ENT
International Association of Orofacial Myology
Dr. Bobby Ghaheri, ENT
For information on infants and oral ties
Carmen Fernando, SLP
Information on the Social and Emotional Toll of Oral Ties
Mukai, S., Mukai, C. and Asaoka, K. (1993) Congenital Ankyloglossia with Deviation of the Epiglottis and Larynx: Symptoms and Respiratory Function in Adult. Annals of Otology, Rhinology & Laryngology, 102, 620-624.