What is a TOT?
The frenulum is the name given to the connective tissue remnant (attachment) under the tongue and lip that serves to support and limit its movement in different directions. If restricted it is called a tie or TOT (tethered oral tissue).
Infant Tongue Tie
An infant tongue is considered tied when the attachment underneath (called the lingual frenulum) is restricted and impairs tongue mobility and function. This may result in dysfunction of eating (breastfeeding). This could mean difficulties breastfeeding your infant, poor latch, poor weight gain, reflux, gassiness, and prolonged feedings.
Infant Lip Tie
The attachment under the lip (called the labial frenum) may be restricted and has limited flexibility. Abnormally tight labial frenulum can disrupt the seal around the breast or bottle nipple leading to increased air intake. This could mean difficulties breastfeeding your infant, poor latch, poor weight gain, reflux, gassiness, and prolonged feedings.
Collaborative Care Treatment Approach
Prior to having a lip or tongue tie evaluation, infants should be assessed by an International Board Certified Lactation Consultant (IBCLC) or feeding specialist (a trained SLP or OT). We also encourage seeing a Chiropractor who specializes in infants and children, if bodywork is needed.
Treatment
The tongue tie and/or lip tie is released using a state of the art CO2 laser by LightScalpel. The oral mucosa (fascia) is vaporized away releasing the tense or restrictive tissue. This permits the lip and/or tongue to move freely.
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Along with the tissue release the older patients will receive myofunctional therapy (physical therapy for the tongue) before and after your frenulum release. Myofunctional therapy helps strengthen the tongue and orofacial muscles through exercises that re-train the tongue and muscles to function properly.
General Anesthesia is not needed for a tongue-tie, lip-tie procedure. We use nitrous oxide and local anesthetic for the older children, and topical anesthetic for the babies.
INFANT Lip & Tongue
Before After 20 days
Toddler Lip
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Before After
Teenager Tongue
Before After
Frequently Asked Questions about lip ties/tongue ties...
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