Tongue & Lip Ties

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Ties are a problem that are present at birth. It happens when the tissue that attaches: 

• The tongue to the bottom of the mouth (lingual frenulum) is too short.
• The lip to the gum (labial frenulum) is too short.
•  The gum to cheek (buccal frenulum) is too short.

First we need to begin by understanding some of the mouth structures:

• Frenum refers to a band of tissue that connects two bodily structures. The term frenulum refers to a small frenum. The terms frena or frenula are the plural forms of frenum and frenulum, respectively. ICAP defines oral ankylofrenulae as restrictive frenula located in the oral cavity that result in a functional restriction. The oral frenula include the lingual frenulum (tongue), the labial frenulum, (lip) and the buccal frenulum (gum to cheek). 
• Ankylofrenula is the overarching term for oral restrictions, including lingual, labial, and buccal frenula. Tethered Oral Tissues (TOTs) A collective term to refer to oral restrictions, including tongue-tie (ankyloglossia), maxillary lip-tie (ankylolabia) and cheek ties (buccal ties). 

What to do about Oral Ties?

A comprehensive evaluation is needed for each individual to determine an individualized treatment plan based on each patient's unique needs. It is important that both:

• Symptoms of the infants, children, young people, and adults be evaluated. Assessment of the impact of the frenula during functional activities, such as breastfeeding, bottle-feeding, eating, drinking, breathing, sleeping, speech production and development. 
• Functional assessment of the frenula. This includes an examination of the tongue and lip appearance, movement & range of motion of the tongue, lip & cheeks. 
• It is also advised to assess for any compensatory full body postural changes ie. recessed jaw, elevation of the upper palate, neck tension (one sided or both), shoulder elevation, breathing alterations...

We advocate for evidence-based treatment approaches integrating both empirical evidence and practice-informed knowledge.