Tethered Oral Tissues

Tethered Oral Tissues (TOTS)

What are tongue and lip ties? Does your child have one?

What is a tongue tie and a lip tie?

It is a shortening or tightness in the connective tissue underneath the tongue or between the upper central incisors. This restricts range of motion in the tongue and/or upper lip.

Can TOTS impact my child’s development?

Yes! A tongue tie and/or lip tie can certainly affect feeding and speech/language development. Common problems include impaired sucking on bottle or breast, difficulty coordinating suck/swallow/breathe, difficulty transitioning to solid foods, inability to drink from a cup, poor speech clarity, dental issues such as malocclusion (misalignment) of the teeth, tooth decay, and airway issues such as apnea. Significant TOTS can contribute to aspiration, failure to thrive, and damage to a nursing mother’s breasts.

What can I do if I suspect my child has a tongue or lip tie?

Mention your concerns to your child’s pediatrician or regular medical provider, and ask for referrals to investigate TOTS. The Early Learning Program can assess your child’s function to determine whether range of motion is impacting your child’s development, and offer therapeutic interventions.

Kristin Coffin, OTR/L

Kristin is an occupational therapist in our Early Learning Program.

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