Tethered oral tissues (diagnosis + treatment)

Ashley Brinkmeyer, MS CCC-SLP

Tethered oral tissues are a fairly common condition that can impact people of all ages, but are most commonly found in infants when it’s noticed that they’re having difficulty feeding. This post discusses the many different forms of tethered oral tissues, and what diagnosis and treatment looks like for these conditions.

Tethered Oral Tissues:

Tethered oral tissue (TOT) refers to tissue in the mouth that restricts movement. The most commonly known types of TOTs are lip and tongue ties; however, there are actually 7 areas of the mouth that can be impacted by restricted tissue. These areas of the mouth include: upper/lower lip, lingual (tongue), and upper/lower buccal (cheek).

Infants and children should be screened for TOTs if they present with speech sound disorders, feeding difficulties (dysphagia), misaligned teeth (dental malocclusions), sleep disturbances, and chronic airway disorders. You may also want to request a TOT screening if your infant or child grinds his/her teeth, snores, mouth breathes, and/or persistently thumbs sucks. 

Once your child has been screened for TOTs, appropriate recommendations will be made by the evaluating therapist. Referral professionals may include a surgeon (Dentist, Oral surgeon, or ENT), Certified Orofacial Myologist, and Lactation Consultant.

If surgical revision is recommended by an ENT, Dentist, or Oral surgeon, it is important that Pre-Op and Post-Op neuromuscular re-education be discussed to ensure an optimal release. If you have concerns about your child having TOTs, please contact us to schedule a free 30-minute consultation. 

Our speech therapists have training in tethered oral tissues and can help with the necessary neuromuscular reeducation that is necessary post-surgery to help your child have success and work toward proper speech and feeding techniques moving forward.