Dr Shereen Lim

23/07/2025

Palate Expansion for 7-Year-Old: 2 Month Progress

Excited to finish the day with this sweet and gorgeous patient, and a fantastic result to date!

So far, there has been great palatal remodelling and improvement in facial symmetry.

We will now pause and address oral dysfunction in conjunction with release of oral ties, and I’ll reassess the need for another round of expansion once her adult upper lateral incisors come through.

Looking forward to the ongoing facial changes ahead.

Disclaimer:

Any orthodontic procedure carries risk, and individual results may vary.
Before proceeding with treatment, you should seek a second opinion from a specialist orthodontist.

22/07/2025

Palate Expansion for 7-Year-Old: 7.5 Week Update

This 7.5-year-old had been under the care of a respiratory physician, immunologist, osteopath, and physiotherapist for persistent breathing concerns.

Despite having her adenoids and tonsils removed four months earlier, she continued to experience:

🔹 Chronic asthma with persistent wheezing and night-time coughing
🔹 Three courses of oral corticosteroids in the past year
🔹 Coughing episodes so severe she was sometimes unable to speak
🔹 Frequent illness, missing around 25% of school
🔹 Daily use of Flixotide and Ventolin
🔹 Escalation to Seretide shortly after our initial consult
🔹 Dental crossbite and mouth breathing contributing to dental decay

At her 7.5-week review, her parents reported noticeable improvements in her overall health and wellbeing:

✅ School absence reduced from 24% over the previous two years to 16% since starting treatment, despite this being through the winter months
✅ Less night-time coughing and wheezing
✅ Significant reduction in Ventolin use
✅ Faster recovery from colds and general illness
✅ Less mucus, likely due to improved nasal breathing and reduced airway inflammation

“We understand how important it is to raise awareness that there are options not solely focused on medication to help children with asthma and respiratory issues. And that looking at how the whole system functions and contributes can have real benefit.” – Parent

I am grateful to ostepathic colleague Dr Robert DeMaio from On The Mend Health for sharing Breathe, Sleep, Thrive with this family and others, and his ongoing support promoting airway health for children.

Disclaimer:
Any orthodontic procedure carries risk, and individual results may vary.
Before proceeding with treatment, you should seek a second opinion from a specialist orthodontist.

17/07/2025

One-Week Review: Lower Lip-Tie Release in a 6-Year-Old
(Before photos on the left)

I had previously released both the upper and lower lip ties in this patient, but more recently I’ve been paying closer attention to how children perform a lower lip puff. I noticed a pattern - the deeper the crease in the chin while puffing air into the lower lip, the tighter the lower labial frenulum often is.

In this case, the frenulum wasn’t the most obvious tie on inspection, but it was associated with significant chin tension during attempted lip puffing. I shared with her parents my impression that this chronic mentalis strain might be contributing to their daughter’s lower dental crowding. I was also curious whether a release could support improved lip seal over time.

We discussed that this was a hypothesis, and that there’s currently no evidence to support it. With agreement from both parents and the child, we scheduled to proceed with release.

Immediately after, the child (unprompted) told her parents that her shoulders felt relaxed. During our TLC call the next day, Mum said she seemed to be standing taller. At today’s review, the patient also said her chin felt looser. One of our oral health therapists, who saw her for a clean today, reported that Mum seemed very happy and had noticed a general reduction in facial tension.

Reflecting on this reminded me of an adult patient I saw just yesterday. We did an upper lip-tie, lower lip-tie, and tongue-tie release, in that order. After the lower lip-tie release, while still lying in the chair, she described the sensation of her shoulders dropping and relaxing.

Last year, I came to realise that upper lip-tie releases can often relieve neck tension. Since then, I’ve been slowing down between adult tie releases and asking patients what they notice after each stage. Now I’m beginning to wonder whether lower lip-tie releases might also influence shoulder tension. I never paid much attention to lower lip-ties before but the lower lip puff is a simple way for me to get an indication if I should.

I also have a colleague interested in a lower lip-tie release in isolation. I hope to carry this out with an osteopath present so we can observe and learn more about the immediate postural changes together.

I’d love to hear from others who can share any insights. Have you noticed similar patterns with lower lip-tie releases?

Disclaimer:
Any surgical procedure carries risks, and individual results may vary. Before proceeding with any surgery, you should seek a second opinion from an appropriately qualified practitioner.

16/07/2025

It was a pleasure to connect with Dr Craig Clayton and bring new airway health insights to his amazing following!

What We Cover:

The alarming number of children being missed and dismissed by providers

Dr. Lim’s personal story of helping her own daughters—and what she wishes she knew sooner

Why airway issues like mouth breathing, sleep disruption, and bedwetting aren’t just “normal”

How her book Breathe, Sleep, Thrive gives parents a framework to understand and act

The pushback she faced early on—and why the momentum is finally shifting

How parents are the key to driving change in pediatric airway health

Where to go and who to trust when you’re looking for answers

Podcast Episode · Dentistry Disrupted · 15/07/2025 · 38m

15/07/2025

Want more info on children’s palate expansion?

Here’s a throwback to a podcast interview I did with the Children’s Airway First Foundation on this hot topic.

My guest today is Dr. Shereen Lim, a Perth-based dentist with a postgraduate diploma in dental sleep medicine from the University of Western Australia. As on...

03/07/2025

Wonderful to meet and be involved in the care of the new bub of one of our most popular collaborators, Dr Addison and Leanne from

It was a treat to have a cuddle, and also to pick Dr Addison’s brain this afternoon on body posture changes pre- and post-release. We are grateful for the fantastic support and care he offers our patients of all ages on their journeys.

30/06/2025

The airway health community is mourning the loss of British orthodontist Dr John Mew.

Dr Mew was a true pioneer who saw beyond crooked teeth, recognising that proper oral rest posture could guide healthy jaw and facial development. He also developed the Biobloc series of appliances to encourage forward facial growth, including the Biobloc Stage 1 Expander, which has become my favourite expansion device for the excellent control it provides over the front of the smile and its potential for some forward midface development.

Though he faced considerable controversy and skepticism from some of the mainstream orthodontic community throughout his career, Dr Mew’s vision and efforts to create change inspired many more of us who adopted his view that facial growth is not fixed, but something we can positively influence. I’m glad he lived to see this way of thinking gain growing momentum and reach a tipping point, and become the way of the future.

I hope his family and friends find comfort in knowing just how far his influence has reached, and the profound impact he’s had in trailblazing a new path for so many of us. His legacy will live on in every child we treat who grows up with healthier, fuller faces and smiles.

Send a message to learn more

27/06/2025

Did you know that a white-coated tongue can be a sign of altered swallowing?

A proper swallow should:

✅ Be silent - with no gulping or clicking
✅ Involve no pursing or tightening of the lips, cheeks, or chin
✅ Happen without head bobbing or visible effort
✅ Create a full tongue-to-palate seal (not forward thrust of the tongue)

When the tongue seals correctly against the palate, it helps clear food remnants from the tongue surface, preventing build-up and reducing the appearance of a white coating.

This child had a history of myofunctional and structural issues related to swallowing:

🧩 Palate expansion for a narrow upper jaw
🧩 Persistent open bite, with concerns about orthodontic relapse
🧩 Tongue thrust and lisp
🧩 Breastfeeding cut short on medical advice due to recurrent, severe mastitis
🧩 Picky eating, including avoidance of meat
🧩 Chronic glue ear lasting over two years
🧩 Signs of sleep-disordered breathing including tummy sleeping, restlessness, and bedwetting

At one point, ARFID (Avoidant/Restrictive Food Intake Disorder) was considered.

But before we assign that label, we need to ask:
Could this child be avoiding food because their altered swallow makes some foods feel difficult or unsafe?

In this case, a previously undiagnosed tongue-tie, subtly restricting elevation of the mid-tongue was a key root cause, introducing dysfunctions that have compounded with time.

Visual clues to watch for:

📷 Image 1: White-Coated Tongue
Without consistent tongue-to-palate contact, the tongue doesn’t self-clean.

📷 Image 2: Attempted Tongue-to-Palate Suction Hold
The child attempts suction, but the seal is weak. The tongue tip lifts, but the mid and back remain low.
Myofunctional therapy can improve tongue tone and coordination. The extent of any tongue-tie restricting mid-tongue lift can then be more accurately assessed.

📷 Image 3: Tongue Tip Elevation with Floor of Mouth Stabilised
With the floor of the mouth gently held down, we can see the mid-to-back tongue is tethered and struggles to lift.

This child’s story gives us plenty of clues.

Many children compensate well, but when dysfunction persists, the tongue doesn’t develop the resting posture and tone needed for optimal oral development, breathing, and sleep.

Let’s pay attention to the basics before we assume a complex diagnosis.

Don’t assume your healthcare professional has looked for this. Even as a dentist, or the so-called expert of the mouth, I didn’t learn any of this in dental school.

Often, the tongue is telling the story. We just need to look and learn.

25/06/2025

Upper lip and tongue-tie release for a 14-month-old – one week review

This toddler's family had a long and difficult search for answers. His ties were dismissed early on when there were breastfeeding problems. When he failed to thrive, the advice was to switch to formula. His ongoing reflux-like symptoms were also brushed off.

Constipation was treated without any alleviation using suppositories, Coloxyl, and even re**al Botox. He underwent colon biopsies on two occasions to assess whether bowel resection would be helpful. The final result was negative. The family was told he had one of the worst cases of idiopathic constipation, and that there were no further pathways to explore.

Coinciding with his tongue-tie release, he experienced immediate and complete relief from constipation. This was the first case I have heard of such a rapid and dramatic shift. It happened to be thoroughly documented, with photos illustrating remarkable before-and-after changes in stools. (I have never been so fascinated to see poo photos!)

This story reminds us of the importance of listening to parents. Their insights deserve to be heard and understood, not dismissed. The impact of these challenges on a child’s quality of life, on bonding, and on a family’s emotional wellbeing is significant.

And when we do take time to listen and learn from the journeys of families, we may find clues that lead to better care for others too.

This is one story I won't be forgetting. It has inspired me to keep asking questions, keep learning, and keep trusting what parents are trying to tell us.

Disclaimer:
Any surgical procedure carries risks, and individual results may vary. Before proceeding with any surgery, you should seek a second opinion from an appropriately qualified practitioner.

25/06/2025

One week post upper lip and tongue-tie release for 14 month old

I am so pleased to have been involved with this little man and his family’s journey in conjunction with Brenda from The Gentle Village and Dr Anna Myers from Melville Osteopathy - and to share mum’s notes (unedited) for our review today.

Changes in Ted:
- Immediately felt ‘floppy’ / was able to comfortably hug into me
- Holds onto me while I carry him (so much better for my back and arms 😂)
- Temperament change: General chirpiness, happiness, content, less demanding, impatient, requiring constant attention and sensory input
- Face shape has changed
- Posture changes at rest - eg: shoulder placement
- Making different sounds and linking noises
- More regularly babbling
- No more snoring - only occasional lightly purring
- More instances of sleeping with his mouth closed or near closed (and breathing through nose)
- Far less gas - not waking during the night, having to wriggle / stretch to release gas painfully
- Sleeping on his back or side much more often / less tummy sleeping
- Using his arms far more above shoulder height
- Bottom teeth have begun to straighten out
- Top teeth position seem to be changing
- Under eye darkness
- Puffiness of eyes
- Using gestures much more - I.e: waving, all done, blowing kisses
- Playing more games like chasey, peekaboo
- More comfortable with teeth brushing
- Drinking from a cup much more willingly
- Far less mess at meal times
- Less pushing food out of his mouth or pulling it out
- Less congestion
- Easier to go down for naps

Changes for the family:
- Increase in confidence to take him places by myself, especially for trips that require long drives
- Increased sense of freedom to engage in activities due to change in temperament
- Ability to leave him to play independently - means I don’t have to panic-rush to get ready, make his meals, do daily chores etc
- A calmer and happier day overall - seeing my little boy happy, comfortable and engaging in life with joy, brings me so much happiness
- A sense of peace and alleviation of the long term anxiety I’ve been experiencing knowing something was going on for my baby, constantly researching and exploring different ways to help him
- Reinforcement of listening to my mother’s intuition, and advocating for my son when much of the medical profession dismissed my concerns and/or incorrectly assessed my baby.

Disclaimer:

Any surgical procedure carries risks, and individual results may vary. Before proceeding with any surgery, you should seek a second opinion from an appropriately qualified practitioner.

25/06/2025

A big thank you to our front office superstar Lauren for a fantastic 6-month return to Sparkle!

We’ve truly appreciated having Lauren back on the team. Her calm, can-do attitude and reliable support has been invaluable, and the time has flown by far too quickly.

We will miss her, and hope she enjoys a bit of well earned rest and relaxation as she prepares to become a new mum of two very soon!