11/25/2025
The evidence is clear.
Correcting structure alone cannot correct a functional problem. This article from LightScalpel is an excellent resource for parents & providers (link in comments).
The most common question we get is whether expansion or a tongue tie release alone can resolve airway issues. The short answer is no. Expansion is valuable. Releases are valuable. But neither one can retrain the orofacial muscles or correct the dysfunctional patterns that created the problem in the first place.
Most airway and facial growth issues begin with dysfunction. A high or narrow palate is often caused by low tongue posture and an incorrect swallow. When the tongue cannot elevate and stabilize properly, the palate doesn’t expand naturally. This is why structural expansion alone is never the full solution.
A release without pre and post myofunctional therapy is incomplete. Expansion without functional retraining is incomplete. A treatment plan that does not include a significant period of functional therapy is incomplete. This applies to infants, children, teens, and adults. Structure can change at any age, but proper function must always be trained.
Current research agrees that before a frenectomy, a functional evaluation is necessary to prepare the tongue, lips, and airway muscles for new mobility. After a release, therapy is required to restore strength, coordination, oral rest posture, nasal breathing, and neuromuscular repatterning of the swallow. Surgery and appliances alone cannot do this.
SLPs are trained and licensed to evaluate and treat swallowing. Swallowing involves tongue elevation, tongue base retraction, lip seal, pressure generation, and coordinating 30+ muscles. Correcting the swallow is the core of successful expansion, airway improvement, and post-release stability.
Without repatterning the swallow and restoring correct tongue posture, the same dysfunctional patterns continue and work against expansion, contribute to relapse, and keep symptoms unresolved.
A truly evidence-based airway plan treats both structure and function. Expansion is one part. Release is one part.
Function is the foundation that makes every structural change stable.