TOTs DOC : Lip, Cheek, & Tongue-Tie Surgery

12/28/2021

We see this cycle more often then not. 😔

If you are not sleeping, breathing and chewing well, it’s physically impossible to be optimally healthy!

Unfortunately, some children miss out on correct facial and jaw development, which often results in underdeveloped faces, crowded teeth, and sleeping/breathing disorders .

Learn more www.thebreatheinstitute.com

07/29/2020

Very informative!!
Tongue ties can contribute to many things you may not understand how and why and even have it overlooked as a contributing factor. Question everything, research and understand it!

Repost from
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Tongue Ties don’t just impact breastfeeding success, they can also contribute to picky eating from the time babies start solids to much later in life. I have had SO MANY kids who ended up on my caseload in elementary school because they “never grew out of picky eating as a toddler” & the culprit all along was a strand of tissue called a tongue tie.
😛We all have a frenum or frenulum that helps anchor our tongue, but when that tissue is too restrictive kids tend to stick chicken nuggets, French fries, yogurt, fish crackers…foods that just SQUISH between the teeth & are easily swallowed.
🧐Here are a few FUNCTIONAL signs that your child may have a tongue tie (ankyloglossia) & would require an evaluation by an experienced SLP or OT.
👉🏼Retraction of tongue upon presentation of the spoon
👉🏻Inadequate caloric intake due to inefficiency & fatigue
👉🏿Tactile oral sensitivity secondary to limited stimulation/mobility of tongue
👉🏽Over-use of lips, especially lower lip
👉🏽Difficulty progressing from “munching” to a more lateral, mature chewing pattern
👉🏻Tongue restriction may influence swallowing patterns & cause compensatory motor movements, which may lead to additional complications, such as “sucking back” the bolus in order to propel it to be swallowed
👉🏻Possible development of picky, hesitant or selective eating because eating certain foods are challenging
👉🏽Gagging & subsequent vomiting when food gets “stuck” on tongue.👉🏼Secondary behaviors to avoid discomfort that are thus protective in nature, such as refusing to sit at the table or being able to eat only when distracted
👉🏼Dental decay in childhood & adulthood because the tongue cannot clean the teeth & spread saliva
👉🏻Possible changes in dentition with certain compensatory methods to propel bolus posteriorly for swallowing, such as finger sucking
👉🏽Open bite
👉Snoring
👉🏼Drooling
👉🏻Messy eating
👉🏿Requiring frequent sips of l

06/24/2020

Great blog post by Alabama Tongue-Tie Center - Richard Baxter, DMD, MS !

It seems that everywhere you read online, a tongue-tie seems to be one of the first issues suggested when babies can’t eat or kids can’t speak well. Let’s go through some easy ways that parents can tell if their baby or child might be affected by this condition. 1. The…

10/13/2019

Sleep apnea affects children in many surprising ways. Consider some of the signs of sleep apnea in children, including sleepwalking, ADHD and others.

09/13/2019

Dr. Sinha at one of his TOTsDOC affiliated practices! Small World Dental

www.doc4tots.com

Pediatric dentist Dr. Sinha of Small World Dental in Staten Island, NY, has just added a LightScalpel CO2 laser to his practice for treatments such as tongue- and lip-tie releases (frenectomy) for children of all ages. A LightScalpel laser frenectomy is safe, quick and easy. A release of a baby’s oral restriction can take less than a minute and requires no sutures and no general anesthesia.

At Small World Dental they offer a unique pediatric and orthodontic dental experience that is affordable, interactive and fun. Combining the right mix of personal care, advanced technology, and continuing education, they maintain a commitment to their patients in every facet of their practice. To learn more call (718) 967-2412 or visit smallworlddental.com.

When compared to conventional surgery, LightScalpel laser procedures result in minimal to no bleeding, little to no swelling and discomfort, reduced risk of infection, and better cosmetic outcomes. The LightScalpel CO2 laser is made in the USA and is cleared by the FDA for many soft-tissue surgical procedures including , , fibroma and mucocele excision, unerupted tooth exposure, and many more. To learn more about the visit: lightscalpel.com/patient-laser-surgery

09/03/2019

Our new website is up!
Check it out...

TOTsDOC is the first provider in the United States to perform Tongue-Tie and Lip-Tie Surgery at home. Physical locations in New York and Philadelphia.

07/30/2019

Adults can also suffer from symptoms associated with a tongue-tie. Learn about these compensatory behaviors from The Breathe Institute

For those who have lived with a shortened or thickened tissue membrane, called a frenum, throughout their lives, (i.e. tongue-tie), myofunctional therapy becomes more than an awareness of learning proper oral rest posture.
These individuals have learned to compensate by incorporating other muscles of the orofacial region (i.e. cheek, lip, and neck areas) in an attempt to perform the basic functions of breathing, chewing, and swallowing.

This learned behavior leads to dysfunction and various disorders, known as compensatory behaviors. Unfortunately, the individual is often unaware of the behavior until he/she suffers harm.




Learn more www.thebreatheinstitute.com

07/20/2019

It’s official! Business cards are in! Thank you Norris Hall Studio for the awesome service!

Stay tuned for the brand new website...

07/15/2019

Excellent response by Dr. Jack Newman to the recent study in JAMA regarding tongue-ties and breastfeeding.

A recent study on tongue-tie and breastfeeding has been misinterpreted in the media as "babies do not need surgery to breastfeed" and made it sound like it is an unnecessary procedure. This is not at all what the article in the JAMA otolaryngology stated. But the article itself is based on the premise that tongue tie does not cause problems with breastfeeding. That is how the authors start off and obviously everything follows from that premise. (Association of Feeding Evaluation With Frenotomy Rates in Infants With Breastfeeding Difficulties, Christen Caloway, MD1; Cheryl J. Hersh, MS, CCC-SLP; Rebecca Baars, MS, CCC-SLP; et al, JAMA Otolaryngol Head Neck Surg. Published online July 11, 2019)

The study did not follow the babies long term (for only 2 weeks after the procedure) to see how they continued to breastfeed.

While it is true that releasing tongue ties should go hand in hand with skilled breastfeeding help, it is interesting to take a look at what sort of "help" with breastfeeding the study participants received. So many mothers suffer today because they do not get early, relevant and appropriate help with their breastfeeding problems. What is completely missing usually is knowing how to tell whether the baby is getting milk from the breast or not by watching the baby at the breast and how to help the mother and baby so that gets more milk from the breast.

What does the study suggest if the baby is not drinking at the breast (in the study called "has transitioned to non-nutritive sucking") and is falling asleep? "Apply a wet washcloth and tapping the infant´s foot". Certainly that technique would help us all improve our appetites.

What does the study suggest if the baby is pulling off the breast?

"Verbal reassurance to continue gastroesophageal medication." Even though this type of medication has been shown in a number of studies that medication is not helpful and may contribute to fractures later in life. In any case, it certainly does not provide help with breastfeeding and does not address the root of the problem.

Not to mention the fact that the study talks about assessing the "initiation and maintenance of the breast and/or bottle" as if it didn't matter where the baby drank.

There are two paragraphs in the study that exemplify the misguided thinking surrounding the situation in many of these babies. Problems are attributed to “overactive letdown” or “oversupply” and “too rapid flow of milk”, when in fact problems arising in the context of rapid milk flow to the baby are due to a less than adequate latch.There is nothing wrong with the mother having a lot of milk. On the contrary, having lots of milk allows many mothers to succeed at breastfeeding in spite of a poor start or poor advice. The article discusses: “Strategies to slow the flow of milk” which is putting the cart before the horse. If the baby cannot handle the flow of milk, the baby’s latch is what needs to be dealt with. However, expressing the first milk as a stratagem will only make the situation worse not better because the baby will be deprived of drinking the milk that is expressed.

Here is our article on tongue tie: http://ibconline.ca/tongue-tie/

You can read more about helping a mother breastfeed successfully in my eBook (also available as a paperback) called Breastfeeding: Empowering Parents:https://www.amazon.com/dp/B07FS6K9SF

07/12/2019

Not all lip-ties need treatment. Thanks again Bobby Ghaheri MD for your informative posts!

The vast majority of those who read the posts on this site show an interest because of problems with breastfeeding. I have pointed out many of those symptoms before: pain, poor weight gain, poor latch mechanics, reflux and so forth. As our awareness about tongue tie and lip tie increases, more moms