Oral dysfunction
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ReBalance is now offering assessment and treatment of various oral dysfunction patterns. This includes assessment of tethered oral tissues, swallowing patterns, sucking patterns and jaw movements.
Tethered oral tissues (TOTs), or more commonly known as tongue, lip and buccal (cheek) ties, are increasingly prevalent in our population. These TOTs can be subtle in their presentation, and should be assessed based on both their anatomical structure as well as their ability to function properly. Improper tongue positioning, sucking, or swallowing (etc.) can lead to a variety of symptoms and compensation patterns. Early detection and treatment leads to the best chance of success. |
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Common signs/symptoms that typically prompt an assessment
- Reflux or excessive gas
- Poor or difficult latch
- Pain, cracking, distortion, blanching, or bleeding from the nipple (sign of improper/shallow latch)
- Side preferences while feeding
- Mouth breathing/low tongue posture
- Inability to fully open the jaw
- Clicking sounds when feeding
- Arching or pulling off bottle
- Weak sucking
- Choking/gagging when feeding
- Low weight gain
- Gumming or chewing at nipple (non-productive suckle)
- Lip blisters
- Excess drooling
- Not able to take bottle or pacifier
- Recessed chin
The suck-swallow-breathe sequence involves 31 muscles, 6 cranial nerves and at least 3 cervical nerves. Tongue-ties interfere with the tongue’s fundamental role in initiation and controlling the suck-swallow-breathe mechanism, setting the stage for compromised swallowing and airway patency later on.
Dr. Lindsey has received additional training in PIPS (pediatric intraoral palate specific) technique which is an assessment and treatment tool for intraoral dysfunction, palate imbalance, TMJD and poor tongue function.
Dealing with restricted oral tissues takes a team based approach and may include co-management with a dentist trained in tie releases, IBCLC (Lactation consultant), physiotherapist and/or myo-functional therapist.
Dealing with restricted oral tissues takes a team based approach and may include co-management with a dentist trained in tie releases, IBCLC (Lactation consultant), physiotherapist and/or myo-functional therapist.
is it safe?
Yes, treatment is very safe. As a mom herself, Dr. Lindsey uses a playful technique to make babies feel comfortable. All techniques used are gentle and, most importantly, quick. Baby can be on the table, on their parent or roaming around (if they are older) and we will always adjust to their needs.
Homecare
As parents, you are a big part of the care team. These dysfunctions do require you to perform manual stretches on the baby throughout the day. You will always be given clear instructions on your homework.
additional resources
- more information about tongue ties HERE and HERE
- more information about PIPS technique and what care would look like.
Available at ReBalance:
- MyoMunchee (baby, mini, junior and adult sizes)
- MyoSpots
- more information about PIPS technique and what care would look like.
Available at ReBalance:
- MyoMunchee (baby, mini, junior and adult sizes)
- MyoSpots
Do all tethers require a release?
Not necessarily! As we are assessing for proper tongue function, there are more mild cases of TOTs that can be treated with manual therapy and exercises. If there are apparent dysfunctional patterns (or any of the symptoms listed above continue to persist with treatment), a proper assessment should be preformed to know if a release would be beneficial.