To Release or Not to Release? That is the Question

Tethered Oral Tissues (TOTs), or oral restrictions such as tongue tie, are congenital abnormalities in which the oral frenula are too tight, too short, too thick or sits in an atypical location. TOTs are one form of an Orofacial Myofunctional Disorders (OMDs), and cause atypical, adaptive patterns that may impact airway, sleep, feeding, speech, feeding and swallowing. Recent research by Diercks et al. (2020) and Hill (2024) point out that not all identified oral restrictions are the sole cause for infant feeding difficulties and the media has scrutinized the evidence and efficacy behind an increase in frenectomies. The first part of this class will review the literature and analyze the current state of why we are seeing an increase in frenectomies and what research is available to support or negate surgery. After research is explored, Robyn will discuss her parent friendly “release readiness” protocol that discussed important factors in determining when patients have the sensory-motor