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Why so much controversy over tongue ties?

This is a frequent question that I get from parents in our practice and community.  As a parent, I had similar questions myself.  My older daughter, Cyrah, had an undiagnosed tongue tie for over 4 years.  I was the parent seeking answers from providers of multiple specialties as to why she didn’t breastfeed well as an infant, why as a toddler she snored, and as a young child had uncontrollable tantrum after tantrum.  The answers I received were not consistent, and as a parent this left me feeling confused and frustrated.  I knew in my gut that something was not right.  However, when you are left unvalidated by healthcare professionals, it makes you start to doubt your own intuition.

Luckily for me, I am fortunate to be in healthcare and I work as a pediatric dentist.  I took it upon myself to learn more about tongue ties and advanced pediatric airway development.  This allowed me to figure out what was the root cause of my daughter’s issues.  So why does there continue to be confusion and a lack of guidance for so many parents out there? 

Here are my observations:

1.      Gaps in educational training: education and training on the diagnosis, impact, and treatment of tongue ties is not covered in any standard medical or dental training.

2.      Complete vs. incomplete procedure:  unfortunately, those that are trained to release ties are not all trained the same; however, we all as providers are grouped under the same umbrella.  Ties can be treated with many different tools including medical scissors and several different types of lasers.  The approach to the procedure can also vary from one provider to another.  So how do we know if the procedure is done well?  If the surgical techniques is incomplete, then we know the outcome will likely be compromised.  This is why many parents will say that their child’s tongue tie release “didn’t work”.  Incomplete procedures lead to sub-optimal outcomes. 

3.      Research:  Historically, there have not been many evidence-based research papers on the efficacy of tongue tie release.  Fortunately, the current research and science has begun to validate what we have already known as practitioners and parents.  Multiple disciplines have been working on collecting data in this field. 

4.      Focus on function:  Releasing a tongue tie is much more than a brief scissor or laser procedure.  It is about making sure that the complex tongue muscles are working in unison to optimize function.  Unfortunately, that is not done by the procedure itself, but rather it is achieved by working closely with specialized therapists before and after your procedure. 

As a parent and a practitioner, my goal is to educate and guide parents into making the decisions that are aligned with their parenting goals.    I think it is important that families understand the different perspectives on tongue ties and where they originate from.  I desire to optimize the health and functionality of my patients and I believe that optimal tongue function is paramount for our children. 

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