Tethered Oral Tissues (TOTs) is a term used to describe tight, restrictive connective tissue between oral structures. This connective tissue is called frena. Everyone has frena but when this tissue is thick, tight, and restrictive of typical movement we say that that there is a “tie.” Lip ties, tongue ties and cheek ties fall under the TOTs umbrella. Identification of TOTs is important as these ties have the ability to negatively impact a child’s feeding skills, proper facial structure development, breathing, sleeping, and speech/language development.

Signs and Symptoms of TOTs

How can you tell if your child may have TOTs? Here are some signs and symptoms:

In babies (0-12 months):

difficulty latching to nipple (breast or bottle)
difficulty gaining weight/slow weight gain
losing milk/formula out of corners of mouth when eating
audible “clicking” sound while eating/sucking
difficulty holding a pacifier in mouth
congestion
reflux
open mouth posture
high, narrow hard palate
difficulty transitioning to solid foods

In toddlers and older children (12 months +):

history of symptoms reviewed above
drooling
messy eating
picking eating
snoring/sleep issues
delayed talking
speech that is difficult to understand
persistent speech sound errors

Tethered Oral Tissues: Tongue Tie/Lip Tie/ Buccal (Cheek) Tie.

Signs and Symptoms of TOTs

Janna Hansen, DC, AFMCP, RYT, SpBAP, chiropractor, functional Medicine

2363 Boulevard cir Ste 12, Walnut Creek, CA 94595 925 494-0632 Team@Perinatalchiropractor.com