I am on my knees on my office floor attempting to maintain some composure while I type this. Today I will beg of you to not simply take the word of your dentist because they are a dentist. When it comes to airway dentistry many dentists know about as much as I know about rocket science…nothing.
As a clinical dental hygienist, I can tell you that the field is saturated and full-time work is hard to come by in many national markets. It is extremely common to have a hygienist work per diem. Outside of that, as a myofunctional therapist, I often visit my referral practices to work a day or so and educate parents on what myofunctional therapy is.
While working strictly as a dental hygienist, per diem, in a dental office I have heard some disturbing things that pressed me to write this bog. Do not, and I must repeat, do not do anything without further research.
Which leads me to my main complaint: Stop just releasing your tie!
Tongue and lip ties are not simply to be released because your dentist has a laser!
There is a multitude of information about Tethered Oral Tissues® available online through reputable sources (Tongue Tie From Confusion to Clarity, ENT Dr. Ghaheri, The Breathe Institute, and research articles), I have an Ultimate Guide For The Tongue Tied here on this site, and there are support communities on Facebook full of people who discuss their experiences. There are two books out that are exclusively about tongue and lip ties, Tongue Tied by Dr. Richard Baxter and SOS 4 TOTS by Dr. Larry Kotlow.
When your dentist looks you in your eyes and gleefully tells you that they can release your tongue tie or that of your child, without offering you any myofunctional therapy before, I want you to smile and collect your things and head straight for the first exit. This is not a drill.
Unfortunately, laser release procedures have become an additional income stream for many dental practices. A laser can be purchased and a weekend course can be taken, but by NO means does that make a qualified practitioner. I have a free resource page with 7 questions you must ask before choosing a provider. These are practical questions that will give you a clear understanding of the experience the practitioner has. I will offer you an 8th question: Have you read Tongue Tied or SOS 4 TOTS and what was your take on function versus appearance of a posterior tie?
That’s a loaded question, that you will tell a lot from just how they answer. There is no right answer, but anyone questioned about function versus appearance should absolutely implore you to look into myofunctional therapy for a second opinion.
THIS GOES FOR BABIES AS WELL! I get it, you are a new mom (or renewed mom) struggling with nursing and a release of a tongue or lip tie seems like the easiest answer. I am a mom of four who has had breastfeeding issues as well and was never told during their infancy that my kids had ties. I always thought until recently that if they were released we would have had no issues. WRONG. There are many things that can impact breastfeeding function, a tongue tie that is impacting function can be released and not always result in immediate proper function. Especially since it is a painful wound. You need a team approach with an evaluation by a IBCLC (lactation consultant), release provider, a bodyworker, and a well trained myofunctional therapist that does screening on babies.
Complaint 2: You cannot just breathe through your nose
Stop listening to your dentist tell you to breathe through your nose to calm your gag reflex.
It is not now, has never been, and will continue to never be that simple. A lack of proper nasal breathing is what got you in this position. If you have trouble breathing through your nose, have narrow dental arches with crowded teeth, and/or predominately mouth breath, you can’t just breathe through your nose. In fact, before you can do myofunctional therapy you may need dental expansion or an ENT evaluation, to functionally breathe through your nose. Bad advice that lacks a general understanding of the way nasal breathing works and why you gag to begin with. (It’s all about the tongue.)
Complaint 3: Grinding is NOT normal
Provide me with the research to prove otherwise and I will retract this complaint. As of this day, there is no definitive reason that explains grinding and bruxism. However, as an airway enthusiast, the airway centered disorder community has connected it to the body opening the airway. Think about it as you try to breathe through the nose and pull your mandible, or lower jaw forward. You may notice that you get more air as your throat opens. It makes sense in a rational way and while there is no abundance of evidence I can lead you to, it is a better explanation than stress.
Ask for an explanation about your grinding, and see if your dentist suggests it as a sleep issue. When you lay down, especially on your back, your tongue may fall back and restrict the airway. Grinding may be the body’s way to resolve that problem.
The truth is, we know more about space than about some basic biological functions. But to write off grinding as normal, especially when there is permanent damage done to the teeth, as a result, is flat out wrong.
Complaint number 4: Lip ties can cause issues
Lip ties can prevent proper lip seal.
I have heard concerned parents come in with a toddler to the dental office and ask about their child’s lip tie. The ill-informed dentist would then tell them not to worry, the lip tie will not encourage cavities and will be released once the child is ready for braces. I can only assume that information is for the parent they think is concerned about a gap between the front teeth. While some lip ties do create that gap between the two front teeth, that is not the only reason to be concerned. Never mind the fact that waiting until the child has reached puberty to do a surgical procedure will create a longer, more memorable, healing experience than a simple procedure during earlier years.
Concern with a lip tie lies in the fact that it does encourage the pooling of liquid around the front teeth, which if that liquid is something other than water, can create cavities. The other concern, that strikes me most as a myofunctional therapist, is with lip seal. If you cannot physiologically create a seal between your lips, you will struggle to maintain proper oral resting posture. This will impact your orthodontic work and efforts to breathe properly.
Complaint 5: Genetics are not why you need braces
Your tongue developed your current oral cavity and facial structure.
I have gone over this in detail with illustrations in The Real Reason Why You Need Braces. As a dental hygienist that went to an exceptional university, I was never informed of the reason why people develop different jaws. So genetics may be the general dentistry response to why your mouth is different from another person’s. However, after much-continued education from leaders in the airway focused field and research, science says your tongue is shaping everything. Airway focused dental practices should not be the only ones giving you that information, but currently, that is the state of affairs.
Complaint 6: Removing teeth for alignment will only harm you
Consider extraction of teeth compaction of your airway volume
So I’m sure there is a way that geometry and physics can explain that when there are crowded teeth and a narrow arch, we can “only” or “easily” extract 2 to 4 teeth to accommodate space for alignment. What good though is a small arch? Especially when the roof of your mouth is the floor of your nose. We need more space, so why not expand the arch, why leave a narrow arch to lessen the treatment time, or convenience the practitioner? Extraction of teeth is a compaction of your airway, and leaves you with straight teeth in a dysfunctional space.
You know what really grinds my gears? Knowing that there are many people who genuinely respect their provider’s opinions and will not second-guess potential bad information. Please do yourself a favor in this age of high priced healthcare, and educate yourself before you make any potential costly mistakes.
Just because your dentist is wrong and ill-informed does not make them a bad provider, it just makes them a person traveling a well-intended journey down the wrong path. Share some great research you may find and share this post. You just may help expand the reach of better care for others!
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