Tongue to Toes: The Whole Body Connection

The human body is an amazing and intricate work of natural art that we will probably study for centuries to come before we ever establish a complete understanding of it. From what we do know from current research and physiologic understanding, it is all very connected.

Every organ, bone, muscle, and tissue is connected in some way to each other. Consider, now, how that connection can impact your body in a negative way.

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Many are familiar with muscles and their connection to the body and movement. Yet, little is ever mentioned of its structural companion, fascia. Fascia is a thin band of connective tissue that envelopes our muscles.

muscle-anatomy

It’s a protective sheath that groups together muscles of similar function and helps to distribute nerves and blood vessels.

While there are 4 layers of fascia that cover certain portions of the body, our outermost layer covers the entire body. Think of it as akin to the skin in encompassing connectivity. If you were to pinch your skin on your arm you may feel the pull or tension of that stretched skin in another area of the arm.

A tongue tie works similarly in fasical pull, as our deep front line fascia connects our tongue in one continuous band of fascia down to our toes.

fascia

It is only in the given imagery above that you can see how a tongue tie (which is restrictive or tight connective tissue band connecting the floor of the mouth to the base of the tongue) can affect breathing, posture, pelvic floor stability, and toe walking. Often a “harmless” tongue tie can be just the clinical tip of the iceberg, masking within the body various linked medical and dental problems.

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Some people do claim to have miraculous feelings of relief or immediate postural improvement. While not unusual, most people do have to wait or accompany a tongue tie release with manual bodywork to assist in fascial strain release. Those pulls by fascia that is holding you together may just be holding you back from real relief.

Don’t let your tongue affect your body negatively. Have your tongue functionally assessed by a myofunctional therapist. Or, learn more about the tongue’s impact on the body, coupled with resources to guide you on your journey from tied to free with our Ultimate Guide for the Tongue Tied.

[Want a closer look at this surgically extracted deep front line with detailed explanation. Get a better view on YouTube.]

The Ultimate Guide for the Tongue Tied

Without fail there are only two responses I get when I notify someone that they have a tongue tie:

  1. No one has ever told me that before
  2. My (or his/her) speech is fine

Given the general lack of information out regarding tongue ties and the linked health concerns, those answers are understandable. However, it is beyond time to break the myths and provide more centralized information that is easy to digest.

A tongue tie may very well be the biggest little thing you never knew you had as it impacts and affects many other parts of the body and is involved in an essential bodily function.

Facts

TMS tongue tie infographic

What if you don’t release

While a tongue tie can very well impact speech, I honestly list speech towards the bottom of reasons to treat a tongue tie. The tongue in it’s proper resting posture should be up against the roof of the mouth for proper breathing, development, and function. A restrictive lingual frenum (string of tissue connecting the floor of the mouth to the base of the tongue) will make proper posture difficult if not impossible. Without release and therapy to obtain proper tongue posture you are risking the possible consequences below.

TMS tongue tie consequence

THE RESOURCES

Frenectomy Tips Before They Snip

A three page guide with the four major steps you should take prior to releasing or considering releasing a tongue tie. Including why pre and post exercising is essential for optimal healing outcomes.

7 Questions You Must Ask Before Choosing A Release Provider

This resource has our list of every essential question you should have answered prior to deciding whether or not this provider is right for you. Not all release professionals are equal in tools, experience, and technique. To make an informed decision you should ask as many questions as possible. Remember, while not a major hospital stay surgery, a tongue tie release is still a surgery.

Tongue Tie Release Checklist and Questionnaire

Accompany resource to our 7 Questions, is this checklist and questionnaire. Use the questionnaire to document what your desires are when it comes to your release experience and healing. Also document the answers to the 7 questions you ask each provider you interview so you can compare responses and make the best decision.

Frequently asked questions

Our YouTube video series, Sixty Second Saturday, answered common questions in less than 60 seconds, like: Frenectomy vs. Frenuloplasty: what’s the difference and Frenectomy healing time: how long.

F.R.E.E. Your Tongue

A self-guided course of myofunctional therapy for those who are unable to work one-on-one with a myofunctional therapist prior to getting released.

 

Why did my doctor recommend myofunctional therapy?

I guess you thought you were in for a simple visit. A routine visit with a simple diagnosis or the always preferred, confirmation of health. Thankfully, you have an excellent doctor who cares about your whole body and sent you on a wellness path!

There are several reasons why you may have been referred to myofunctional therapy, and several types of providers who do refer.

Who may have sent you and why

Speech Language Pathologist (speech therapist) – refer for speech problems that are not improving due to a tongue tie or tongue thrust. Common referrals include lisps and difficulty with S, L, T, D and N sounds. (*myofunctional therapists that are NOT speech therapists do not treat the speech problem, they treat the tongue posture and speech improves in conjunction with continued treatment with the speech therapist)

Otolaryngologists (ear, nose, and throat doctors)– refer in conjunction with a dentist in their airway team. Typically for those with high narrow dental arches, chronically inflamed tonsils or adenoids, and/or a deviated septum.

Dentists or Orthodontists – refer for tongue thrust, open bite, malocclusion, thumb sucking, high palate (roof of the mouth), narrow arches, mouth breathing, and most commonly in conjunction with braces or oral appliance.

Sleep Physicians – refer for mild sleep apnea and CPAP (continuous positive airway pressure) compliance.

If you do myofunctional therapy…

There is far more to gain from myo then what you may have been referred for. Often times problems you had no idea were associated, can be caused by an orofacial myofunctional disorder (OMD).

The body is one large connected unit with many functioning parts. When there is dysfunction in a muscle, often it leads to the body creating a compensatory use of another muscle to perform the task. For example, when you have a reverse swallow it can cause overdevelopment of your mentalis muscle and alter facial appearance.

OMDs can contribute to numerous problems as can be seen below in the infographic. Myofunctional therapy may be the answer you never knew you needed to problems your healthcare provider referred you for, in addition to other underlying issues.

25 Health Benefits of Myofunctional Therapy-01

Still unsure where to go on this airway health journey? Read start with this beginner’s guide.

Contact us to get started with myofunctional therapy today!

Pre and Post Frenectomy Excercising: An Analogy to Make it Simple

The decision to release a restricted or “tied” tongue and/or lip is not one to be taken lightly. While the procedure itself is a minor surgery with relatively quick recovery, several factors should be considered prior to committing.

  • Research
  • Professional Confirmation
  • Pre- and Post-procedural exercise regimen
  • Recovery timeline and commitment

Research

Believe it or not, tongue ties and releases fluctuate in popularity. In the early to mid 20th century, midwives used to release the restricted tongue with one swipe of a sharp fingernail. Through the years the trends have shifted and medicine has steered away from diagnosing or recommending frenectomy in newborns. Bottle feeding newborns and braces are the new norms. Perhaps in the next 15-20 years we may see a return in the popularity of early releases. Until then we are in a current state where there are children and even adults who have frequently visited a dentist or physician and have never once been informed of their tongue tie. The physician literally looks into the mouth everytime they see you and request you say, “ah.” The dentist works almost exclusively within the mouth and is seen more frequently by some people than the physician.

These providers should have an obligation to look within the oral cavity and inform their patients of any abnormalities. Granted a physician may see patients that are suffering from deadly, debilitating and life-altering diseases. So a tongue tie that is not impacting speech or quality of life does not alarm or alert their senses to do no harm.

Limited teaching is done on tongue ties in medical and dental schools. So while it may be personally disturbing to think that you have gone your whole life only to have a dental hygienist at your new dental office inform you of your tongue tie, despite your 60+ years of medical and dental encounters previously, rest assured you are not alone. Dentists and MDs are not trained thoroughly on the impact and presentation of tongue ties. New research is presenting frequently with connections to health and tongue ties.

It is critical that you invest your time in looking into ALL the researched associations and implications of living with a tongue tie prior to deciding to go for release.

Professional Confirmation

Perhaps your enlightened and knowledgeable dental hygienist, dentist, speech-language pathologist, bodyworker or doctor has informed you that you and/or your child has a tongue tie. What should you do with this information?

Get a second professional opinion from another enlightened and knowledgeable healthcare provider. Preferrably one who specializes in tongue ties such as a dentist that performs releases, a bodyworker, or a myofunctional therapist (a.k.a. orofacial myologist).

The later is able to determine if your tongue tie is functional or not. In other words, do you have a tongue tie that can be rehabilitated to maintain proper oral resting posture; or do you need a frenectomy in order to establish and maintain proper oral resting posture.

Pre and Post Exercises Analogy

Imagine that your arms have been attached to your torso from the armpit down to the wrist. If a doctor informed you that a release was necessary would you know what to do with your arms once they were freed? Would your muscles be strong enough to perform all the directional pulls, lifts, twists and bends that you are capable of? If you failed to utilize those movements post-release how would the arm heal?

The last of these questions is of the utmost importance. Scar tissue is the body’s natural healing response. An arm released that does not move would naturally form scar tissue between the torso and the arm. You may not be fully restricted, but you would have failed to gain the complete release you could have achieved.

Making the most of your decision to release has to include work with a myofunctional therapist to perform pre- and post-frenectomy exercises. The exercises will not establish a proper oral resting posture, but they will stretch and strengthen the muscles, and prepare some muscle memory for the healing process. This a short part of a complete myofunctional therapy program that focuses on preparing the patient to be eligible for release and prevent the re-restrictive development of scar tissue.

Recovery Timeline & Goals

A minor surgery is a surgery. Recovery is necessary. Listen to the releasing provider and plan your schedule accordingly. You will need to take some time off of work or your child may need to take a day or two out of school.

Be sure to plan for pain management. Some people have minimal pain post-procedural, while others take longer to recover from pain. Prepare for the worst while expecting the best.

Move that tongue as much as possible. Perform your post-procedural exercise regimen as much as possible in the first 72 hours. Remember to follow-up with your myofunctional therapist in addition to your releasing provider to ensure your recovery is going smoothly.

Conclusion

Nothing guarantees a better outcome than preparedness.

Go into the decision to have a tie released by doing your research on possible consequences, getting an informed second opinion, working with a myofunctional therapist to prepare and understand your recovery prognosis.

An airway issue has been identified…now what?

So you had what you thought was going to be a routine dental or medical evaluation and your provider has just informed you that you and/or your child has a breathing or airway issue. You are understandably confused and possibly have been given too much information about a problem you never knew existed.

You have landed in the right place! I will break down the logistics of some information you have been given, possibly give you more you didn’t think of and present you with a to-do list so you know how to proceed.

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All was well and right with the world until that visit. You knew your body and/or your child and there were no words other than healthy to describe you. Yet, a few questions and one exam later knocked down all the blocks in the tower you were building.

Here’s what you should know:

  • Mouthbreathing is ineffective and inhibits your body from functioning optimally. The visible signs that your doctor may have noticed are in the graphic below. These are the tip of the iceberg in diagnostic signs of an orofacial myofunctional disorder (OMD).

    An OMD is an inability to utilize proper oral or facial muscle function. Characterized by over or underutilization of muscles when breathing, masticating (chewing) and/or swallowing.

    myofunctional therapy Cork

  • There is no official way to predict the future health implications of OMDs. Airway issues and dysfunctions have been tied to sleep apnea, asthma, eczema, TMJ disorders, ADHD/ADD, daytime sleepiness, tongue thrust, speech issues, enlarged tonsils/adenoids, snoring, grinding, messy/loud eating, picky eating, slow labored eating, poor dental arch formation, malaligned teeth, poor facial development, anxiety, poor emotional regulation, frequent congestion, and proneness to allergies.
  • Not all tongue ties need to be released. There is a functional and non-functional tongue. The decision for a release should always include a myofunctional therapist, even if just for a consultation. Craniosacral therapists and Osteopathic physicians are also great to consult for eligibility to release. Read more about them below in part 2.
  • We spend 1/3 of our lives sleeping and there is no more critical bodily process than breathing, yet medical and dental schools spend less than 10 hours studying both. With the exception of specialists, medical school graduates are mostly unaware of sleep disordered breathing and orofacial myofunctional disorders. In fact, in most cases where a knowledgeable dental provider indicates an OMD and the patient/parent goes back to their primary care physician, the physician will disregard or dismiss the issue.
  • While there are many possible causative factors for OMDs, the only preventative measures that can be considered are to have newborns evaluated for lip and tongue tie, breastfeed for 1-2 years without regular bottle supplementation, do not introduce a pacifier or take away a pacifier at or before 6 months of age, do not introduce sippy cups, go from breast to regular cup or cup with straw, allow babies to have tummy time, limit baby sleeping in unnatural positioners (walker, rocker, swing, bouncer, carrier), and discourage thumb, finger, tongue or object sucking. The aforementioned measures can help reduce the risk of a child developing an OMD but is not guaranteed. Some hereditary, genetic and otherwise elusive factors are involved.
  • You are not alone. Due to our diets, fast-paced society, and perceived norms many people have OMDs that are undiagnosed. Hard crunchy foods are not the integral part of the diet as it used to be. Caffeine is the stimulant used to power the body and keep it alert and awake, as opposed to adequate oxygenation and sleep. Snoring, painful breastfeeding and needing braces are all considered normal in society, as opposed to signs of airway problems. If you took a walk down a city street and watched carefully, it is a good prediction to say that 70% of the people you pass will have an open mouth and one or more other signs from the graphic above.
  • There are solutions, but you have to be prepared and fully aware of the time and financial commitment that it will require. If you take your steps wisely, you may be able to get some financial help from both medical and dental insurance to help reduce costs in some areas.

Which leads us to

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What on earth do you do with all this new information? How do you apply it and where do you go from here?

The detailed plan

  1. Assemble your team
    1. Dentist- A progressive dentist that specializes in sleep and/or airway dentistry. This dentist does all types of “typical” dental services such as examinations, fillings and preventative care. However, they also evaluate for tongue ties, airway obstruction, screen for sleep issues and utilize orthopedic or orthodontic appliances to expand the airway. They can offer you dental solutions for sleep problems.
    2. Sleep Physician- A sleep specialist can consult with you and determine your need for a sleep study. A sleep study is used to monitor your brain and vital activity while sleeping. The physician will read the results of the study and determine if there were episodes of obstructive breathing or poor sleep quality. In some cases, a sleep study that results in a diagnosis of obstructive sleep apnea can warrant your medical insurance to reimburse or pay for dental appliances to expand the airway. A specially trained dentist (general or pediatric) or an oral maxillofacial surgeon can perform releases of tongue or lip ties.
    3. Bodyworker- This team member can feel and manipulate tensions, pains, and dysfunctions in the body. An osteopath is a medical doctor that specialized in osteopathic medicine. These doctors are often recommended by dentists who utilize the orthodontic appliances. Alternatively, a craniosacral therapist works with the cranium, spine and pelvic area. They are certified professionals who have at least 2-3 years of training and clinical experience.  Sometimes trained in orthodontic appliances, bodyworkers understand how to symmetrically balance the growth of the palate with the entire cranium. With tongue ties and other body restrictions or tensions, they may be able to perform treatments to alleviate the tension or manipulate the restriction. In most cases, neither of these professionals are covered by insurances but may qualify for out-of-network reimbursement.
    4. Myofunctional therapist- A myofunctional therapist or orofacial myologist is a speech-language pathologist, dental hygienist or dentist that has pursued additional education and training for the treatment of OMDs. This professional can work with patients to help them establish proper oral resting posture. They are also able to help eliminate noxious oral habits, such as thumb sucking, nail biting or prolonged pacifier use. These professionals are able to assess the functionality of a tongue frenum to determine if the tongue is functionally or non-functionally tied.
    5. ENT- An ear, nose, and throat doctor can evaluate the airway for obstructions. They will determine if the obstruction is capable of rehabilitation without surgical intervention.
  2. Make modifications accordingly
    1. Change the diet. Along this journey, various members of your team will inform you that gluten, dairy, processed foods, and sugar all increase body inflammation. If you have an airway obstruction, the first and easiest change to make is in the diet.
    2. Perform nasal hygiene. Just as you would brush your teeth daily, cleanse the nasal passages with a saline rinse daily.
    3. Try natural solutions. Nasal strips can help to open the nasal passages. Sleeping on your side can help you to breathe better. Eliminate sucking objects (bottles, sippy cups and pacifiers) for young children. Be aware of your mouth posture and close the lips comfortably together to consciously nasal breathe.
  3. Research, Research, RESEARCH
    1. Don’t take everything you hear from your professionals and hold onto it. Process the information internally, and add the wealth of information available online from various professionals. Remember, you are not alone. There are blogs from professionals (like this one), blogs from individuals who chronical their journeys, peer-reviewed journal articles and research available for you to review online.

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Once you know more, you are able to not just do better, but also BE better. It is a long and hard journey, but there is significant light at the end of the tunnel. You are strong enough to complete this journey.

Continue to follow this blog for more helpful posts that may guide you along the way.