Restricted Tethered Oral Tissues (RTOTs): Understanding the Impact on Infants

At Breathe For Foundational Development, we understand that Restricted Tethered Oral Tissues (TOTs), such as tongue- and lip-ties, can significantly impact an infant’s ability to properly feed, and swallow properly. These conditions, where the frenum (the connective tissue under the tongue or lips) is abnormally tight or short, can interfere with an infant’s ability to nurse or properly use a bottle, sleep well, and grow appropriately.

Healthy tongue, lip, and cheek function is essential to proper growth and development of the face and overall craniofacial complex. Proper lip seal and pressure from the tongue during swallowing are instrumental in growing and shaping the jaws. Healthy, developed jaws provide a foundation for face and airway development. So while healthy nursing and feeding is important for nutrition, it is also crucial for proper growth and development.

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Symptoms of RTOTs in Infants:

Effects on the Mother:

Long-term Consequences if RTOTs Remain Untreated:

Comprehensive Diagnostic Approach

Recognizing the right symptoms early can lead to more effective interventions. Dr. Buehler and her team employ a detailed clinical examination, which often includes a fascial evaluation to assess how the oral tissues affect the entire body. This thorough diagnostic process ensures that every symptom is understood in context, not just treated in isolation. Dr. Buehler likes to teach that everyone has a string of tissue (frenum) under their lip and under their tongue.

The mere presence of this tissue does not indicate a restriction. A thorough, clinical, in-office evaluation is necessary to properly diagnose a restriction of this tissue. Most patients will benefit from seeking additional collaborative care from our list of skilled providers. Dr. Buehler is very clear that she is only a piece of the puzzle; the best care is always a result of a team-based approach!

STATE-OF-THE-ART TREATMENT FOR RTOTs

Expert Treatment and Collaborative Care

Our approach to treating RTOTs uses the latest in laser technology—the LightScalpel CO2 laser. This tool allows us to perform minimally invasive corrections with precision, significantly reducing discomfort and promoting faster healing. Dr. Buehler’s philosophy centers on gentle, yet effective, interventions that minimize stress on the infant and provide relief as quickly as possible.

Integrated Care from a Multidisciplinary Team

This team approach ensures comprehensive care that addresses all aspects of recovery and development, facilitating the best possible outcomes for each child and their family.

Ongoing Support and Education

Breathe For Foundational Development is committed to supporting families throughout their journey. We offer a range of resources and support services designed to educate and empower parents as they navigate the challenges and successes of raising a child affected by RTOTs.