ORAL FUNCTION SUPPORT

Special thanks to Sara Rafeie, RDH, Myofunctional Therapist who wrote this educational post in the group and gave permission for me to share it here!

“RDH Myo Therapist here! I thought I’d do an educational post to tackle some common questions that come up in this space. Drop a comment if you’d like to talk more about a topic or if you have a different question.

1. Sometimes the nomenclature around tongue and other oral ties can get a little confusing. One term I see getting misused often is “Revision”. Revision means to “fix” or “redo” something. If it’s a first tongue tie release, it’s called a release. If it’s a second release or beyond, then it is called a revision because the first release is being redone or fixed.

2. Preparing for and healing from a release is just as important as the release itself. For infants, you need to work with some type of feeding therapist and/or a IBCLC before and after a release. For children and adults, you must do myofunctional therapy before and after a release. Just a release alone does not fix function, and no properly trained release provider will touch a tie without the patient getting the green light from a myofunctional therapist first. If a doctor says they will do a release without Myo it means they aren’t trained properly and they just want your money. Both infants and adults should do some type of body work around the time of their releases. This is a whole body issue not just a tongue issue.

3. No doctor or dentist learns how to do a functional frenuloplasty in school. They only learn how to do a frenectomy, which is just cutting the skin. They don’t learn how to assess function or reach “posterior” tongue ties (restrictive fascia underneath the mucosa and sometimes into the genioglossus muscle). If you go to just any regular dentist, pediatrician, or ENT, chances are they won’t even know what to look for and will tell you there are no ties, or they will make things worse not better. You’re better off leaving it alone than going to the wrong person and getting a partial release and scar tissue. A properly trained myofunctional therapist or IBCLC will connect you with the right provider.

4. The person using the tool is more important than the tool itself. Just like using a good hammer doesn’t make someone a good carpenter. For infants it’s important to use lasers because they can’t get stitches. For children and adults a provider can use scissors, laser, or a combo of both. The results come down to the skill of the provider. Healing tends to be a bit faster with laser, but regardless of using a laser or not, stitches SHOULD be placed on everyone except infants. Period. The bigger the wound the bigger the scar. When stitches are placed healing is pretty similar regardless of using laser or scissors. Infants can’t get stitches because they’re too tiny and we don’t want needles around awake and wiggly baby faces. This is why you have to do stretches of the wound every few hours with infants but not for kids or adults with stitches. The stitches do all of the work of primary intention healing and preventing excess scarring.

4. The person using the tool is more important than the tool itself. Just like using a good hammer doesn’t make someone a good carpenter. For infants it’s important to use lasers because they can’t get stitches. For children and adults a provider can use scissors, laser, or a combo of both. The results come down to the skill of the provider. Healing tends to be a bit faster with laser, but regardless of using a laser or not, stitches SHOULD be placed on everyone except infants. Period. The bigger the wound the bigger the scar. When stitches are placed healing is pretty similar regardless of using laser or scissors. Infants can’t get stitches because they’re too tiny and we don’t want needles around awake and wiggly baby faces. This is why you have to do stretches of the wound every few hours with infants but not for kids or adults with stitches. The stitches do all of the work of primary intention healing and preventing excess scarring.

5. The only appropriate laser for a frenectomy/frenuloplasty is a CO2 laser. Not a diode laser or electrocautery. Diode and electro burn tissue and cause more scar tissue."

- Sara Rafeie, RDH, Myofunctional Therapist
Revealmyotherapy.com/faq