Last fall I went through a stressful stretch in life. I started noticing that my jaw would not open fully without my jaw clicking in the morning. It started to pop and click when I opened my mouth, when I yawned, while I was eating. It was very annoying and got to be painful. Backstory…. I have been diagnosed with TMJD. I wear an occusional splint at night.
I am a licensed speech language pathologist with over 23 years experience. The past 7 years I have been blessed with the opportunity to participate on global evaluation teams weekly. That being said the past few years I have been reading more about TOTS (Tethered Oral Tissues) and looking in my kids’ mouths more with hopefully a better eye. There are 3 types of TOTS including lingual (tongue-tie); buccal (cheek) and lip ties. In the past I wondered about my own self and a tongue-tie. When I had the time and the opportunity to shadow a pediatric dentist I scheduled my own consult also. Sure enough! Class 3 tongue tie.
When you look at the existing literature with our infant population you will find information on how a tongue-tie can impact the tongue’s ability to help shape the palate. When the tongue sits in the bottom of the mouth due to a tongue-tie this can impact the formation of the palate. AKA high palatal arch. Tongue restriction can impact the ability to obtain an adequate and/or sustained latch on a bottle or a mother’s nipple. This in turn can affect the quality and/or the ability to coordinate an adequate suck swallow breath pattern. Have you ever looked at any work done by Patricia Oetter and Eileen Richter? They created an amazing visual with the suck swallow breathe pattern at the epicenter of the diagram. From there, the visual displays the impact on all areas of development when this pattern is impacted.
That being said, due to the jaw pain I was willing to follow up with a myofunctional therapist and see what kind of relief I might receive. Little did I know that I’m not chewing properly and I have a tendency to thrust my tongue. Eek. Did you know that a tongue-tie can impact your jaw? I own the book Tongue Tied by Dr. Richard Baxter and found the chapter regarding adults interesting for myself. If you have decreased range of motion and over compensate, over time you can develop jaw pain and overall bad habits. Also, from what I have read, the decision to have a release often lies in if the tongue-tie affects function.
I also suffer from allergies. I have a tendency to present with an open mouth posture when I’m moving throughout my day. There is some interesting information out there with regards to breathing patterns, allergies, etc. This makes me wonder about the open mouth and the tongue tie too and how that could have played a roll for me during the course of my life. Within therapy sessions we have been working on breaking old habits to create new ones which are closer to what “normal” would look like. Retrain the brain to retrain the behaviors. I told my therapist I did not need to be perfect but I would like to be using my articulators , abdomen, etc optimally. Somewhere in the middle of the gadgets, the research, and the clinical experience lies the approach for each individual person in my opinion. I have not looked into the research behind myofunctional therapy but I will tell you that the dentist would not do the release unless I saw someone.
My takeaway is that we as professionals need to be looking in our kids’ mouths. We need to be educated on TOTS. We need to educate our families. And, we need to educate other professionals. On a side note, my experience personally and professionally is that a correlation often exists between persons with low tone, motor planning, tongue-tie and reflux.
For years I have been over compensating. Not too mention the hurried patterns of life. Eating quickly. Talking too long on one breath.
I have to tell you I called another SLP the other day. She told me I need to talk about my anxiety around this tongue release. She said that people do not talk about it so here we go… the past couple of weeks the thought of having a hole underneath my tongue and how it gets there has been a little troublesome. I am fearful of the procedure and something happening. I wonder if that fear stems from that actual fear or just my general tendency to feel like something bad will happen; like I am making a bad decision; that I am wrong. I have been plagued throughout my life with these types of fears. I have had people in my life that would like me to continue to believe those fears. These fears have driven me to try to do better, to learn more, and to try to be good enough. The past few years I have been slowing down. I have been letting go of people and ideas that no longer work for me. They do not serve me anymore. And, I am good enough. Just the way I am.
Somewhere inside of me I feel this procedure is the right thing to do to see if it alleviates the jaw and neck pain I have experienced the past several years. When you begin to trust yourself more, the fears do not drive you. My release is scheduled for the end of June 2020. I will see my myofunctional therapist before and after the surgery. I have also been seeing the acupuncturist and receive regular massages. Final takeaway… find beauty in the here and the now. It is right in front of you.
More to come…Post release…
Patricia Oetter, MA, OTR/L, FAOTA 1989; Oetter Richter, Frick, revised 1993, 1998, Relationship of Development to the Suck/SwallowBreath Synchrony, MORE Integrating the Mouth with Sensory and Postural Functions https://www.eppicot.com/patricia-oetter.html
Richard Baxter, DMD, MS, Tongue Tied https://tonguetieal.com/book/
The Breathe Institute, https://www.thebreatheinstitute.com/myofunctional-therapy.html
Bobby Ghaheri, MD, https://www.drghaheri.com/blog/2014/3/22/rethinking-tongue-tie-anatomy-anterior-vs-posterior-is-irrelevant
#Beth
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Samara Shalom
From another SLP that realized she was tongue tied, I wish you well. I have not been formally diagnosed. My kids needs were more pressing and even though part of me wanted to just fix everyone’s at the same time and be done, as you say, find beauty in the here and now and don’t rush. All of the work was pushed off by COrona but we will get back there and yes, please all SLP’s need to have some basic knowledge of this. I worked with a kiddo in the clinic when I was in Grad school working on /r/. I came across the same kid 6 years (ish) later being dismissed from Speech due to lack of progress for /r/. With what i know now, I believe this kiddo had some type of TOT and we had put an impossible task in front of this child. I’m grateful to have the knowledge I do know both personally and professionally. I am not an expert, I am not an oral myologist, and I truly acknowledge the need to know about this. Wishing you well!
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