If you are confident that your baby or child does have a tongue tie and are looking for help, you have come to the right place! I know how challenging it can be to find a good tongue tie professional. You may have no idea how to start or where to look. What type of professionals treat tongue tie? Is a tongue tie release enough or should you find other support services as well? The goal of this article is to answer all of those questions and more.
If you think your child does have a tongue tie but are not sure, I recommend seeing a professional who can properly assess and diagnose them (or not!). Dr. Ghaheri is a highly respected ENT who has a great post about assessing babies for lip and tongue ties. If you can’t easily access a professional’s opinion, this may be a good place to start to give you an idea if you should proceed further.
For more information about signs of tongue tie in babies and children, check out this post from the Alabama Tongue Tie Center.
Trust your instincts. If you know in your gut that there is something going on with your baby or child, you have to listen to that voice! Tune out the noise of others telling you “it’s normal”, “they’re fine”, “they will grow out of it”. Unfortunately, these may be things your pediatrician has told you. But you are the expert on your child, not their doctor. Pediatricians are generalists and they typically do not have specialized training on how to assess for or diagnosis tongue tie. If you don’t feel listened to or supported, I strongly recommend finding a knowledgeable and experienced professional who can help your family.
What Type of Professionals Treat Tongue Tie and Related Issues?
When parents first think about tongue tie treatment, they often think about who will do the release. A release is the surgical management of tongue tie and is done either by using scissors or a laser. Release providers can be ENTs or dentists. There are some pediatricians with this training as well. That said, most dentists and most ENTs are not knowledgeable or experienced on this topic. You have to find the right person for the job! And I will help guide you on that path later in this article.
You may have heard that some people recommend other types of treatment in addition to (or sometimes instead of) the release. The benefits of pre and post tongue tie release treatment are becoming more widely known and accepted. Babies and children with TOTs (tethered oral tissues) typically have other areas of tension in their body. They therefore benefit from bodywork and manual therapies to help relieve this tension and improve motor patterns.
Many children have other challenges related to their tongue tie diagnosis, such as feeding & swallowing issues, digestive issues, motor skill delay or dysfunction, torticollis or plagiocephaly, sleep challenges, state regulation issues, etc. These children need support from the appropriate professional for these issues and a release alone will likely not be enough to resolve their challenges. For more information about these related issues, check out our article The Long-Term Effects of Tongue Tie.
The following list of professionals and types of treatment is not exhaustive by any means. There are so many different types of professionals entering the tongue tie world because we are learning more and more about how complex this diagnosis can be. The following list is a great place to start and you will naturally find other solutions as you continue on your journey.
As stated above, providers that do tongue tie release procedures are typically ENTs (ear nose and throat medical doctors) and dentists. Some pediatricians are also trained in the procedure. Most ENTs, dentists, and pediatricians do not do release procedures, so you must find a provider with this specialized training.
Release providers use either scissors or laser to do the procedure. There is much debate over which method is better, but most professionals agree that what’s most important is the experience of the provider, not the tool. Dr. Ghaheri wrote a great article about this topic: Does Laser Vs Scissors Matter?
Bodywork and Manual Therapy
There are many different types of bodywork and manual therapy. This may include myofascial release, trigger point release, massage, cranial sacral therapy, and more! What’s most important is not necessarily the specific type of treatment, but rather the experience of the professional. Bodywork and manual therapies may be provided by: Occupational therapists, physical therapists, chiropractors, cranial sacral therapists, osteopaths, and massage therapists.
If you are having challenges with breastfeeding, I highly recommend working with an IBCLC with tongue tie knowledge. IBCLC stands for International Board Certified Lactation Consultant. Other professionals may have the designation of lactation educator, lactation counselor, or they may even call themselves a lactation consultant. However, these titles are not equivalent to IBCLC. Obtaining board certification is a rigorous process and this designation signals a higher level of knowledge. That said, certification alone does not make a good professional, so do your research to find someone with the right experience to help you and your little one.
Myofunctional therapists help to correct improper function of the tongue and facial muscles. They are either speech and language pathologists, occupational therapists, or registered dental hygienists. In order to participate in this type of treatment, children need to have the cognitive development skills of a 4 year old, so this approach is typically best for older children. Prior to age 4, occupational therapists and speech and language pathologists with training if feeding therapy are the ideal professionals for treating oral motor dysfunction.
Feeding and Swallowing Therapists
If your infant or child is coughing while eating, not chewing food thoroughly, avoiding certain textures, or having any other feeding related issues, a feeding evaluation is indicated. Feeding therapists are either occupational therapists or speech and language pathologists with special training.
Airway Centric Dentists
Due to improper tongue positioning, many children with tongue tie will have dental issues as a result. For example, they may have a high arched palate due to low tongue resting posture. When the frenulum under the tongue is tight, it often leads to the tongue being pulled down to the floor of the mouth rather than resting up at the roof of the mouth (the palate) like it should.
Because the tongue is what shapes the palate, if the tongue is not resting up at the roof of the mouth, the palate can become high and arched rather than broad. This can then lead to dental crowding and malocclusions (misaligned teeth). Dentists who have advanced knowledge on the airway understand the importance of palatal shape and structure in a way that the average dentist may not. If you are concerned about the size or structure of your child’s palate or jaw or if you have other dental related concerns, an airway centric dentist can be an asset.
Ear Nose & Throat Doctors
In addition to being release providers, ENTs are also important if there are concerns related to your child’s airway. If you are concerned your child may have sleep disordered breathing (such as snoring or sleep apnea), or enlarged tonsils or adenoids, a knowledgeable ENT is an essential member of your team. They may recommend that your child have a sleep study or recommend removing their tonsils or adenoids to open their airway which may improve their breathing and sleep.
Occupational therapists (OTs), physical therapists (PTs), and speech and language pathologists (SLPs) are experts on child development. Depending on what challenges your child may be experiencing, one or more of these professionals may be a good support system.
A PT may be best if your child is delayed with gross motor skills, has difficulty with balance, or has weakness. OT may be a better fit if your child has difficulty using their hands for activities or has sensory processing challenges. An SLP is helpful if you’re concerned about speech and language. These professionals address so much more than this, but this brief description hopefully helps point you to the right person to get started.
How to Find the Right Tongue Tie Professional
While many different professionals are legally allowed to provide care to babies and children with tongue tie, not all are knowledgeable and experienced on this topic. So how do you find someone good? How do you know if they have the right experience if you are a parent new on this journey with limited knowledge yourself?
Unfortunately, there is not one simple answer for this. There is an abundance of ever-changing information on the topic of TOTs (tethered oral tissues). There are constantly new courses being developed for professionals and new forms of treatment being offered. There is not one license, certification, or designation that will tell you that you have found a good tongue tie professional.
There are many well respected entities and experts training and credentialing professionals on topics related to tongue tie. Many of these organizations have a directory of the professionals they have trained. It may take some searching on your part to find the right person. But I sincerely hope that this list will make that searching easier. I wanted to put all of this information in one place to provide an easy and straight forward resource for parents.
Keep in mind, that you should do as much research as you can after you identify a specific person to work with your child. Ask around, search the internet, and ask the professional questions about their experience. Most professionals do not work with babies or children as this is a specialty. So make sure you ask before you book the appointment!
Professional Organization & Other Directories
Keep in mind that for some of these directories, professionals can simply add themselves to the list. Just because they are on the list, does not in itself make them a qualified professional.
- American Academy of Otolaryngology/ENT Health: Find an ENT – ENT Health
- Academy of Orofacial Myofunctional Therapy: Myofunctional Therapist Directory
- Airway Circle: Directory of a variety of tongue tie and airway professionals
- Feeding Matters: Directory of professionals who address feeding related issues
- International Affiliation of Tongue Tie Professionals: Directory of a variety of professionals
- International Association of Healthcare Practitioners: Directory of Cranial Sacral Therapists
- International Consortium of Anklyofrenula Professionals : Directory of a variety of professionals
- Tongue Tie Life: Directory of a variety of professionals
Directories of Professionals Who Have Taken Specific Courses
Keep in mind that while the following are all highly respected courses, taking one course does not ensure that a professional has the right experience to treat your child. Always research the individual provider!
- Beckman Oral Motor: Therapists trained in specific oral motor techniques
- The Breathe Institute: Breathe Affiliates and Breathe Baby Affiliates -Dentists educated by and recommended by The Breathe Institute, a leader in TOTs and airway
- Chrysalis Orofacial -Directory includes a variety of professionals trained in TOTs assessment and treatment
- IBCLC Masterclass-Find a lactation consultant with specialized training on TOTs
- Light Scalpel Laser Doctors -ENTs and dentists with special training using lasers for tongue tie release
- Tummy Time Method-Directory includes a variety of professionals educated on treating TOTs (particularly in babies) as well as the whole body and nervous system
Parent Support Groups
While I recommend asking professionals for advice whenever possible, it is also often helpful to get advice from other parents who have been down a similar road. You can inquire about providers recommended in your area and hear about the experience of others. Remember to take any individual experience with a grain of salt, because you are only hearing one side of the story. But if you read many responses about one particular provider that follow a certain theme, there is likely some validity to the information!
Facebook has a tongue tie support group for nearly every state. The Breastfeeding Mama has compiled a list organized by state on her website which is a super helpful resource.
Airway Circle also has a Facebook group dedicated for patient questions. Parents can post questions and professionals (as well as other parents in the group) typically respond pretty quickly. You can also inquire about provider recommendations.
La Leche League International has support groups around the world and may be helpful if you are struggling with breastfeeding.
- Recommendations for how to choose a lactation consultant
- Recommendations for how to choose a release provider
- Giselle Tadros is a well known physical therapist in the tongue tie world who runs the Instagram page @milkmatterspt. Her story highlight “finding help” offers a variety of options for finding providers.
- Facebook group to find practitioners trained in the Gillespie Approach, a specific type of cranial sacral therapy.
Will Treatment Be Covered By Insurance?
Unfortunately, the answer in many cases is…no. But there are ways to keep costs down. While many professionals do not bill insurance, they often provide patients with a superbill to submit to their insurance for possible reimbursement. I recommend reaching out to your insurance company ahead of time, so you are clear on the process.
Other professionals may offer a sliding scale if cost is a hardship for your family. Don’t be afraid to ask!
For therapy services (such as occupational, physical, or speech therapy), I recommend checking with your state’s early intervention program if your child is under the age of 3. All early intervention programs are free or low cost. The CDC has a directory of all programs listed by state. You may get lucky and find a therapist knowledgeable on the topic of tongue tie. And even if aren’t, some therapists may be able and willing to carry over a special program designed by a tongue tie professional that you see a few times to get started.
I know all of these different types of treatment can be expensive and that can be really hard for some families. Early identification and treatment of issues is key to keep costs down.
If you’re able to find a professional with several different skill areas related to tongue tie, that can also help to reduce the number of appointments and cost. Some therapists may be trained in various manual therapy techniques and body work and also be able to address developmental skills, feeding and breastfeeding!
I know this journey can be stressful and overwhelming. I hope this post helps to make the process a little easier!
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Disclaimer: This is not medical advice. Please consult your own health care provider regarding your specific case.