Tethered Oral Tissues (TOTS) can consist of either a tongue tie (where the thin piece of skin under a baby’s tongue restricts movement of the tongue) or where the upper lip is restricted due to being anchored to the gum. This thin membrane of tissue should undergo cell death during embryonic development but in some cases will fail to do so, thus, creating a “tethered-like” cord of tissue. TOTS is a condition that often runs in families and is said to have a genetic component.

 

In the case of an upper lip tie, the baby may not be able to obtain a proper latch or seal on the breast. A successful latch occurs when the baby is able to flair their upper lip and take both the areola and the nipple in their mouth. When a baby has an upper lip tie, they are unable to flair their top lip out effectively (like fish lips) and may only take the nipple into their mouth. This may lead to a poor seal and swallowing excessive amounts of air during feeding. The air in the baby’s belly can then lead to symptoms of colic or reflux and unnecessary medications may be prescribed. Lip ties can also hold mother’s milk on the front surface of the upper front teeth during night time at-will feeding, leading to dental decay.

TOTS is considered a “mid-line” defect; meaning it affects the core of our body. The tongue is anatomically attached to the bone and fascial structures of the head. The tension caused from the tethered tissues can create long-lasting structural changes to the musculoskeletal system; especially in the neck, cranium and face. The changes in these regions can then lead to adaptive changes throughout the rest of the body and then present as postural abnormalities or asymmetries. In infants, these postural challenges can lead to difficulties in reaching various developmental milestones such as: rolling over, creeping or crawling. Developmental milestones are necessary in order for a child develop a healthy sensory-motor system. Proper sensory input is essential for academic, social, emotional and motor skill learning and development. If there is abnormal structure of any spinal regions, this critical sensory information may not make it to key areas of the brain and a child may develop a “disorganized” sensory- motor system. A child may later on go on to receive the diagnosis of “Sensory Processing Disorder” and have trouble with attention, learning and/or behavior.

TOTS can also affect the subtle “pumping” movement of the cranial bones. This action is necessary in order for the cerebral spinal fluid, the fluid that protects the brain and spinal cord, to move toxins and away from the brain. The cerebral spinal fluid is like a sewer system that eliminates waste but when the cranial pumping motion is inhibited, toxins can affect brain function and development.

Why Chiropractic & Cranial Sacral Therapy is Important

Due to the structural changes associated with TOTS, it is imperative that pre and post revision care includes chiropractic spinal adjustments and cranial-sacral therapy. The spinal column; especially the cervical spine (neck region) has a vast amount of neurological sensory input projecting to the brain. If there are structural stressors on the spine or cranium, this will lead to poor neurological communication from the body to the brain which will alter proper neurological function and development. Specific spinal adjustments can restore proper musculoskeletal structure, which in turn will restore neurological function.

 

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