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Diagnosing Tongue / Lip Tie – Function First Model

The Function First Model is a two-part approach to diagnosis and treatment of patient with Tethered oral tissues aka TOTS from birth through adults.  The first component is a comprehensive team approach to treatment and the second is a diagnostic component that emphasizes the importance of a functional diagnosis. In my opinion, utilizing this model leads to more predictable outcomes for all ages and more accurate diagnosis. 

The comprehensive team consists of the family, primary care provider, functional provider, and release provider. All of these team members work together to support the patient before, during the frenectomy procedure process. Unfortunately, in most cases, simply performing a frenectomy does not instantly lead to optimal function. Therefore, it is important to collaborate with other specialists to bring the function up to speed and to support the patient during the process.

The diagnosis component emphasizes the importance of obtaining a functional diagnosis prior to assessing the need for a release procedure (frenectomy). A release provider couples the functional diagnosis with anatomy to indicate whether a release procedure is indicated or not.


Who are Functional Providers:

Functional providers are those that can identify specific functional deficits. Depending on the presenting symptoms, one or a few of these providers may be needed., as they each specialize in a different area of function. For example, lactation specialists and speech language pathologists are adept in evaluating tongue function, whereas a chiropractor can identify alignment issues. Examples of functional providers are listed below:

1.      Lactation Specialists

2.      Speech Language Pathologists

3.      Chiropractors

4.      Craniosacral Therapists

5.      Physical Therapists

6.      Occupational Therapist

7. Myofunctional Therapist

Who are Release Providers:

Release providers are well trained in accurate diagnosis, release and post operative management of release procedures (frenectomy/frenotomy/frenuloplasty). Examples of these providers are listed below:

1.      Pediatric Dentists

2.      ENTs

3.      Pediatricians

4.      General Dentists

Keep in mind that each individual will need a different team of people for their comprehensive team depending on the functional deficit. This model should be used as a guide for both parents and practitioners to ensure that there is comprehensive and cohesive care.

Dr. Piya Gandhi
Founder of West U Pediatric Dentistry

📧 info@westupediatricdentistry.com
4130 Bellaire BLVD Suite 214
Houston, TX. 77025

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