I wanted to get multiple opinions from several dentists on my tongue tie and oral anatomy. It took awhile to get in with them all, but I'm so glad I reached out to multiple providers so that I could do what felt best for me, my family budget and what my ultimate goal is. As an adult, oral dysfunction is very complex and the situation needs to be viewed holistically, but also realistically.
Walking past a room prepped for an infant release as I went to my consult with one of the dentists.
Dentist Consult #1
I met with dentist #1 for my first consult. We refer babies there often so I was excited to hear their expert opinion on my situation as an adult. The dental assistant took my full history including what symptoms I'm facing and we took a look at my x-rays sent over from my dentist.
This dentist's biggest concerns for me were my limited airway and how that is affecting my ability to breath normally, especially at night. My tongue tie is also super thick and tight. I told them to not sugar coat anything so they told me that it would be a harder recovery for me because there is so much tissue to release. I would really need to get in there to do wound stretches and massage the floor of my mouth as things are healing. They are not comfortable doing a release until I have a CBCT scan so they can make sure my airway is clear enough that a tongue tie release would not make breathing harder for me. They recommended continued myofunctional therapy with the goal being that I can hold suction without my tongue quivering like it does now. That tongue strength would also be required before they would release my tongue.
My jaw is retrognathic meaning it's set back pretty far, most likely due to the increased fascial tension under my tongue as my face developed. My jaw on the right side pops out of disc when I open my mouth wide that has caused increased muscle tension surrounding that area and even down into my neck. They suggested a dental appliance called Seattle Protocol to move the jaw forward gradually.
My palate is narrow and really high. The dentist suggested palate expansion to help with my teeth and tongue crowding. As an adult she suggested expansion with a microscrew appliance to open up the palate suture and regrow the bone so that over time my palate would expand. This part I'm on the fence about to be honest. It seems pretty awful.
In the short term we agreed to have me start using breath right strips at night and mouth taping to help reteach my body to close my mouth at night. I will continue with myofunctional therapy and bodywork while I wait for the next dentist consult.
Dentist Consult #2
Met with dentist #2 specifically for expansion. This dentist does not release oral ties. I really enjoyed this consult and felt the dentist was willing to meet me in the middle knowing that my issues are really complex. I heard many of the same things in this second consult that I heard in the first. My palate is very narrow and leaving no room for my tongue to rest. My airway is a concern especially with my nighttime snoring. We talked about what could have triggered the sudden start to snoring. Stress, weight gain and allergies could be playing a role. The teeth on my lower jaw have recently shifted causing my teeth to rub against the bottom of my tongue causing a callous. It's very uncomfortable.
This dentist suggested I attempt mouth taping at night as a first step, but to do a trial for an hour before I try to fall asleep. They thought the trial may be difficult for me with my airway issues. They also wanted a CBCT scan to check my airway in more depth. A sleep study was also suggested. They would like to have me see them as a last stop after the scan, sleep study, more myofunctional therapy and tongue tie release.
They recommended not doing the microscrew expander because it's aggressive (and I'm assuming very painful although none of the dentists have said that specifically) and I'm all on board with that. Their concern is also that the screws are going into the sinus (or near) and with my airway issues that could be dangerous. Instead of a bone expansion we would upright my teeth that are currently slanted inwards and get a little bit more space that way. After expansion we would straighten my teeth with regular braces or Invisalign. To address the snoring we would use an appliance to move the jaw slightly forward while I sleep.
In my situation I have to weigh the financial impact of some of these treatments with the possible symptom resolution. Getting to 100% function as an adult is not something that I have the money or time for to be completely honest. My symptoms are not severe enough that I would want to, or need to, be super aggressive with treatments. I appreciated the wisdom of decades of practice from this dentist.
Dentist Consult #3
Met with dentist #3 who again echoed many of the things the other 2 dentists found. This dental office would be a great option because they offer all the things that I would need at that location. The also wanted a CBCT scan as well as a K7 scan for jaw tracking.
They did recommend palate expansion as a most likely first step and did not recommend the micro-screw option either as they think it's too aggressive an option for my specific situation. After palate expansion we would release my tongue as long as the CBCT scans showed clear airway. I would most likely need Invisalign or regular braces to close any gaps in the teeth that the expansion left.
I did end up using this dentist for my scans and am waiting on the results of those before a treatment plan is presented to me. The jaw tracking scanner was wild! I had a magnet on my lower gums and this strange head gear thing on as I opened and shut my mouth and moved my jaw around. I'm anxious to see what the test results are for that one.
I did also finally get in with a sleep specialist and am waiting for my home sleep study kit scheduling. That test will be able to tell us if I have sleep apnea. If so, that may complicate things a bit more regarding the tongue tie release.
Stay tuned for the results of my testing and which treatment plan option I end up choosing!
This blog post is in no way medical advice and just my personal experience.
Local to the Milwaukee, Wisconsin area? Need to get your older child assessed for oral ties? Book a visit with our Occupational Therapist, Julia!