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Toddlers & Tongue Ties


Was baby diagnosed with a "small tongue tie" but didn't require treatment to breastfeed? Or maybe a tongue tie was never diagnosed during infancy, but now you notice symptoms consistent with toddlerhood tongue ties. Sometimes maternal milk supply is so robust that a tongue tied baby requires very little effort to breastfeed. Or a bottle fed baby may have a tongue tie go undetected, because family found the right bottle that met baby's needs for compensation (like flat nipple bottles, or shallow latch bottles, nipples baby can bite on to express milk, etc). Either way, these are some of the common symptoms associated with an orofacial myofunctional disorder, or tongue tie, in toddlerhood:

  • History of breast or bottle feeding difficulties

  • Gags or chokes on solids

  • Picking eating, food refusal

  • Chronic open mouth

  • Drooling

  • Poor sleep quality

  • Obstructive sleep apnea

  • Snoring

  • Dark circles under the eyes

  • Chronic ear infections

  • Enlarged adenoids/tonsils

  • High palate and narrow upper dental arch (front teeth protrude)

  • Teeth grinding

  • Tooth decay

  • Tongue thrust with speech and swallow

  • ADHD like symptoms, behaviors, learning difficulties

  • Thumb/finger sucking

  • Biting or mouthing nonfood objects

  • Difficulty potty training


Who should you see for a tongue tied toddler?


Tongue tie management at any age requires a team approach. Members of your healthcare team will depend on symptoms, which providers in your community have advanced training in tethered oral tissues and myofunctional disorders, and child's age. If you don't know where to start, start with a reputable, airway-centric pediatric dentist. From there, the team may include:

  • ENT

  • Orthodontist

  • Myofunctional trained feeding therapist:

    • Speech-Language Pathologist

    • Occupational Therapist

  • Physical Therapist

  • Chiropractor


What does feeding therapy look like in toddlerhood? It's play-based, with a lot of parent coaching. The goal is optimal oral rest posture (mouth closed and tongue up), and appropriate muscle function for speech and feeding. While toddlers aren't old enough to actively participate in myofunctional therapy, we target oral function through play. The important thing at this age is that we can get the mouth closed to combat risk of dry mouth and tooth decay, support nasal breathing and proper airway growth, good oral/dental development, and protect against respiratory infections and inflammation of lymph tissue. Treatment may also address feeding challenges. What kind of feeding challenges might be associated with a tongue tie?

  • Picky eating, preference for snack foods or other easy-to-chew foods

  • Preference to graze over eating a meal

  • Coughing on food/liquid

  • Overstuffing the mouth

  • Pocketing food in the cheeks

If you are in the Spokane area and think your toddler has a tongue tie, we specialize in assessment and treatment of tongue ties and myofunctional disorders. Schedule a free phone consultation online!


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