Tethered Oral Tissues (TOTs) is the restriction of the frena or frenulum—small folds of tissue that connect bone to tissue and support or limit movement. While not a new condition, the term TOTs was coined by Kimberly Benkert, RDH and later by Dr. Kevin Boyd in 2014 to describe restrictions in the tongue (ankyloglossia), lip (lip-tie), or buccal frena.

This course focuses on an evidence-based approach to treatment, exploring controversies ranging from the necessity of surgery to the importance of pre- and post-op care. Based on Lori and Robyn’s theoretical foundation that the oral sensory-motor system cannot be separated, this class demonstrates how TOTs impacts movement and the processing of sensory information for feeding and speech.

Participants will walk through a "task analysis" of interventions and learn neuromuscular re-education techniques ranging from passive to active. These strategies are applicable across the life span and various cognitive skills, covering pre-feeding and feeding for: breast, bottle, cup, spoon, solid, and straw.

The course also covers oral placements for speech clarity, surgical procedures, and techniques for the cheeks, lips, and tongue. A new dedicated section addresses strategies for success with the toddler population.

• List at least 2 surgical techniques for TOTs.
• Identify at least 2 goals of a pre-op TOTs plan of care.
• Execute at least 3 neuromuscular education activities for pre and post op TOTs (1 buccal, 1 labial, 1 lingual).

This presentation will focus on treatment methods related to the use of TalkTools® OPT resources. Other similar treatment approaches will receive limited or no coverage during this lecture.