Tethered Oral Tissue(s) References

Written b: Robyn Merkel-Walsh MA, CCC-SLP/COM®
Lori L. Overland, MS, CCC-SLP, C/NDT, CLC, FOM

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Brooks, L., Landry, A., Deshpande, A., Marchica, C., Cooley, A., & Raol, N. (2019). Posterior tongue , base of movement, and pharyngeal dysphagia: what is the connection? Dysphagia, 1-4.

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Cadwell, K., & Turner-Maffei, C. (2016). The Lactation Counselor Certificate Course Notebook, 2016-2017 Ed. East Sandwich, Massachusetts, Healthy Children Project, Inc.

Caloway C, Hersh CJ, Baars R, Sally S., Diercks, G., Hartnick CJ.(2019). Association of feeding evaluation with frenotomy rates in infants with breastfeeding difficulties. JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2019.1696

Chaubey, K.K., Arora, V.K. , Thakur, R. & Narula, I.S. (2011). Perio-esthetic surgery: Using LPF with frenectomy for prevention of scar. Journal of Indian Soc Periodontics, 15(3): 265-269).

Chu, M.W. & Bloom, D.C. (2009). Posterior ankyloglossia: a case report. International Journal of Pediatric Otorhinolayryngology, 73(6):881-3.

Cioffi Izu, S., Harumi Itamoto, C., Pradella Hallinan, M., Ulson Pizarro, G., Tufik, S., Pignatori, S. & Raimundo Fujita, R. (2010). Obstructive sleep apnea syndrome (OSAS) in mouth breathing in children. Brazil Journal of Otorhinolayringology, 75(5). Retrieved from :

Coryllos, E., Genna, C.W. & Salloum, A.C. (2004). Congenital tongue-tie and its impact on breastfeeding. American Academy of Pediatrics. Retrieved from:

Daggumati, S., Cohn, J. E., Brennan, M. J., Evarts, M., McKinnon, B. J., & Terk, A. R. (2019). Speech and language outcomes in patients with ankyloglossia undergoing frenulectomy: A Retrospective Pilot Study. OTO Open,;3(1).doi: 10.1177/2473974X19826943. e

de Castro Rodrigues,R.L., Marchesan,I.Q., Gusmao,R.J. de Castro Rodriguez, A. & Berretin-Felix, G. (2014). Characteristics of altered human frenulum. International Journal of Pediatrics and Child Health Care, 2, 5-9.

Devishree, Kumar-Gujjari, S. & Shubhashini, P.V. (2012) Frenectomy: a review with the reports of surgical techniques. Journal of Clinical Diagnosis and Research, 6(9):1587-1592.

D'Onofrio, L. (2019). Oral dysfunction as a cause of malocclusion. Orthodontics and Craniofacial Research 22(S1):43- 48.

Elad, D., Kozlovsky, P., Blum, O., Laine, A. F., Po, M.J., Botzer, E.& Sira, L. B. (2014). Biomechanics of milk extraction during breast-feeding. Proceedings of the National Academy of Sciences, 111(14), 5230-5235.

Emanuel, M. (2017). Developing considerations with TOTs: tummy time. Presented at: Connecting the Dots in TOTs. New York, N.Y.

Emanuel, M. (2016). Oral restrictions. Retrieved from:

Fernando, C. (1998). Tongue tie - from confusion to clarity: a guide to the diagnosis and treatment of ankyloglossia. Sydney, Australia: Tandem Publications.

Ferret-Amat, E., Pastor-Vera, T., Ferres-Amat, E., MarequeBueno, J., Prats-Armengol. J. & Ferres-Padro, E. (2016). Multidisciplinary management of ankyloglossia in childhood. Treatment of 101 cases. A protocol. Journal of Oral Medicine and Pathology, 1:21 (1):39-47.

Forienza, G., Paradise-Black, N.M., McNamara, E.G, & Sullivan, S.E. (2010). Ankyloglossia: exclusive breastfeeding and failure to thrive. Pediatrics, 125 (6); e1500-e1504.

Francis, D.O., Chinnadurai, S., Morad, A., Epstein, R.A., Kohanim, S., Krishnaswami, S., Sathe, N. & McPhetters, M. (2015). Treatments for ankyloglossia and ankyloglossia with concomitant lip tie. Effective Healthcare Program: Comparative Effectiveness Review, US Department of Health and Human Services, NO.149 AHRQ Publication No. 15-EHC011.-EF.

Gatto, K. (2016). Understanding the orofacial complex. Denver, CO: Outskirts Press.

Geddes, D.T., Kent, J.C., Mitoulas, L.R. & Hartmann, P.E. (2008). Tongue movement and intra-oral vacuum in breastfeeding infants. Early Human Development, 84(7): 471-7.

Genna, C.W. (2016). Supporting sucking in infant breast feeding infants. (2nd ed.) Burlington, MA: Jones and Bartlett Learning.

Genna, C.W. (2002). Tongue tie and breastfeeding. Leaven, 38(2): 27-29.

Genna, C.W. & Coryllos, E.V. (2009) Retrieved From:

Genther, D. J., Skinner, M. L., Bailey, P. J., Capone, R. B., & Byrne, P. J. (2015). Airway obstruction after lingual frenulectomy in two infants with Pierre-Robin Sequence. International journal of pediatric otorhinolaryngology, 79(9), 1592-1594.

Ghaheri, B. A., Cole, M., Fausel, S. C., Chuop, M., & Mace, J. C. (2017). Breastfeeding improvement following tongue-tie and lip-tie release: A prospective cohort study. The Laryngoscope, 127(5), 1217–1223. doi:10.1002/lary.26306

Ghaheri, B. (2017). Aftercare. Retrieved from:

Ghaheri, B, (2015). The importance of active wound management following frenectomy. Retrieved From:

Ghaheri, B. (2014a). Diagnosing tongue-tie in baby is not a fad. Retrieved from:

Ghaheri, (2014b). Rethinking tongue-tie: anterior vs. posterior is irrelevant. Retrieved from:

Ghaheri, B. (2014c). How to assess a baby for tongue-tie or liptie. Retrieved from:

Hari Iyer, V. & Sudarson, S. (2015). A comprehensive treatment protocol for lingual frenectomy with combination of laser and speech therapy. International Journal of Laser Dentistry, 5(1): 12-21.

Hazelbaker, A. (2010). Tongue-tie: Morphogenesis, Impact, Assessment and Treatment. Columbus, OH: Aidan and Eva Press.

Holtzman, S. (2018). What age is appropriate for OM treatment? Orofacial Myology News. Retrieved from:

Horton C.E., Crawford H.H., Adamson J.E., Ashbell T.S. (1969). Tongue-tie. The Cleft Palate Journal, 6: 8–23. PMID 5251442.

Huang, Y.,Quo, S., Berkowski, J.A. & Guilleminault, C.S. (2015). Short lingual frenulum and obstructive sleep apnea in children International Journal of Pediatric Research, 1:1, ISSN:2469- 5769.

International Affiliation of Tongue-Tie Professionals (2011). Classification. Retrieved from:

International Lactation Consultant Association (ILCA). (2011). Position paper on the role of IBCLC. Morrisville, NC: ILCA.

Ito, Y., Shimizu, T., Nakamura, T. & Takatama, C. (2014). Effectiveness of tongue-tie division for speech disorders in children. Pediatrics International, 57:2, 1442-200x.

Kassing, (2008). Breastfeeding and craniosacral therapy: when it can help. Low Milk Supply. Retrieved from:

Khaimar, M., Pawar, B. & Khaimar, D. (2014). A novel presurgical technique for the management of ankyloglossia. Journal of Surgical Technique Case Reports, 6(2): 49-54.

Kotlow, L. (2018). The Breastfeeding Dilemma: Misdiagnosed TOTS or Just Ignoring their Existence? Med Case Rep J., 1 (1):1-5.

Kotlow, L. (2001). Infant reflux and aerophagia associated with maxillary lip-tie and ankyloglossia. Clinical Lactation, Vol. 2- 4, 25-29.

Kotlow, L. (2014). Lasers in Pediatric Dentistry. Dental Clinics of North America. 48:4.

Kotlow,L. (2015). TOTS-tethered oral tissues: the assessment and diagnosis of the tongue and upper lip ties in breastfeeding.

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Kummer, A. (2016). To clip or not to clip? That’s the question. Presented at the annual convention of The American Speech and Hearing Association, Philadelphia, PA.

Kummer, A. (2005). To clip or not to clip? That’s the question. The ASHA Leader, 10:6-30.

Kupietzky, A. & Botzer, E. (2005) Ankyloglossia in the infant and young child: clinical suggestions for diagnosis and management. Pediatric Dentistry, 27:1, 40-46.

Larjava, H. (2012) Oral wound healing: cell biology and clinical management. Wiley-Blackwell: Vancouver BC, Canada.

Lee, N. (2016) Complementary and alternative medicine in breastfeeding therapy. Amarillo, TX: Praeclarus Press LLC.

Levine, R. Vitruk, P. (2015b). Enhanced hemostasis and improved healing in CO2 laser assisted soft tissue oral surgeries. Implant Practice US 8(3). 34-37

Marchesan, I.Q. (2004). Lingual frenulum: classification and speech interference. IJOM, XXX:31-38.

Marchesan, I.Q, Canton, P. & deCastro Martinelli, R.L. (2018). Understanding the Lingual Frenulum Literature. Cefac Soude e Educacao. Poster session at The International Association of Orofacial Myology, Charlotte, S.C.

Mayo Clinic (2016). Diseases and conditions: tongue-tie (Ankyloglossia). Retrieved from:

Marchesan, I.Q. (2012). Lingual Frenulum Protocol. International Journal of Orofacial Myology, 38, 89-104.

Marshalla, P. (2008). Oral Motor Treatment vs. Non-speech Oral Motor Exercises. Oral Motor Institute, 2(2). Available from

Marshalla, P. (2007). Oral Motor Techniques Are Not New. Oral Motor Institute, 1(1). Available from:

Marchesan, I. Q. (2005). Lingual frenulum: quantitative evaluation proposal. The International Journal of Orofacial Myology,31: 39-4.

Martinelli, Roberta Lopes de Castro, Marchesan, Irene Queiroz, & Berretin-Felix, Giédre. (2014). Longitudinal study of the anatomical characteristics of the lingual frenulum and comparison to literature. Revista CEFAC, 16(4), 1202-1207.

Martinelli, R. L., Marchesan, I. Q. , & Berretin-Felix, G. (2018). Posterior lingual frenulum in infants: occurrence and maneuver for visual inspection. Revista CEFAC, 20(4), 478-483.

Martinelli, R. L., Marchesan, I. Q. ,Honorio, H.M. & BerretinFelix, G. Tendency of tongue positioning during crying in infants with and without lingual frenulum alteration. International Journal of Development Research, 08, (11): 24310- 24312.

Martinelli, R.L.C., Marchesan, I.Q., & Berretin-Felix, G. (2012). Lingual Frenulum Protocol with Scores for Infants. International Journal of Orofacial Myology, 38, 104-113.

Meaux, A., Savage, M., & Gonsoulin, C. (2016). Tongue ties and speech sound disorders: what are we overlooking? Presented poster at the Annual ASHA Convention, Philadelphia, PA.

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Merdad H. & Mascarenhas, A,K. (2013). Ankyloglossia may cause breastfeeding, tongue mobility, and speech difficulties, with inconclusive results on treatment choices. Journal of EvidenceBased Dental Practice, 10(3):152-3.

Merkel-Walsh, R. (2019). Tongue-tie and speech clarity: what we think we know. Presented at: The Annual Convention of the International Association of Orofacial Myology. New Orleans, LA.

Merkel-Walsh, R. & Overland, L.L. (2019) The speech pathologis’ts role in tethered oral tissues. Presented at: The Annual Convention of the Am

Merkel-Walsh & Overland, L.L. (2017). TOTs: the functional impact on feeding and speech (joint lecture). Presented at: Connecting the Dots in TOTs. New York, N.Y.

Merkel-Walsh, R. (2016). A modern look at Van Riper’s phonetic placement approach. . Poster session. ASHA Connect Convention. Minneapolis, MN.

Merkel-Walsh , R. & Jahn, A. (2014). Teaming up to correct tongue-tie. The ASHA Leader ,19. Retrieved from :

Merkel-Walsh, R. (2011) Systematic Intervention for Lingual Elevation (SMILE). Charleston, SC: TalkTools.

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