MyoGrow Frequently Asked Questions
Our pediatric airway program goes by the name of Myogrow. It encompasses the assessment and management of tethered oral tissues (TOTs), development of the head and neck, breathing patterns, and myofunctional habits, i.e., the manner in which we use our muscles and body to breathe, sleep, eat, and speak. Here’s a video that explains more: https://www.youtube.com/watch?v=LTnSo6YDEkQ&t=9s
These concepts are relatively new. Some providers may not be familiar with them yet. We strive to remain current with the latest research and work in collaboration with other healthcare professionals who do the same. Our approach involves a comprehensive evaluation of craniofacial growth patterns, as well as an assessment of sleeping, breathing, eating, and swallowing habits. This integration of factors is distinctive and requires expertise across various specialties.
These concepts are relatively new. Some providers may not be familiar with them yet. We strive to remain current with the latest research and work in collaboration with other healthcare professionals who do the same. Our approach involves a comprehensive evaluation of craniofacial growth patterns, as well as an assessment of sleeping, breathing, eating, and swallowing habits. This integration of factors is distinctive and requires expertise across various specialties.
If you do not have any immediate concerns regarding your child’s sleeping or dental health, we still suggest that you have them screened at least once between the ages of 4-11. Occasionally, early intervention is necessary to address specific concerns that the screening reveals and/or to ensure that growth is progressing in the appropriate direction. Remember, even if your child does not require immediate treatment, preventive measures can be taken to establish healthy habits that promote proper growth and development.
During the initial “records” visit, we will gather various forms of information to aid in our evaluation and treatment planning. This includes taking photos, measurements, medical history, and conducting a CT scan of the airway, as well as obtaining a digital scan of the teeth. After compiling and analyzing this data, we will share our findings and treatment recommendations with you (the parents) via a virtual Zoom meeting.
- If we need to release tethered oral tissue – We may also suggest releasing tethered oral tissues, or some combination of these treatment options, depending on the individual needs of your child. Our goal is to provide a personalized treatment plan that addresses all of their unique concerns and promotes optimal growth and development.
- If we need to expand the jaws – One treatment option we may recommend is expansion of the jaws, which can be effective in addressing issues related to breathing and sleeping, as well as promoting proper craniofacial growth.
- Who we need to collaborate with – We collaborate with a range of specialists, including ENTs, myofunctional therapists, orthodontists, oral surgeons, sleep physicians, allergists, and more, to ensure that your child receives comprehensive care tailored to their specific needs.
In our evaluation process, we do not separate airway and tongue tie assessments. Our diagnosis is informed by both functional and structural information, and considers the broader craniofacial complex. While tongue tie may be a contributing factor to a patient’s symptoms, it is only one part of a larger puzzle. Therefore, we take a comprehensive approach to treatment, which involves a detailed analysis to identify the root cause of symptoms and determine the most effective course of action for long-term benefit.
It is worth noting that a patient’s symptoms may be caused by an issue other than tongue tie, or a patient may not be a candidate for a release at the time of evaluation. Our detailed analysis helps determine which specialists a patient should be referred to, which procedures are indicated, and in what order. We understand that our approach may not be suitable for all families, as some may prefer a more targeted approach. However, our aim is to provide our patients with a thorough evaluation and comprehensive treatment plan to achieve optimal outcomes.
Expansion techniques are tailored to each patient’s age, symptoms, goals, and family preferences. Our office offers various appliances for pediatric expansion, including ALF, Myobrace, Healthy Start, Invisalign, as well as traditional fixed and removable orthodontic appliances. To achieve our desired outcomes, we typically recommend a combination of techniques that are most appropriate for the individual patient.
- Upper and Lower Jaw Expansion – Our approach involves expanding both jaws. Although the lower jaw lacks a suture that can actually widen the jaw, we can achieve a more accurate depiction of the relationship between the upper and lower jaws by uprighting (or decompensating) teeth. This helps to center the teeth over the bone, without any tipping or tilting that may otherwise mask the true bite.
- Comprehensive Diagnostics – We prioritize the use of tongue space and a patient’s symptoms/sleep quality as key indicators for guiding our treatment approach, as opposed to solely relying on measurements and bite relationship.
- Early Intervention – Orthodontic treatment can provide a multitude of health benefits, particularly in improving breathing and sleep quality. We believe that it is crucial for children to experience these benefits at an early age when their growth potential is at its highest. While some providers may prefer to wait until a child is at least 7 years old before commencing treatment, our approach is to begin treatment as soon as possible when symptoms are identified.
Surgical precision and maximum post-operative comfort are our priorities. We employ the latest CO2 laser technology from LightScalpel to treat tethered oral tissues (TOTs). This technology is widely considered the gold standard for treating soft tissue.
For infants, we perform frenectomies in conjunction with a team of functional providers that may include lactation consultants, speech pathologists, and occupational therapists.
In older children and adults, we typically recommend completing myofunctional therapy prior to a release of a “tongue tie” via functional frenuloplasty. This step may be preceded by expansion, depending on the age and stage of growth, to ensure there is adequate room for the tongue in the mouth after the release.
We understand that some patients may come to us with a particular appliance in mind. While we are happy to discuss the advantages and disadvantages of various treatment options, we encourage patients to remain open to our recommendations. We recognize that there is no one-size-fits-all treatment and that airway work requires highly individualized care that may evolve over time. If a particular treatment is not offered at our practice, we are more than happy to refer patients to a colleague who may be better suited to address their specific needs.
Fees for this are comparable to traditional phase 1 orthodontic cases. A comprehensive airway plan will likely also include myofunctional therapy and a release of tethered oral tissues.
We understand that dental treatment can be a significant financial investment. While we are not in network with any insurance company, we are happy to file any dental insurance benefits that you have. It is important to note that the majority of our treatment costs are typically out of pocket expenses for most individuals. However, we strive to make treatment feasible and accessible for our patients and their families by offering individualized payment plans and financing options. It is also worth noting that some dental insurance plans may cover a portion of the cost of frenuloplasty and frenectomy procedures, and orthodontic benefits may be available once in a patient’s lifetime. We are happy to discuss all options and help you make the best decision for your individual needs.
We do not file medical insurance at this time.
We are grateful to be able to treat patients who travel to see us as well as our local community.
For expansion and craniofacial development treatments, patients can expect to come in for appointments every 4-6 weeks for 1-2 years for expansion and craniofacial development treatments. The frenuloplasty procedure typically involves a pre-op appointment, the procedure itself, and two post-op appointments in conjunction with myofunctional therapy both before and after the procedure.
Our team is happy to treat patients for airway only, or both general dentistry and airway. If you already have a dentist you love, we encourage that! We will keep your dentist informed about our work and your progress throughout treatment.
Absolutely! Seeing patients regularly at cleanings helps us stay in touch and see how patients are growing. We don’t do fillings for patients 6 or younger, but are happy to refer to a pediatric dentist if any procedures are needed that we do not perform.
We hope this is helpful when deciding where to go for your care, and we thank you for considering our team.
Should you wish to schedule an appointment, please contact info@myogrowairwaycenter.com
Thank you for your interest, we hope to see you soon.
Infant Frenectomy Frequently Asked Questions
A tongue tie, or ankyloglossia, is a condition when the frenum under the baby’s tongue is restricted in its ability to move.
A combination of genetic and environmental factors contribute to the occurrence of tongue ties.
It is estimated to be between 5-10%
The tongue is a unique structure that falls in the scope of practice of both Ear Nose and Throat doctors as well as dentists. Both are licensed to treat tethered oral tissues, but more important is their post-graduate training. Tethered oral tissue diagnosis and treatment is not taught in medical or dental school, so providers must seek additional training to be knowledgeable in this area.
Those performing the procedure are knowledgeable about the anatomy. How babies feed and use their tongue involves specialties like Speech Pathologists, Lactation Consultants, and Occupational Therapists. Both are important in achieving best results.
We utilize state of the art CO2 light scalpel laser technology.
The procedure lasts a few seconds, and your baby will be with our team for a few brief minutes in total.
This varies by patient, as feeding concerns may not surface until later in infancy. Ideally, we see patients during the newborn phase, less than 3 months old. However, we treat babies up to 1 year.
We evaluate lips, tongue, and cheeks (buccal) to screen for any possible restricted areas
Weight gain is not the only indication of healthy functional feeding. Mothers and babies may be
compensating in order to find a way to eat, but those compensations may have consequences
later as we reach milestones of speech and eating solid foods.
Healthy tongue function and mobility is important for many reasons other than breastfeeding,
including proper swallow, draining of eustachian tubes, eating solid foods, and speech.
Unfortunately, there are no guarantees with this work. Tongue ties are complex and how babies
respond can vary. It is important to understand this is a frenectomy meant to help support infant
feeding and get babies off to a good start. Other interventions are still likely indicated in the
future for full jaw and airway development. We encourage those wanting to learn more to go to
our “Myogrow” page. A frenectomy is not the same as a frenuloplasty, which may still be
indicated later in life.
Healthy tongue function is important for breathing, sleeping, feeding, and speaking. This has
implications for both craniofacial development as well as quality of life. The pressure of the
tongue on the roof of the mouth during swallowing is what forms the upper jaw. The roof of the
mouth is the floor of the nose, and the position of the jaws dictates how much space we will
have in our airway to breathe. We consider this a fundamental and critical aspect of overall
health
This varies by patient, as feeding concerns may not surface until later in infancy. Ideally, we see patients during the newborn phase, less than 3 months old. However, we treat babies up to 1 year.
Our role in this process is limited to improving range of motion by addressing the anatomical
structures that may be restricting movement. Functional providers, like a lactation consultants,
help identify the symptoms that indicate a primary reason for release, offer non-surgical
methods first, and are available post release to help babies learn to use the increased range of
motion achieved by a release.
We require a functional need to be present as the primary reason for a release, and to know
that non-surgical methods have been attempted first. This eliminates performing unnecessary
procedures and ensures that a release is truly indicated.
A lactation consultant, occupational therapist, or speech pathologist. Within those specialties,
we exclusively work with providers who have further education on tethered oral tissues.
This can be frustrating and confusing for families when they get conflicting advice regarding
tethered oral tissues. When weighing recommendations, we suggest families also consider what
training and experience providers have. With hundreds of hours of post-graduate education on
this topic, Dr. Shannon and her team have positioned themselves as local experts in this specific area. Our goal is that our work helps educate other professionals about the importance of healthy tongue function so that messaging to families can be more consistent.
The baby will be gently and expertly secured and all safety precautions taken. Two team
members are present in addition to the doctor to ensure the baby’s safety.
We recommend families not be present in the room for the release. This is to help promote
mothers’ readiness to feed afterwards, as well as making sure our team is comfortable taking
the time they need to do the procedure completely and effectively.
We do not to use any numbing gel. This is because we do not want the baby to swallow the
anesthetic, and we want tongue mobility intact so the baby can feed afterwards.
Babies are able to soothe afterwards, so we compare the pain level to circumcision and
vaccination. We recommend Tylenol afterwards for baby’s comfort.
You will be stretching the release site several times a day to promote proper healing. These
stretches guide the healing in the right direction and are done instead of stitches. Babies are
initially fussy but recover quickly after the procedure. We advise families on pain control
methods for the first 1-2 days. We recommend families practice stretches before the
appointment to prepare.
Feeding issues are complex, and we encourage families to find a functional provider they trust
to help navigate the feeding process. A release can help when it is indicated, but it does not
help with every issue every time. It is important to manage expectations and understand there are many factors to consider. However, when we carefully select who is a good candidate and prepare patients well, most families see improvement. We are happy to recommend functional providers trained in tethered oral tissues.
Absolutely. If your provider is not familiar with how to diagnose and manage tethered oral
tissues, we are happy to help make recommendations. Our process involves close comanagement of patients with providers with specific training.
We are happy to have a consultation-only appointment or perform same day treatment.
Depending on the situation, we may make additional referrals before a release.
While we encourage families to be familiar with the process and the importance of addressing TOTs, we do not perform frenectomies for purely preventative reasons. Therefore we engage functional colleagues to help determine if there is a need related to function that would indicate the need for a frenectomy.
Our detailed process is meant to help promote best outcomes. By working with a team, we find
families get better results and prevent negative outcomes. We understand this approach may
not be the right fit for all families, and that the logistics of managing multiple appointments can
be difficult. We are here to support families as much as we can.
Breastfeeding improvement following procedure
Folic acid supplementation as it relates to ankyloglossia
Lip ties
Breastfeeding difficulties and tongue ties
Role of therapy and frenectomy in infant feeding
Management of tongue ties with therapy and frenotomy
Multidisciplinary management of ankyloglossia in childhood
