Doctor of Philosophy (PhD)


Communication Disorders

Document Type



Assessment and treatment of tethered oral tissue, or tongue tie, vary within and across providers, resulting in inconsistent surgical and therapeutic outcomes. Assessment and treatment have historically focused on the anatomical (structural) underpinnings of tongue tie, as opposed to the physiological (functional) aspects that can affect daily activities. This is particularly noteworthy in the infant population in regards to breastfeeding. Clinical findings, however, suggest that connections exist between tongue tie and a variety of other oral functions that go beyond breastfeeding. The goal of this research was to examine a relatively small group of breastfed infants with tethered oral tissue holistically prior to and at one week and three weeks following surgical intervention for tethered oral tissue using a particular laser (i.e., frenectomy). Data were obtained through direct observation of structural and behavioral changes, as well as a parent questionnaire.

Questionnaire results indicated problems across a wide spectrum of oral dysfunction symptoms known to be associated with tethered oral tissue and of perceived changes post-operatively. The role of supplemental aftercare therapy following frenectomy and its perceived value were discussed. In addition, the role of supplemental therapy as a form of non-surgical intervention was examined using a small sample size. This research suggested that differences exist in oral function of the infant and for maternal breastfeeding complications before and after frenectomy, but that these differences are not dependent on the appearance (or perceived visual severity) of the restrictive tissue. Evaluation of the whole child and the breastfeeding dyad together is critical to determine the relationship between anatomic structure and function. Surgical intervention for the treatment of tethered oral tissue, as well as therapeutic care from a skilled provider, should be considered for breastfeeding dyads who exhibit signs and symptoms of oral dysfunction.



Committee Chair

Norris, Janet