International Journal of Orofacial Myology and Myofunctional Therapy

2 pages, 243 KiB

Open AccessEditorial

Capturing a Moment in an Evolving Landscape: Contemporary Management of Ankyloglossia

by Raymond J. Tseng and Sharon Smart

Int. J. Orofac. Myol. Myofunct. Ther. 2024, 50(2), 1-2; https://doi.org/10.52010/ijom.2024.50.2.7 - 1 Dec 2024

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This special issue on ‘Contemporary Approaches to Collaborative Management in Ankyloglossia’ contains a collection of scholarly papers that address the assessment, diagnosis, treatment, and follow-up care of tethered oral tissues (TOTs). In this column, the editors summarize the content of the issue and [...] Read more.

This special issue on ‘Contemporary Approaches to Collaborative Management in Ankyloglossia’ contains a collection of scholarly papers that address the assessment, diagnosis, treatment, and follow-up care of tethered oral tissues (TOTs). In this column, the editors summarize the content of the issue and reflect upon its relevance at the current time in the evolution of research and clinical care of TOTs. Full article

20 pages, 1668 KiB

Open AccessReview

Gastrointestinal Symptom Improvement in Infants After Restrictive Tethered Oral Tissue Release: A Systematic Review and Meta Analysis

by Humera Khatri, Iqbal Musani, Prashant Udavant and Tushar Parikh

Int. J. Orofac. Myol. Myofunct. Ther. 2024, 50(2), 1-20; https://doi.org/10.52010/ijom.2024.50.2.6 - 1 Dec 2024

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Abstract

Purpose: The purpose of this systematic review was to systematically explore improvements in gastrointestinal symptoms 1 week and 1 month following the frenotomy procedure, compared to before the procedure for infants under 12 months of age using meta-analysis calculations. Methods: Studies were selected [...] Read more.

Purpose: The purpose of this systematic review was to systematically explore improvements in gastrointestinal symptoms 1 week and 1 month following the frenotomy procedure, compared to before the procedure for infants under 12 months of age using meta-analysis calculations. Methods: Studies were selected that presented data on breastfed infants under 12 months of age, with gastrointestinal symptoms and reflux, who underwent surgical correction for restricted maxillary labial frenum and/or ankyloglossia, and/or maxillary buccal frena. Case reports, letters to editors, previous systematic reviews, in vitro and animal studies, and only abstracts were excluded. An integrative literature review was carried out in MEDLINE via PubMed, EBSCOhost, Scopus Embase, Web of Science & Cochrane Library from April 2016 to March 2023. Risk of bias was evaluated using the Modified Newcastle‐Ottawa Scale. GRADE profiler (GRADEpro) was used to rate the quality of evidence. We conducted meta-analysis using random effects modelling with the RevMan Software 5.4. Results: Out of the 90 studies identified, nine studies were included, seven were prospective cohort studies, one was a prospective randomized trial, and one was a retrospective analysis. Gastroesophageal reflux symptoms showed statistically significant improvement in I-GERQ-R scores after 1 week (effect size = 3.40, p < 0.00001) and 1 month (effect size = 6.37, p < 0.00001) as compared to before release. Kotlow Class 3 and Class 4 lip tie, Coryllos Type 3 and Type 4 tongue tie showed maximum symptoms and the greatest improvement after release. Conclusion: Tethered oral tissues should be considered as a potential etiology in the differential diagnosis of gastrointestinal reflux in infants. Full article

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11 pages, 805 KiB

Open AccessArticle

Feeding and Gastrointestinal Symptomatology: Comparing Infants Without Oral Restriction to Those with Treated and Untreated Tethered Oral Tissues

by Rebecca R. Hill

Int. J. Orofac. Myol. Myofunct. Ther. 2024, 50(2), 1-11; https://doi.org/10.52010/ijom.2024.50.2.5 - 10 Oct 2024

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Abstract

Objectives: The aims of this study were to (1) evaluate if there were any significant differences in gastrointestinal (GI) and/or feeding symptoms for infants with tethered oral tissues (TOTs) pre-frenotomy compared to infants with untreated TOTs and infants without TOTs, and (2) evaluate [...] Read more.

Objectives: The aims of this study were to (1) evaluate if there were any significant differences in gastrointestinal (GI) and/or feeding symptoms for infants with tethered oral tissues (TOTs) pre-frenotomy compared to infants with untreated TOTs and infants without TOTs, and (2) evaluate if treatment via frenotomy led to improvements in symptoms that more closely align with GI and/or feeding symptoms in infants with untreated TOTs and/or infants without (TOTs). Methods: This study utilized a pretest-only control group design. The Infant Eating Assessment Tool (InfantEAT) and Gastrointestinal and Gastroesophageal Reflux (GIGER) Scale were used to evaluate infant feeding and GI symptoms, respectively. Multiple linear regression was used to compare scores between the three groups at baseline, controlling for age and gestational age at birth. Treatment group’s average score after intervention was compared to the mean baseline score of the other two groups. For the treatment group, paired t-test was used to evaluate changes in scores before and after the treatment. Results: All subscales of both the InfantEAT and GIGER demonstrated statistically significant differences for infants with TOTs before intervention when compared with infants with TOTs who did not undergo treatment and infants without TOTs. Conclusion: This study demonstrates the importance of considering structure along with function for infants with tongue- and/or lip-tie. Clinicians must evaluate maternal symptoms alongside infant factors. The decision to treat TOTs via frenotomy is multifactorial and is not necessary in every mother-infant dyad. Full article

17 pages, 952 KiB

Open AccessArticle

Global Perspectives on Tongue-Tie Assessment of One to Ten Year-Old Children in Speech-Language Pathology

by Sharon Smart, Zoe Whitfield and Mary Claessen

Int. J. Orofac. Myol. Myofunct. Ther. 2024, 50(2), 1-17; https://doi.org/10.52010/ijom.2024.50.2.4 - 30 Sep 2024

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Abstract

Purpose: Speech-language pathologists (SLPs) are essential in evaluating tongue structure and function. Due to limited psychometrically validated assessment tools, evidence-based practitioners often rely on clinical expertise to inform their assessment and clinical decision-making. This study aimed to explore how SLPs assess tongue structure [...] Read more.

Purpose: Speech-language pathologists (SLPs) are essential in evaluating tongue structure and function. Due to limited psychometrically validated assessment tools, evidence-based practitioners often rely on clinical expertise to inform their assessment and clinical decision-making. This study aimed to explore how SLPs assess tongue structure and function in children aged 1 to 10 years suspected of having a tongue-tie by examining global practice patterns. Methods: A total of 194 practicing, English-speaking SLPs participated in a global online survey. The survey gathered information on participant demographics, classification tools used, and methods for assessing tongue structure and function, oral motor function and speech production in children with suspected tongue-tie. Results: Participants reported using various measures, including case history, oral examination, and clinical assessment. These measures encompassed evaluation of tongue structure, oral motor tasks and functional measures, including observation of speech, feeding, and swallowing. Notably, 40% of participants indicated they did not use any published assessment tool. While over 90% of participants evaluated feeding skills through parent questionnaires, only 55% observed feeding during mealtimes. Additionally, SLPs in the United States reported using different classification tools for tongue-tie compared to their counterparts in Australia, the United Kingdom and other countries. Conclusion: There is a global trend of limited use of published tongue-tie assessment tools in clinical practice. Most clinicians rely on various measures to evaluate tongue structure and function in children with suspected tongue-tie. These findings highlight the need for a specialized assessment tool that is designed and validated for evaluating tongue structure and function in children beyond infancy. Full article

11 pages, 875 KiB

Open AccessPerspective

International Consortium of Oral Ankylofrenula Professionals (ICAP) Practice Guidelines for Ankylofrenula Management

by Sharon Smart, Andrea Kittrell, Robyn Merkel-Walsh and Raymond J. Tseng

Int. J. Orofac. Myol. Myofunct. Ther. 2024, 50(2), 1-11; https://doi.org/10.52010/ijom.2024.50.2.3 - 27 Aug 2024

Cited by 2 | Viewed by 1203

Abstract

This document contains Practice Guidelines developed by the International Consortium of oral Ankylofrenula Professionals (ICAP) Consensus Committee and accepted by the Board of Directors to delineate the roles and responsibilities of healthcare professionals involved in caring for individuals with ankylofrenula. These Practice Guidelines [...] Read more.

This document contains Practice Guidelines developed by the International Consortium of oral Ankylofrenula Professionals (ICAP) Consensus Committee and accepted by the Board of Directors to delineate the roles and responsibilities of healthcare professionals involved in caring for individuals with ankylofrenula. These Practice Guidelines apply to practitioners serving individuals across all age groups, from infants to adults. It aims to standardize healthcare practices concerning ankylofrenula definition, diagnosis, assessment, and management. The purpose of these Practice Guidelines is twofold: firstly, to communicate ICAP’s stance on the standardization of healthcare practices for health professionals engaging with patients and families affected by ankylofrenula. Secondly, it serves as an educational resource and advocacy tool for ICAP in interactions with external stakeholders, such as multidisciplinary team members, healthcare management, government bodies, researchers, funding agencies, patients, caregivers, and their families. Full article

13 pages, 1121 KiB

Open AccessPerspective

Clinical Perspectives on Post-Operative Care for Tethered Oral Tissues (TOTs)

by Robyn Merkel-Walsh and Lori L. Overland

Int. J. Orofac. Myol. Myofunct. Ther. 2024, 50(2), 1-13; https://doi.org/10.52010/ijom.2024.50.2.2 - 6 Jul 2024

Cited by 1 | Viewed by 331

Abstract

Introduction: Post-operative frenectomy care is often focused on active wound management (AWM) and followed by neuromuscular re-education (NMR). The standard practices of AWM are varied amongst providers. AWM is often expected to be performed by caregivers who have little to no experience with [...] Read more.

Introduction: Post-operative frenectomy care is often focused on active wound management (AWM) and followed by neuromuscular re-education (NMR). The standard practices of AWM are varied amongst providers. AWM is often expected to be performed by caregivers who have little to no experience with AWM. In contrast, NMR is individualized to patient needs and has been emerging in external evidence as a beneficial modality for the functional implications of tethered oral tissues (TOTs). It is guided by licensed professionals but is not often accessible or recommended. New Perspective: AWM and NMR often are similar in execution but differ in goals. AWM is focused on wound debridement and avoiding scarring or reattachment of the frena, whereas NMR is focused on airway, sleep, feeding, swallowing, speech, and optimal orofacial growth. AWM has little consensus or external evidence compared to NMR which has both internal and external evidence. AWM for oral care is also limited by scope of practice (SOP) which few licensed professionals have. NMR has a broader range of professionals such as International Board-Certified Lactation Consultants (IBCLCs), speech-language pathologists (SLPs), physical and occupational therapists (PT/OT) and registered dental hygienists (RDHs). Conclusions: NMR has multiple benefits post-operatively, is individualized and performed by multiple professionals. It is suggested that release providers consider gentle, functionally directed post-operative NMR techniques that are individualized, and research the impact these approaches have on wound care goals. Full article

15 pages, 473 KiB

Open AccessConference Report

Proceedings of the 2024 ICAP Convention

by International Association of Orofacial Myology

Int. J. Orofac. Myol. Myofunct. Ther. 2024, 50(2), 1-15; https://doi.org/10.52010/ijom.2024.50.2.1 - 28 Jun 2024

Viewed by 169

Abstract

Objective analysis of tongue movements during feeding helps differentiate patterns typical of ankyloglossia versus musculoskeletal or neurological conditions [...] Full article

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Int. J. Orofac. Myol. Myofunct. Ther., Volume 50, Issue 2 (October 2024) – 7 articles

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