Tethered Oral Tissues Mission The MU Tethered Oral Tissues Clinic strives to provide a thorough evaluation of oral motor functioning to determine if speech and/or feeding difficulties are related to lingual, labial, buccal ties, or oral motor dysfunction. What can I expect on my first visit to Marshall University TOTs Clinic? During the first visit, patients will receive a comprehensive structural and functional oral motor assessment by a licensed pediatric speech-language pathologist (SLP). The SLP will offer recommendations and answer any questions you may have related to his/her scope of practice. Patients should plan to be at the clinic for approximately 1 hour. The SLP will obtain a thorough case history, photography of the oral/lingual structures and posture, completion of a full orofacial myofunctional examination (4 years and older), observation of feeding/chewing/swallowing, and completion of a full articulation assessment. At the conclusion of the assessment, patients will be provided with a list of recommendations and strategies. This evaluation will determine the need for further evaluation by a bodyworker (occupational therapist and/or chiropractor), and/or a pre-frenectomy consult by a release provider, such as a pediatric dentist, ENT, or oral-facial surgeon. When is the clinic? Marshall University’s TOTs clinic is typically offered every Friday on Marshall University’s Huntington campus in Smith Hall. This can change due to holidays and provider scheduling conflicts. What do I need to bring? A physician or dental referral is needed to complete the assessment. For infants and toddlers, we request patients to bring any feeding tools that you use during snack/meal times. For older children and adults, no additional items are needed. What can I expect after the initial evaluation? The results of the initial evaluation will determine the need for follow-up visits. Depending on the patient’s age and results/recommendations, patients may be immediately referred to a release provider (DDS, ENT, or Oral Surgeon) or they may be asked to complete 2-4 pre-frenectomy treatment sessions to ensure two things. 1) To ensure the family and child are ready for release and 2) To ensure knowledge and readiness for post-release care and stretching of the wound site(s). If a child is scheduled for a lingual, labial, or buccal tie release, it is recommended to follow up with the SLP 3-4 days post-release and then once a week for 4-6 weeks. Once the wound has healed, a full functional assessment will be completed and further need for oromyofunctional treatment will be determined. What are the costs associated with the TOTs Clinic? The speech pathologist will bill insurance for services provided. Patients should check with their insurance to determine the co-pay or cost associated with these services.