How are you? Just a few questions for when you have a
10 year old girl who had a frenectomy last year. I saw
her a few months post but did more traditional artic
therapy (sh,ch, s, ) with some of your program. She
has no lip rounding for SH and kept for mouth open for
sh, ch, and s. Jaw tends to push out forward with
speech. Her carryover homework was fair. Attendence
was ok but always late. She is an overbooked kid with
soccer after school almost every day. Overall
improvement was inconsistent.
Anyway shes back . I spoke to Mom about importance of
homework and that shes approved till Nov. If no changes
I will discharge her.
I am thinking about using your program with her
consistently. I do not believe she was a tongue
thruster from testing her previously but she has
incoordination and strength issues with her tongue:
Lingual palatal seal is done with jaw jutting forward
and she says it hurts her frenum a bit.
Tongue elevation is relying on bottom lip. ‘
My question is
Do you think its a good idea to do your program with
her even if she is not a tongue thruster?
How do I incorporate speech and at what point ?
Any other thoughts…………..
SHe needs help but I am feeling lost.
Good to hear from you. I was thinking about you earlier today. I got a new data entry system which now is ready to have entries made re addresses, etc. I came upon yours right off the bat.
For post frenectomies, I always do profic exam #1 rather strictly. Secondly, it is not unusual for a former tongue-tie client to be a “functional” class III occlusion. In other words, they had to carry their mandible forward when they were tongue tied. It may become a fucntional habit thereafter. That could explain the jaw being pushed forward during some speech sounds and the difficulty with lip rounding. Try pushing/holding your mandible far forward and you’ll see that successful lip rounding is compromised quite a bit.
So, what to do?
1. Prof exam #1 as thoroughly as possible
2. Be sure that she learns and uses correct posture: back teeth almost closed, tongue tip to
spot (definitely the back part of the spot), and lips closed.
3. How strong are her lips? Sometimes overly strong lips are an indicator of Class III
4. Do the suctioning exercises until she is really good at them. That way she’ll learn to suction up and back with her back teeth closed (diagonal straw, for example).
5. Keep in touch and let me know if I’m on the right track or something else is in order….
Is there much business successful with students who have a hygiene background that take this class and try to build their own practice?
Hi! I wondered if I could run a client by you who called me today. It was exciting since it was my first ‘real’ client! The mom shared with me that her son is 14 and going into freshman year. He has an open bite on the right side and a class III malocclusion. He […]
We look at several things here. First of all, look at where the frenum inserts into the floor of the mouth. Is it on or right below the lower alveolar ridge? Or is it fairly far back on the floor? Also, look where the frenum inserts into the tongue itself. Is it about midway or is it closer to the tip? Or is it far down at the base of the tongue?
I wanted to get your thoughts on whether lip incompetence in an adult (in their 30’s) that has an overjet and overbite can be remediated through lip stretching exercises. Is it worth it to try?
Bi lateral linea alba was present and also extended to the inside of her lower lip. She states that she rests her tongue on the mandibular teeth and she closes and bites her tongue – which eventually causes pain and she opens her mouth.
In adult patients with TT, do you find less pain in the post frenectomy rehabilitation phase when a period of pre habilitation is undertaken, in essence conditioning the musculature as much as possible?
Are there exercises in your manual that will help a child who has difficulty in lifting the middle and back of the tongue enough to suction it to the palate?
I just screened a new resident post CVA with noted aphasia in her record and some dysarthria. On exam, her tongue had a fairly significant fissure at midline. Any recommendations for healing?
Could an improper oral rest postures/enlarged tonsils/inconsistent mouth breathing completely inhibit the ability to produce /k,g/?
I recently picked up a six year old boy who has been in speech therapy for years for production of velars. He consistently fronts /k,g/ and is not stimulable for the sounds.