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(763) 450-5664

SEND US AN EMAIL

hello@releaseandbreathedentistry.com

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Can You Release the Day of The Consultation?

The Importance of Comprehensive Care

Everyday, Release and Breathe Dentistry receives calls from patients who were referred by healthcare providers.  They are seeking an evaluation for a tongue and sometimes also a lip tie.  On the phone, we educate on what we term an “airway exam,” which is not solely focused on the string under the tongue called a frenum. Dr. Geisler understands the significance of proper tongue function for optimal airway growth and takes a holistic approach to assess the overall well-being of the person.

 

Comprehensive vs. Simplistic Approach

Our patient coordinators explain to our families that we are a comprehensive care practice.  If someone is looking for “just a snip” and do not want to take a comprehensive look at the issues, we are not the practice for you. We liken this to the following analogy.  Imagine your child tore a ligament in their knee and you went to an orthopedic surgeon for a consultation. Your expectation is that an exam is done, a recommendation for surgery is made and a date scheduled.  What if, in addition to assessing the knee, the physician found signs that your child may have diabetes and wanted to run some tests?  Imagine your surprise! Maybe you would think “This wasn’t what we were expecting. I don’t think they have diabetes and the primary care provider has never been worried about this.” When you hesitate to allow the tests to be run, the surgeon educates you that diabetes is a serious medical problem in and of itself, and will change the healing dynamic for surgery.  Should the doctor allow your family to turn a blind eye and do the surgery without learning more?  Of course not.  Any surgeon would not move forward with surgery even if the family wanted this approach.  Similarly, if concerns for breathing disorders are seen at our practice, we will request more testing, imaging, or outside help before moving forward with the tongue-tie procedure. Sleep Disordered Breathing (SDB) often is focus of our conversation once a through history and examination take place.   SDB encompasses various symptoms such as fatigue, snoring, difficulty falling or staying asleep, gasping or choking, teeth grinding, apnea, emotional instability, ADHD/ADD, recurrent tonsillitis, poor school or work performance, and other related issues.  Not everyone who has a tongue tie has SDB, but a large percentage do.  Dr. Geisler knows the many symptoms and signs that may show an increased risk of breathing problems while asleep. 

 

Thorough Examination Process

For children, we request parents to complete a sleep inventory questionnaire before the appointment, which helps gather relevant information. During the examination, the team captures images of the face, upper and lower arches, tongue, back of the throat, and full body posture. Various measurements are taken and we thoroughly examine the tonsils, back of the throat, dentition, TMJ function, the muscles we used to chew and outer appearance of the nose. More often than not, we request sleep screening or a sleep study, which often is easily done at home.  We now know, a good airway is closely linked to quality sleep. Many individuals with tongue ties exhibit compensations and may have a collapsible or narrow airway.

 

Diagnostic Tools and Imaging

Past X-rays or new imaging might be requested, such as a panorex, cephalometric film, or Cone Beam CT (CBCT).  Further steps might involve referrals to healthcare professionals like ENT specialists, sleep doctors, chiropractors, orthodontists, physical therapists, and myofunctional therapists who are also speech language pathologists.

 

Tailored Approach to Treatment

When diagnosing a tongue tie, we discuss the appropriate timing for a frenectomy, which may be a “functional frenuloplasty” for adolescents and adults using sutures.  When seeing babies, we utilize a CO2 laser leaving the site open.

 

Sleep Screening and Individualized Care

In our dental practice, we utilize many types of sleep screening tools worn at home, either the Sleep Image’s Cardiopulmonary Coupler approved for ages 6 months and above or the high-resolution pulse oximeter (HRPO) suitable for both children and adults. More recently, for adults who prefer to not have an in lab sleep study, we provide a Watchpat sleep device (ages 12 and up) that is easy to use and takes only one night in your own bed.  The data is read by a sleep physician who may diagnose a breathing difficulty.  One other test we recommend often for children is from True Sleep Diagnostics, which is also read by a physician.  Some patients need to have a sleep study in a sleep lab, or already have results from one.  The results of the sleep data and report (if received) is reviewed via a phone call.  In addition, if a 3D scan was taken, the radiology report of the 3D imaging is reviewed at this consultation.  Next steps may include orofacial myofunctional therapy, a visit to an ENT,a consultation with an allergist, a referral to a physical or occupational therapist, orthodontic care, or a tongue tie release.  The plan moving forward is as individual as all our patients are, there is no one way that works best for everyone.