Next TOT Clinic: There are currently no TOT Clinics scheduled. Please check back for updated information.

What is TOT clinic?

TOT clinic is for pre-crawling infants who may need functional assessment for tethered oral tissue. Tethered oral tissue is an unusually shortened, thickened, or tightened frenulum that restricts or limits necessary range and function of the structure, often resulting in reduced oral motor skills.

Underlying structural concerns often present as a variety of symptoms, including (but not limited to) nursing pain or difficulty, slow weight gain, failure to thrive, GERD, aerophagia, gas, constipation,  colic, and airway or respiratory issues. Other indicators of oral dysfunction include torticollis and cranial molding that does not resolve within the first 8 weeks.

Tethered oral tissue may refer to any oral tissue that restricts optimal function, including lingual, maxillary, labial, or buccal frena.

First Choice engages in evidence-based clinical assessment of oral tethers using the Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF), the highest standard for peer-reviewed research regarding tongue tie assessment. The HATLFF has been developed to give a quantitative assessment of tongue-tie recommendations about frenotomy (release of the frenulum). The assessment received will result in a set of care recommendations based on the score your child receives during the assessment. Services rendered today are provided in a context of academic scholarship, research, and ongoing evaluations, if you should decide to become a patient at First Choice.

What is a functional assessment?

A functional assessment includes but is not limited to:

  • An intake of health and medical history
  • A 15-minute HATLFF assessment and score
  • Observations of full-body movement patterns
  • Recommendations based on observations

By consenting to a functional assessment with us, you agree and understand that:

  • First Choice will use a hands-on assessment for my child.  
  • This is not a substitute for medical or psychological treatment. 
  • All medical and social information on the intake form is correct to the best of my knowledge.
  • There will be no diagnoses of illness or disease.
  • There will be no prescribed pharmaceuticals.
  • There will be no spinal manipulations or manual therapy.
  • This recommendation is not a treatment plan and is not a substitute for medical care.
  • Your visit at a TOT clinic (alone) does not make you a patient of First Choice.