Pre-op and post-op frenectomy

Please use this page to guide you through your pre-op and post-op exercises over the next 6 weeks!

Planning for bodywork

Fascial work is highly recommended before and after tethered oral tissue releases. Oral ties are ties in your deep front line of fascia and can contribute to tension in the fascial network that travels through the whole body. This is also true in reverse because the deep front line of fascia is continuous through the whole body, fascial tension elsewhere can contribute to fascial tightness in the mouth. It is recommended to have body work prior to the release to prime the body and its tissues for the release that is about to happen, then after the release to help the body work through tension now that a source of tension has been released.

Bodywork is a catch all term that can include:

Myofascial release (MFR)
Craniosacral therapy (CST)
Craniofascial therapy (CFT)
Osteopathic manipulation
Chiropractic care

You do not have to do all of them, and there isn’t one right way to have bodywork done. There can be a lot of overlap in techniques between these modalities as well! The most important thing is that there is a focus on the fascial system, especially the deep front line of fascia that tethered oral tissues are a part of.

What do you need to achieve before a release?

Prior to tethered oral tissue releases there are 3 main things that we need to achieve:

A solid baseline for nasal breathing and correct tongue posture at rest.
Eliminating compensation patterns- your tongue needs to be able to move on its own without neck engagement, jaw engagement or facial muscle engagement.
Suction hold for at least 2 minutes - prior to having a release you should be able to easily hold your suction with your mouth open for at least 2 minutes. This is a good indicator of tongue strength, but it is also helpful for the release procedure to be able to easily hold your tongue in a good position for the clinician to access the frenum.

What to expect after a release?

You’ll get a lot more information on the specifics of what the process will look like in the post- release section. Before starting your release process, it is important to understand what to expect long term with the release.

Some people may notice a big difference right away, but for many it is a slow progression and it may even feel worse in the beginning when the tissues are healing!

Pre-release exercises

Suction hold 3x/day - 2 minutes Tongue pushes 3x/day - 1 minute

Upper teeth trace 3x/day - 1 minute Tongue trace 3x/day - 1 minute

Manual stretches with paper towel 1x/day Practice forklift stretch atleast 3x before release

Practice tongue wound massages atleast 3x/ before release Cheek / Lip Puffs and Stretches / Massage

Post-release process and exercises

Day 1-3

With sutures we can allow the tongue to rest and heal during the first few days. Our talking and eating throughout the day is enough movement for the tongue. On Day 3 you can lightly start tongue pushes, tongue trace, upper teeth trace, 30 seconds, 4x/day.

Without sutures, we will begin stretches and tongue exercises the night of the release. This includes the tongue pushes, tongue trace, tongue caves, and upper teeth trace, and the manual stretches with paper towel all done 4x/day.

Lip or cheek releases will rarely have sutures so you can begin cheek puffs and stretches the day of the release. These should be done 4x/day.

This is when the tongue is the sorest, especially day of and day after. Eating may be difficult, especially for foods that require a lot of chewing or moving around the mouth. Try to eat what you can, but it is very helpful to have soft foods on hand for the first few days- yogurts, cottage cheese, scrambled eggs, mashed potatoes, soup, smoothies and protein shakes are good options.

Talking may be sore as well; it will probably be easiest to talk slow but try to not avoid talking all together. This kind of movement is great for the tongue.

We don’t need extensive tongue movements, but consistent movement is important. The more you keep the tongue lightly moving, the looser it will stay and if you don’t move it at all it will feel tighter and more sore.

Days 4-6

With sutures you will go through your tongue exercises 4x/day for 30 seconds each time. At this point we are still keeping movements lighter and not trying to stretch all the way in the movement. The exercises are the tongue pushes, tongue trace, and upper teeth trace. Add tongue caves day 5. 30 sec, 4x.day. If sutures are no longer present - follow the no sutures instructions below.

If there were no sutures placed (or all fell out), you will continue the tongue exercises and manual stretches with paper towel 4x/day. You will also add in the forklift stretch and begin using Serrapeptase if you have chosen to use it.

For lip and cheek releases, continue doing the cheek puffs or swishes and stretches 4x/day.

Tongue Pushes, 30 seconds, 4x/day Tongue Trace, 30 seconds, 4x/day

Upper Teeth Trace, 30 seconds, 4x/day Forklift Stretch

(If no sutures)

Days 7-14

Exercises for sutures/non sutures will be the same at this point, continue tongue exercises, going full range of motion and trying to stretch the tongue

Tongue pushes, tongue trace, upper teeth trace, suction hold 4x/30seconds.

Manual stretches with paper towel and forklift stretch 4x/30seconds. Serrapeptase usage if you have decided to use it.

For lip and cheek releases, continue doing the cheek puffs or swishes and stretches 4x/day.

NOTE: ON Day 10 - continue with everything listed + add in wound massages (I may recommend starting this sooner based on your healing) 4x/day

Days 14-28

Now that a lot of the inflammation is going down, we will focus on finding our tongues full range of motion. Our body has its muscle memory, after the release we have to learn how to work past that muscle memory and figure out how much the tongue can actually move post-release.

We will continue the stretches, massages, and serrapeptase usage. For lip and cheek releases, continue puffs and stretches.

New exercises will include Super Glue Tongue Clicks, Circle Lip Trace, TTS extension hold, all 4x/30 seconds.

Finding your new range Super Glue Tongue Clicks

Circle Lip Trace TTS Extension Hold

Day 28+

Continue the stretches, massages, and serrapeptase usage.

For lip and cheek releases, continue puffs and stretches.

Additional exercises will go back to your regular exercise assignment routine and will go back to focusing on your other goals outside of release healing.

It is preferred to continue the stretches and massages through 6 weeks, after that you can utilize them just when needed. You may have days here and there where you feel a little tighter!