We continue the conversation with Dr Vanessa Fisher, Osteopath about Tongue Tie. Vanessa has experience helping babies and parents assess and advise the next steps in treatment or recovery. She has years of experience as an Osteopath, in this area.
Who in Australia can diagnose tongue tie?
The following professionals are commonly involved in diagnosing and managing SIGNIFICANT tongue ties in Australia:
GPs (general practitioners) — first point of contact
Paediatricians — for complex or broader developmental concerns
Paediatric dentists and ENT specialists — formal assessment and surgical options
Speech-language pathologists — assess functional impact on feeding and articulation
International Board-Certified Lactation Consultants (IBCLCs) — specialist feeding evaluation
Osteopaths and Chiropractors with training in Oral Function
The multidisciplinary consensus on tongue tie in Australia includes representation from both the Australian Chiropractic Association and Osteopathy Australia. As part of the expert panel, they highlight their role in management within a team-based model of care.
Osteopaths with experience in orofacial assessment and oral function may:
• Evaluate tongue mobility and its functional effects
• Assess associated musculoskeletal and cranial patterns
• Identify compensatory tension in the jaw, neck or fascia that can influence feeding mechanics
Similarly, chiropractors with paediatric and oral function experience may assess how structural restrictions (e.g., in the neck or cranial region) can affect feeding and sucking patterns.
Note: While these professionals can assess tongue function and can recommend further assessment when needed. A formal diagnosis of tongue tie is made by medical or dental practitioners.
What Do I Do Next?
1: Functional Observation & Support
Start with careful observation and feeding support:
• Work with an IBCLC to assess latch and feeding mechanics
• Monitor feeding efficiency and growth
• Observe for compensatory behaviours (e.g., excessive jaw tension)
2: Comprehensive Assessment
If functional issues persist, seek assessment from:
• A paediatric dentist or ENT specialist — for formal diagnosis
• A clinician trained in oral function (speech pathologist, IBCLC, osteopath/chiropractor) — for detailed
functional assessment
3: Collaborative Care Planning
Care for a tongue tie often involves collaboration:
• Conservative support — feeding strategies, oral exercises
• Manual therapy / bodywork from Osteopath/Chiropractor — to support the musculoskeletal and
fascial components of oral function
• Referral for frenotomy or frenuloplasty — in cases where restricted tongue movement is
significantly impairing function
What About Manual Therapy / Bodywork?
Osteopaths and Chiropractors use manual therapy to support function in the head, neck, jaw before or after surgical release. Techniques can include gentle cranial-based approaches and soft-tissue work that aim to improve mobility.
Clinical resources used by health professionals training in this area describe bodywork as one part of a multidisciplinary approach.
Important: The evidence base for bodywork alone is limited and still developing. Functional assessment and evidence-based decision-making should guide your choices.
Vanessa Fisher is a Doctor of Osteopathy based on the Northern Beaches of Sydney. She practises out of Brookvale and Newport. To make an appointment for professional advice or learn more about her approach, click here.
