More Than the Tongue: Rethinking Oral Ties, Latch, & Facial Development (w/Dr. Shereen Lim) [Ep.166]
The DOC PodcastShow Notes
In this episode, I'm joined for the second time by Dr. Shereen Lim, an internationally recognized dentist whose work is reshaping how we think about oral tethered tissues and their role in craniofacial growth, airway health, and orthodontic outcomes. Since her first appearance on the show (Episode 34 - link below), Dr. Lim has pushed even further beyond tongue ties, focusing her clinical lens on lip ties, buccal frenum ties, and their profound influence on facial development, maxillary arch constriction, dental crowding, and orthodontic relapse. This conversation is a masterclass in staying intellectually curious, remaining open to what the evidence in your own practice is telling you, and constantly reassessing your diagnosis and treatment approach as new information emerges. Timestamps 0:00 – Introduction & episode overview 3:12 – Welcome back: Dr. Lim returns to The DOC Podcast 4:43 – Beyond tongue ties: Dr. Lim's evolving focus on lip and cheek (buccal) ties and their impact on latch, facial tension, and development 8:46 – The lower lip tie discovery: how chin strain and mentalis tension led to a clinical breakthrough 9:55 – Buccal ties, orthodontic relapse, and how cheek tension shapes the dental arch 14:45 – Interdisciplinary collaboration: working with osteopaths, chiropractors, and lactation consultants 15:59 – The emotional weight of realizing what we've missed — and why blinders happen 19:01 – Case study: the patient with severe malocclusion and the tightest cheek ties Dr. Lim has ever seen 22:03 – My talk on why orthodontists resist airway-focused care — and granting colleagues grace 25:44 – Tongue ties without transverse deficiency: how cheek ties may explain the variation 27:36 – V-shaped arches, orthodontic relapse, and the role of perioral restrictions 29:39 – Historical perspective: the Frenkel appliance, lip bumpers, and treating the etiology 33:03 – How to assess what's normal vs. abnormal: signs to look for across infancy, childhood, and adulthood 36:41 – The procedure: CO2 laser technique, team-based approach, and what to expect after releases 39:10 – When outcomes fall short — and why proper pre/post care changes everything 41:34 – A remarkable case: releasing ties in an infant with Down syndrome against specialist advice 44:19 – Challenging the 2020 AAO-HNS consensus statement and the misuse of evidence-based medicine 46:53 – The real value of clinical observation and patient-reported outcomes 50:19 – Pushback on social media vs. trust within the clinical community 52:10 – Functional trainer appliances (Myobrace, Vivos, 2Pill): where they help and where they fall short 56:18 – Post-release comfort: why oral releases may make functional appliances easier to tolerate 57:54 – The journey approach: doing one thing at a time and building confidence incrementally 1:00:46 – Vestibuloplasty technique: releasing multiple sites together for better outcomes 1:03:46 – A message to overwhelmed clinicians: you don't have to do it all at once 1:06:32 – Evidence-based practice in action: what Dr. Lim is actually doing in her clinic 1:07:09 – Where to find Dr. Lim & closing thoughts This conversation reminded me of why I do this work. Dr. Lim's willingness to look critically at her own outcomes, stay open to what her patients are showing her, and continuously evolve her clinical approach is a model for all of us. Whether you're brand new to airway-focused dentistry or have been in this space for years, I hope this episode leaves you a little more curious, a little more humble, and motivated to ask whether there's a better way to serve the children and families we care for. LINKS Episode 34 w/Dr. Lim: LINK Dr Lim’s Book: Breathe, Sleep, Thrive Dr. Lim’s Website: https://www.drshereenlim.com.au/ Dr. Lim’s IG: @dr.shereenlim Dr. Lim on FB: LINK Register for the In-person Early Treatment Comprehensive: https://www.earlyorthotreatment.com/ Join The DOC Community on Facebook for more great content and discussions: https://www
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