More Than the Tongue: Rethinking Oral Ties, Latch, & Facial Development (w/Dr. Shereen Lim) [Ep.166]

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.Timestamps0:00 – Introduction & episode overview3:12 – Welcome back: Dr. Lim returns to The DOC Podcast4:43 – Beyond tongue ties: Dr. Lim's evolving focus on lip and cheek (buccal) ties and their impact on latch, facial tension, and development8:46 – The lower lip tie discovery: how chin strain and mentalis tension led to a clinical breakthrough9:55 – Buccal ties, orthodontic relapse, and how cheek tension shapes the dental arch14:45 – Interdisciplinary collaboration: working with osteopaths, chiropractors, and lactation consultants15:59 – The emotional weight of realizing what we've missed — and why blinders happen19:01 – Case study: the patient with severe malocclusion and the tightest cheek ties Dr. Lim has ever seen22:03 – My talk on why orthodontists resist airway-focused care — and granting colleagues grace25:44 – Tongue ties without transverse deficiency: how cheek ties may explain the variation27:36 – V-shaped arches, orthodontic relapse, and the role of perioral restrictions29:39 – Historical perspective: the Frenkel appliance, lip bumpers, and treating the etiology33:03 – How to assess what's normal vs. abnormal: signs to look for across infancy, childhood, and adulthood36:41 – The procedure: CO2 laser technique, team-based approach, and what to expect after releases39:10 – When outcomes fall short — and why proper pre/post care changes everything41:34 – A remarkable case: releasing ties in an infant with Down syndrome against specialist advice44:19 – Challenging the 2020 AAO-HNS consensus statement and the misuse of evidence-based medicine46:53 – The real value of clinical observation and patient-reported outcomes50:19 – Pushback on social media vs. trust within the clinical community52:10 – Functional trainer appliances (Myobrace, Vivos, 2Pill): where they help and where they fall short56:18 – Post-release comfort: why oral releases may make functional appliances easier to tolerate57:54 – The journey approach: doing one thing at a time and building confidence incrementally1:00:46 – Vestibuloplasty technique: releasing multiple sites together for better outcomes1:03:46 – A message to overwhelmed clinicians: you don't have to do it all at once1:06:32 – Evidence-based practice in action: what Dr. Lim is actually doing in her clinic1:07:09 – Where to find Dr. Lim & closing thoughtsThis 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.LINKSEpisode 34 w/Dr. Lim: LINKDr Lim’s Book: Breathe, Sleep, ThriveDr. Lim’s Website: https://www.drshereenlim.com.au/Dr. Lim’s IG: @dr.shereenlimDr. Lim on FB: LINKRegister 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.facebook.com/share/g/1Cb9rkQVde/Check out the DOC CE Courses: https://theorthocoach.com/ce-courses/Website: theorthocoach.comYouTube: @theorthocoachInstagram: @theorthocoachEmail: [email protected]