Treatment for Tongue-ties

Treatment for Ankyloglossia, Commonly known as Tongue-tie

Dr. Lori Cockley has a special interest and advanced training in the diagnosis and treatment of Tethered Oral Tissues (TOTs), commonly known as “tongue-ties” and “lip ties.” She is a member of the International Affiliation of Tongue-tie Professionals (IATP) and has trained nationally and internationally with some of the most renowned names in the field. She has mentored and trained other doctors and team members, has authored several peer reviewed articles and has lectured internationally on the subject. Since 2012, Dr Cockley has successfully treated thousands of tongue-tie cases of all ages. In 2018, the Pennsylvania Tongue-Tie Center, an affiliate of East Berlin Smiles, was formed. PTTC was one of the first in the nation to incorporate supportive TOTs rehabilitation therapies and surgical corrections under one roof.
Approximately between 4% and 15% of children are born with tongue-ties. This means their tongues have a congenital abnormality characterized by an excessively short, tight membrane of tissue (frenum) connecting the tongue to the floor of the mouth. These vary greatly in degrees of severity but cause impingement of mobility and may profoundly affect the proper function of the tongue. This can cause anything from moderate inconveniences (e.g., inability to lick an ice cream cone), to more severe impairments (e.g., inability to breastfeed in infancy and the development of significant speech impediments).
A diagnosis of TOTs is based on symptoms as well as clinical appearance. Some TOTs are obvious, while others, such as posterior tongue-ties, require careful examination to detect. A frenectomy is a delicate surgical procedure to release these restrictions. It is done with a laser, with no pain, and typically no bleeding. The procedure takes only a few moments. While Dr. Cockley performs these frenectomy procedures on patients of all ages, she is one of the few practitioners in the area who is experienced in treating newborn infants.
For your convenience, infant consultations and procedures may be done at the same visit. Immediately after the procedure, our comfortable, private breastfeeding area is available for you to bond with your baby. Toddlers, children and adults typically require a full functional evaluation and often pre and post release therapy in order to alleviate symptoms and regain proper oral muscle function and balance. Our in-house therapists are available to you, or we are able to coordinate care with our wide network of experienced therapists across the state and beyond. We are happy to offer an initial consultation to go over your individual needs and plan your individualized treatment.

East Berlin Smiles

Dr. Lori Cockley | DDS, MAGD

418 West King Street
East Berlin, PA 17316

Business Hours

East Berlin Smiles

Monday 7am – 7pm
Tuesday 7am – 7pm
Wednesday 7am – 7pm
Thursday 8am – 1pm
Friday – Sunday Closed

Infant symptoms of tongue-tie/lip tie may include the following:

Shallow, poor or unsustainable latch
Clicking noises with baby repeatedly “clicking off” the breast while feeding
Exhaustion and falling asleep at the breast before full
Frequent coughing or choking on milk
Gasping for air mid-feed
Frequent release and re-latch
Unsatisfied after prolonged feeds
Poor weight gain/failure to thrive
Gas/reflux/colic/hiccups due to swallowing of air
Frequent and prolonged nursing sessions
Fussing, fighting, or crying or seeming frustrated during feeding sessions
Lip blisters
Milk leaking from the corners of the mouth during feeding
Gumming and chewing on the nipple
Unable to open wide to latch

Some symptoms for breastfeeding mothers include the following:

Severe pain during breastfeeding
Poor or incomplete milk transfer (breasts don’t feel emptied after feedings)
Undersupply or oversupply
Mastitis and/or thrush
Cracked, sore, or damaged nipples

For those who do not undergo frenectomy in infancy, potential complications may include the following:

Poor oral hygiene (due to the tongue not having freedom to effectively cleanse the oral cavity)
Difficulty swallowing or the development of an abnormal swallow pattern such as tongue-thrust
Loud slurping/gulping sounds when eating
Needing to drink a lot during eating
Messy eating
Choking/gagging easily
Disruption of normal oral and facial development
Low resting tongue posture
Sleep-disordered breathing/sleep disturbances
Delayed speech or significant speech impediments
Gum recession
Cavities
Periodontal disease
Tightness of the neck and shoulders
TMJ symptoms
Headaches/migraines
Orthodontic concerns such as an open bite, gaps, tipping of teeth
Social concerns (licking an ice cream cone, kissing)

A Multidisciplinary Effort

Many times, the surgical release of the restriction alone is not adequate for full function. We encourage follow-up with the appropriate practitioner, whether it be a speech language pathologist, chiropractor, body worker, myofunctional therapist, or lactation consultant. We work closely with our multidisciplinary team to ensure you have full support.

We now offer tongue-tie supportive therapy through our office in the newly opened PA Tongue-Tie Center, located on the second floor of East Berlin Smiles.

Body Work/Craniosacral Therapy (CST)
Oral Myofunctional Therapy (OMT)
Lactation Counseling (LC)
Occupational Therapy/Feeding Therapy

For more information or to make an appointment for CST, OMT, or LC, contact us at (717) 259-9596.

Lindsey Mackley

OMT

Lindsey Mackley is a Certified Myofunctional Therapist with a passion for help people find relief from symptoms such as headaches, neck pain, mouth breathing, snoring and more. Born and raised in York, PA, Lindsey developed an early interest in the field of Dentistry and this led to her pursuing a career in Dental Hygiene. After working as an RDH for over a decade, she was introduced to the fascinating specialty of Orofacial Myofunctional Therapy. She completed training and certification with the AOMT and launched Tri-State Myofunctional Therapy in 2020. In 2021, she began to partner with Dr. Cockley at East Berlin Smiles / Pennsylvania Tongue Tie Center. Lindsey has been honored to see dozens of patients through their tongue tie releases and pre and post procedure Myofunctional Therapy. When Lindsey is not working, she and her husband enjoy time together restoring their old house, traveling to see their grown children, and taking walks with their grand-dog. Their son works in Finance, and their daughter is in the Army. Lindsey currently resides in Hagerstown, MD where her therapy practice has its primary location. She is honored to be a part of the Pennsylvania Tongue Tie Center each Thursday. Lindsey continues to grow professionally as a therapist with advanced training and certifications. Her desire is to serve each patient to the best that she possibly can.

Amber Pierce

EFDA, CLC, IFC

With a unique blend of dental expertise and lactation counseling, Amber Pierce brings comprehensive care to families. As an Expanded Function Dental Assistant at East Berlin Smiles and Surgical Assistant/Lactation and Infant Feeding Counselor at Pennsylvania Tongue-Tie Center, Amber integrates her in-depth knowledge of dental anatomy and tongue function to optimize infant feeding outcomes. Inspired by her personal experience overcoming breastfeeding challenges with her daughter, Amber understands the frustration and disappointment that can come from inadequate support. Dissatisfied with the guidance she received, Amber pursued education to fill the gaps and now dedicates herself to providing empathetic, expert care to families. Certified since 2018 as a Lactation Counselor (CLC) and 2024 as an Infant Feeding Counselor, Amber continues to advance her expertise, currently pursuing international lactation certification. In February 2024, Amber founded Bond and Bloom LLC, expanding her reach to provide support for in-home and office visits. This allows her to offer personalized, flexible care to more families.

Services include: Breastfeeding and bottle-feeding support; Home and office visits for personalized feeding guidance; Pre and post TOT’s release feeding support for a smooth transition

Moriah Cockley

LMT, MS

Moriah has been a massage therapist since 2008, with a specialization in CranioSacral Therapy (CST), Craniosacral Fascial Therapy (CFT) and other gentle manual therapy techniques. As a member of the Pennsylvania Tongue-Tie Center team, Moriah has over 6 years of experience and continuing education focusing on treating oral restrictions and their many associated problems, including TMJ dysfunction and voice and swallowing disorders. She sees patients of all ages for pre- and post-frenectomy bodywork, and for general complaints such as chronic pain, stress, and sleep issues. Moriah is also a yoga student and instructor, helping people to incorporate mindful movement and breathing to manage stress, reduce tension, and improve overall functioning and quality of life.

Stephanie Utz

OTR/L,CLC

Stephanie is a registered and licensed occupational therapist in both PA and MD. She graduated from Towson University with her Master’s degree in Occupational Therapy in 2018. Stephanie has also obtained her lactation counselor certification (CLC) in 2023. Stephanie found her love for supporting babies and pediatrics with developmental and feeding difficulties as well as pre/post release care early on during her clinical internship in Nashville, TN. She established her therapy practice, Small Steps, Big Leaps where she strives to provide the best care she can to her patients within the home and community settings. Stephanie’s professional passions include supporting babies with torticollis, head flattening, and side preferences, breastfeeding and bottle feeding skills, transition to solid difficulties, and picky eaters birth to early childhood. Stephanie’s services are tear-free, play-based, individualized, and child-led. For individuals with muscle tension, weakness, and/or poor coordination, Stephanie utilizes an infant’s active engagement through the process rather than “stretching” techniques to ensure effective neural pathway and muscle pattern development for lasting results.Stephanie is honored to be part of the Pennsylvania Tongue Tie Center team.