{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T13:35:48Z","timestamp":1787664948296,"version":"build-2736575974"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T00:00:00Z","timestamp":1697068800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Oral Rehabilitation"],"published-print":{"date-parts":[[2024,2]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The buccal frenum is connective tissue that adheres the mucosa of the cheek to the alveolar process. When restricted, this condition is commonly known as a buccal\u2010 or cheek\u2010tie. Restrictive buccal frena are often treated during tongue\u2010 and lip\u2010tie procedures, yet widely accepted classification, diagnostic and treatment guidelines are lacking.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n Provide a scoping review on the evaluation and management of buccal\u2010ties, including diagnosis, classification, symptoms and treatment, by surveying healthcare providers with experience evaluating and managing oral restrictions.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Literature review and IRB\u2010approved survey to assess practice patterns among healthcare providers identified from online directories of tongue\u2010tie release providers and associated allied health professionals.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A multidisciplinary group of 466 providers responded. About 87% indicated that they assess buccal restrictions. Evaluation methods included finger sweep (89.1%), visual inspection (76.4%), tissue blanching (66.5%) and functional assessment (53.4%). Around 94% of providers reported that objective and subjective findings are both needed for diagnosis and that an estimated 5%\u201310% of infants may be affected. About 70% of providers release buccal\u2010ties (if needed) simultaneously with tongue\u2010ties, and 76.8% recommend post\u2010operative stretches as necessary for optimal healing. Respondents indicated a need for further research, evidence\u2010based assessments, a classification system and treatment protocols.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Evaluating a buccal frenum to diagnose a symptomatic buccal\u2010tie relies upon visual inspection, palpation and assessment of oral function. Survey data and clinical experience are summarized to review classification systems, diagnostic\/evaluation criteria and treatment recommendations as a foundational cornerstone for future works to build upon.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/joor.13609","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T05:50:06Z","timestamp":1697089806000},"page":"369-379","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The buccal frenum: Trends in diagnosis and indications for treatment of buccal\u2010ties among 466 healthcare professionals"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7468-0040","authenticated-orcid":false,"given":"Richard","family":"Baxter","sequence":"first","affiliation":[{"name":"Alabama Tongue\u2010Tie Center Pelham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"Merkel\u2010Walsh","sequence":"additional","affiliation":[{"name":"Diamond Myo Ridgefield New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Lahey","sequence":"additional","affiliation":[{"name":"Advanced Breastfeeding Care and Indy Myofunctional Therapy Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad","family":"Knutsen","sequence":"additional","affiliation":[{"name":"The Breathe Institute Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3673-9099","authenticated-orcid":false,"given":"Soroush","family":"Zaghi","sequence":"additional","affiliation":[{"name":"The Breathe Institute Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,12]]},"reference":[{"issue":"6","key":"e_1_2_8_2_1","article-title":"Clinical anatomy of the frenulum of the oral vestibule","volume":"9","author":"Iwanaga J","year":"2017","journal-title":"Cureus"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.4047\/jap.2011.3.4.236"},{"issue":"4","key":"e_1_2_8_4_1","first-page":"309","article-title":"Short lingual frenum in infants, children and adolescents. Part 1: breastfeeding and gastroesophageal reflux disease improvement after tethered oral tissues release","volume":"21","author":"Hand P","year":"2020","journal-title":"Eur J Paediatr Dent"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-5037.2008.00348.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817690135"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.23804\/ejpd.2023.1817"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820915457"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/08903344231159378"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2023.111638"},{"issue":"3","key":"e_1_2_8_11_1","first-page":"11","article-title":"Oral diagnosis of abnormal frenum attachments in neonates and infants: evaluation and treatment of the maxillary and lingual frenum using the Erbium: YAG laser","volume":"10","author":"Kotlow LA","year":"2004","journal-title":"J Pediatr Dent Care"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334413491325"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/2333794X17718896"},{"key":"e_1_2_8_14_1","unstructured":"BaxterR.What is a buccal tie or cheek tie? \u2013 Alabama Tongue\u2010Tie Center. Accessed April 26 2023.https:\/\/tonguetieal.com\/what\u2010is\u2010a\u2010buccal\u2010tie\u2010cheek\u2010tie\/"}],"container-title":["Journal of Oral Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joor.13609","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,20]],"date-time":"2024-01-20T01:43:56Z","timestamp":1705715036000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/joor.13609"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,12]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1111\/joor.13609"],"URL":"https:\/\/doi.org\/10.1111\/joor.13609","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/JOOR.13609\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JOOR.13609\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JOOR.13609\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JOOR.13609\/v1\/review3","asserted-by":"object"}]},"ISSN":["0305-182X","1365-2842"],"issn-type":[{"value":"0305-182X","type":"print"},{"value":"1365-2842","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,12]]},"assertion":[{"value":"2023-08-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}