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LFQs: Laser-Focused Questions for Lawrence Kotlow, DDS

Dr. Lawrence Kotlow answers questions about Tethered Oral Tissues (TOTs) and the Pediatric Laser Symposium in Dallas April 4-6, 2019.

LFQ-LarryKotlowDDS Dr. Lawrence Kotlow answers questions about Tethered Oral Tissues (TOTs) and the Pediatric Laser Symposium in Dallas April 4-6, 2019.

Introduction: Dr. Kotlow, is a board-certified specialist in pediatric dentistry in Albany NY, serving the needs of children from birth through the early teen-aged years since 1974. His practice specializes in using preventive dentistry, infant care, and the use of lasers for releasing tongue and lip-ties in infants and children. Dr. Kotlow is an active ALD member since 2002.

ALD: Dr. Kotlow, what is TOTs, how prevalent is it in infants, and is it being adequately diagnosed and treated by pediatric physicians and dentists?

Dr. Kotlow: TOTs is an acronym for tethered oral tissues. These are the frena that attach the tongue, lips and cheeks to various oral structures. When they interfere with normal body function, growth and development revising or releasing them often will quickly correct symptoms.

ALD: Speaking of symptoms, if left untreated, TOTs can result in multitude of oral, developmental and systemic health issues. Can you give us a few examples?

Dr. Kotlow: The number of problems that can be associated with untreated TOTs are numerous. They range from inability to achieve a good latch onto the mother’s breast or bottle, failure to thrive, sleep apnea, air induced reflux. What’s more, many maternal breast problems may occur such as mastitis, plugged mammary ducts, breast abscesses, and post-partum depression. For adults in general, TOTs can be attributed to snoring, sleep apnea and inappropriate social behaviors.

ALD: What are the main barriers to TOTs treatment care? Lack of properly trained clinicians? Lack of insurance coverage? The need for patient education? All the above?

Dr. Kotlow: The major reason parents have difficulty in having TOTs released is due to a lack of education and understanding by the vast majority of medical caregivers. This is especially true of pediatricians and ENT physicians. In addition, in both medical and dental school education and post graduate specialization, there is relatively little TOTs information included in medical or dental residencies or internships.

ALD: During the upcoming ALD annual meeting in Dallas, you’ll be conducting a symposium entitled, “Lasers in the Pediatric Setting: TOTs”. Who should attend and what will be the main takeaways?

Dr. Kotlow: Pediatric dentists, general dentists and anyone who treats children would benefit by attending. This symposium includes detailed information about the tongue, how it functions and affects other body systems and using your laser for soft tissue surgery in all ages.

ALD: One last question - The Theme of ALD 2019 is “Laser-Systemic Connection: Lighting the Way Towards a Healthier Mouth and Body”. Do you think the use of lasers to treat TOTs can encourage closer collaboration between pediatricians and pediatric dentists?

Dr. Kotlow: Dental-medical collaboration is certainly a goal we should strive for. However, at the present time there are many healthcare professionals suggesting that lasers are dangerous due to lack of any dental laser education or hands-on training. The ALD is committed to filling this knowledge gap by providing education and training by qualified instructors in a thorough and unbiased manner. The Pediatric Symposium at ALD 2019 is an example of this ongoing commitment. In addition, for more medical/dental collaboration to occur, there needs to be increased open-mindedness within both the dental and medical professions. Both groups need to fully-understand how a properly equipped and trained dentist can safely and effectively help those afflicted by TOTs.

A note from ALD about the uniqueness of ALD’s Dental Laser Meeting
For practitioners new to the field of lasers, it can be a confusing landscape. The Academy of Laser Dentistry is committed to an open-minded and commercially unbiased perspective in having inclusive, rather than exclusive, discussions, and thereby continually pushing the envelope of possibilities towards improving the health and well-being of our patients. We invite all dental professionals to join us in this quest.

Additional Reading

TOTS-Tethered Oral Tissues The Assessment and Diagnosis of the Tongue and Upper Lip Ties in Breastfeeding
Click here for full article

SOS 4 TOTS by Lawrence Kotlow, DDS

Dr. Larry Kotlow 2018-09-21
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