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When does my child need a tooth extracted?
July 25th, 2026 | by Dr Helen FungHearing that your child might need a tooth removed can feel worrying, especially if it’s their first time facing dental treatment. The reassuring news is that in paediatric dentistry, removing a tooth is generally a last resort, not a first-line option. Wherever possible, we look for ways to save, treat or simply monitor a tooth before considering extraction. This guide explains, in plain terms, when extraction may become necessary — and when a wobbly tooth is simply doing what it’s meant to do.
Extraction is usually a last resort
At Tooth Town, our starting point is always to protect and preserve your child’s natural teeth. Fillings, crowns, pulpotomies and other treatments exist precisely so that a tooth can be kept doing its job for as long as possible — supporting eating, speech and the space for adult teeth developing underneath. Removing a tooth is something we consider only when other options have been ruled out or aren’t appropriate for that particular tooth.
If your child’s clinician does raise the possibility of extraction, it’s because they’ve weighed up the alternatives, not because it’s the easiest or default choice.
When extraction may become necessary
Every situation is individual, and your child’s clinician will only confirm what’s appropriate after an examination (and X-rays, where needed). In general terms, extraction may be considered when:
- The tooth is too decayed or damaged to restore. Sometimes decay or trauma has affected too much of the tooth structure for a filling or crown to work reliably.
- An infection isn’t resolving. If a tooth is causing an infection that isn’t settling with other treatment, removing it may be the safest way to protect your child’s health.
- There’s an orthodontic reason, on a clinician’s advice. Occasionally, removing a baby tooth helps guide the way for adult teeth or supports a broader orthodontic plan. This is only ever recommended after assessment — orthodontic treatment planning at Tooth Town is managed through our dedicated orthodontic care pathway.
Outside of these situations, we’ll generally look at ways to manage or monitor the tooth instead.
What about a tooth that’s just wobbly?
Not every loose tooth needs a dentist’s help. Baby teeth are designed to become wobbly and fall out on their own as the adult tooth underneath gets ready to come through — this is a completely normal part of growing up, not something to worry about. A naturally wobbly tooth usually just needs time, and your child may enjoy wiggling it themselves.
If you’re ever unsure whether a wobbly tooth is part of normal exfoliation or something that needs a check, it’s fine to ask us — we’re always happy to help you tell the difference.
If an early extraction is needed: space maintainers
If a baby tooth does need to come out earlier than it would naturally fall out, your child’s clinician may talk to you about a space maintainer. This is a small device that holds the gap open so the adult tooth underneath has room to come through as intended. We’ve written a separate guide on space maintainers if you’d like to read more about how they work and what to expect.
Comfort and options for your child
We know that any mention of a tooth being removed can feel daunting for both you and your child. Comfort is something we take seriously, and the right approach depends on your child’s age, anxiety levels and the specific treatment needed. Your child’s clinician will talk you through the options suited to their situation as part of your visit — we won’t assume a one-size-fits-all approach, and we’ll make sure you understand what’s involved before anything goes ahead.
Frequently asked questions
Is it normal for my child to lose a baby tooth early?
Sometimes, yes — but it’s worth having it checked. Early tooth loss can happen for a few reasons, and your child’s clinician can confirm whether a space maintainer or any follow-up is needed.
Does losing a baby tooth early cause problems with adult teeth?
It can affect the space available for the adult tooth if nothing is done to hold the gap, which is why a space maintainer may be recommended in some cases. Your child’s clinician will assess this individually.
Will my child be in pain during an extraction?
Comfort is a priority, and there are options that can be discussed with you based on your child’s needs and the treatment involved. Your child’s clinician will explain what’s suited to your child at the visit.
How do I know if my child’s wobbly tooth is normal or needs a dentist?
Most wobbly teeth are simply baby teeth getting ready to fall out naturally and don’t need intervention. If you’re ever unsure, or your child has pain, swelling or a tooth that’s wobbly from an injury, it’s worth getting it checked.
Can a baby tooth be saved instead of removed?
Often, yes. We always look at options like fillings or other treatments first. Extraction is only considered when a tooth can’t be reasonably saved or treated.
Who decides if my child needs orthodontic-related extractions?
Any orthodontic-related extraction is only recommended after assessment, and orthodontic treatment planning at Tooth Town is managed through our dedicated orthodontic care pathway.
What to do next
If you’ve noticed a wobbly tooth, a tooth that looks damaged, or you have questions about what your child’s next appointment involves, our team is here to talk it through with you. Book an appointment and we’ll assess your child gently and explain exactly what — if anything — needs to happen next.
This guide is general information and doesn’t replace an individual assessment. Your child’s clinician will confirm what’s most appropriate for them after examination.
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Preparing for a special needs dental visit at Tooth Town
July 25th, 2026 | by Dr Helen FungEvery child and every family is different, and that’s especially true when it comes to dental care for children and adolescents with additional needs. Whether your child has sensory sensitivities, communicates differently, has a complex medical history, or simply finds new environments harder to settle into, we want you to know that Tooth Town is here to work with you — not around you. This guide shares some practical ways to prepare for a visit, and what you can expect from our team along the way.
Our approach to special needs dentistry
At Tooth Town, special needs dentistry is led by Dr Candy Fung, who cares for children, adolescents and adults with additional needs. Telehealth may be offered where appropriate for your child’s situation. If telehealth might suit your family, it’s worth raising this with our team when you get in touch.
We don’t believe in a one-size-fits-all dental visit. Every child’s needs, preferences and history are different, so we take a person-centred approach — getting to know your child and planning the visit around what will genuinely work for them, rather than fitting them into a standard appointment format. This might mean a longer appointment, a different order of steps, extra breaks, or simply more time spent talking with you before we talk with your child.
Talk to us before the appointment
The single most helpful thing you can do is talk to our team ahead of time. The more we understand about your child before they arrive, the better we can plan a visit that feels manageable for them. Things you might like to share include:
- Sensory preferences and sensitivities — for example, reactions to noise, light, touch, taste or unfamiliar smells.
- How your child communicates — including whether they use particular words, gestures, visual supports, an AAC device, or prefer information delivered in a certain way.
- Known triggers or things that help — anything that tends to cause distress, and anything that tends to help your child feel calmer.
- Previous dental or medical experiences — good or difficult — so we can plan around what has and hasn’t worked before.
- Relevant medical history and medications — including any conditions, allergies or medications that may be relevant to their care and comfort on the day.
There’s no such thing as too much information here. Sharing these details in advance means our team can plan properly, rather than working it out on the spot.
Practical ways to prepare
Alongside talking with our team, a few practical steps can make the visit itself feel more predictable for your child:
- Bring a comfort item — a favourite toy, blanket, headphones or other item that helps your child feel secure is welcome to come along.
- Consider a shorter familiarisation visit first, if this would help your child. Some families find it useful for their child to visit the practice, meet the team and see the space before any treatment is attempted. If you think this could help, ask us about it.
- Let us know about routines that help — for example, a preferred way of being greeted, a countdown before something happens, or a particular way of explaining what’s coming next.
- Plan for the practical logistics — such as how your child copes with waiting, whether a quieter arrival time might help, or whether you’d like to wait somewhere specific before being called through.
Every one of these is optional, and none is expected to apply to every child. The point is simply to tell us what’s true for your child, so we can plan accordingly.
What you can expect from our team
Families preparing for a special needs dental visit can expect our team to be patient, flexible and non-judgemental. We aim to adapt our pacing and approach to suit your child, rather than asking your child to adapt to us. This might mean taking things slowly, pausing when needed, adjusting the environment where we’re able to, or simply spending extra time building trust before moving ahead with any examination or treatment.
Some children find that certain environmental adjustments help them feel more at ease. If there’s something specific that tends to help your child — for example, around lighting, noise or seating — please ask us what may be available on the day, and we’ll talk through it with you honestly.
Above all, we want you and your child to feel heard, respected and unhurried. If a visit needs to be paused, broken into shorter steps, or rescheduled, that’s a completely reasonable part of getting the care right — not a failure.
Frequently asked questions
Do I need a referral to see Dr Candy Fung?
Please contact our team to discuss the best way to book an appointment for your child. We can talk you through what’s needed based on your situation.
Will my child definitely need treatment on the first visit?
Not necessarily. The first visit is often about assessment, getting to know your child, and understanding what approach will work best. Dr Candy will discuss the most appropriate next steps with you after meeting your child.
Can I stay with my child during the appointment?
Yes — you’re welcome to stay with your child for their appointment. The only time parents aren’t permitted to stay is during treatment under general anaesthesia, where this isn’t allowed in the hospital operating theatre, in line with national standards across all hospitals. Beyond that, please let us know your preferences when you book, so we can talk through what position or level of involvement in the room will work best for your child and your family on the day.
What if my child has had a difficult dental experience before?
That’s really important for us to know. Please tell our team about previous experiences so we can plan the visit differently and help build a more positive association with dental care over time.
Is telehealth available for special needs consultations?
Telehealth may be offered where appropriate, depending on your child’s situation. Please ask our team when you get in touch and we can discuss whether this could be suitable.
What if my child needs more time or a different kind of appointment structure?
Just let us know. We plan visits individually, and there’s no single “normal” appointment we expect every child to fit into.
What to do next
If you’re preparing for your child’s first special needs dental visit, or you’d simply like to talk through what might help before booking, our team is very happy to have that conversation with you first. Contact Tooth Town to share what we should know about your child, or book an appointment and let us know in advance so we can plan the visit around them.
This guide is general information and doesn’t replace an individual conversation with our team. Dr Candy Fung and the Tooth Town team will work with you to plan an appointment that’s appropriate for your child.
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Tongue and lip ties in babies and children: a parent’s guide
July 25th, 2026 | by Dr Helen FungIf someone has mentioned that your baby or child might have a “tongue tie” or “lip tie,” it’s natural to feel unsure about what that means — and whether it’s something to worry about. This guide explains what tongue and lip ties are, the signs parents sometimes notice, and how they’re assessed at Tooth Town. Our approach is calm and careful: we look at how your child’s mouth works, not just how it looks, and we only recommend treatment when it’s likely to genuinely help.
What is a tongue or lip tie?
“Tongue tie” is an everyday term for a condition called ankyloglossia. Before birth, a small band of tissue called a frenum helps guide the development of the mouth. Everyone keeps a small frenum — you can feel the one under your own tongue. In some children, this band is tighter or attached in a way that restricts how freely the tongue or lip can move.
A lip tie is a similar idea involving the band of tissue that connects the upper lip to the gum.
The important point is this: a tie is only relevant if it affects function. Many children have a frenum that looks a little tight but causes no problems at all — and those children don’t need any treatment.
Signs parents sometimes notice
Tongue and lip ties can show up differently at different ages. The signs below are things families sometimes mention — they don’t confirm a tie on their own, and each has other possible causes too. If any of these sound familiar, it’s worth a proper assessment rather than guesswork.
In babies, feeding is usually where concerns arise. Parents sometimes describe difficulty latching, feeds that take a very long time, a clicking sound during feeding, ongoing nipple pain, or a baby who seems unsettled or windy. Bottle-fed babies can have feeding difficulties too.
In toddlers and older children, parents sometimes wonder about the tongue’s range of movement, certain sounds in speech, or eating particular foods. It’s worth knowing that speech and feeding are complex and have many possible contributors, so a tie is only ever one part of the picture.
Because these signs overlap with so many other things, the most helpful next step is a functional assessment rather than trying to decide at home.
How Tooth Town assesses a tongue or lip tie
Tongue and lip tie assessments at Tooth Town are carried out by Dr Helen Fung, your dentist with a particular interest in this area (you may also see this referred to as the Brisbane Tongue Tie Clinic). All of the general dentists consulting at Tooth Town are well versed in screening for tongue and lip tie concerns as part of your child’s routine check-ups, so if something is worth a closer look, your regular dentist can refer you through for a full functional assessment with Dr Helen — you don’t need to notice it yourself or seek her out directly.
The most important principle in our assessment is that ties are assessed on function, not appearance alone. Two children with a similar-looking frenum can have completely different needs. During the consultation, Dr Helen will talk with you about your concerns and your child’s history, and assess how the tongue and lip actually move and work.
A consultation is a chance to understand what’s going on — it does not automatically mean treatment will be recommended. For some families, the assessment brings reassurance that no treatment is needed. For others, Dr Helen may suggest support from other professionals first, such as a lactation consultant or feeding specialist for a baby, or an oral health/myofunctional practitioner for an older child, because improving how the mouth is used can make a real difference on its own.
We have quiet, comfortable rooms where parents and babies can feed in privacy around the consultation, and toys to keep older siblings happy. You’re welcome to stay with your baby or child for the whole consultation, and for a release if one is recommended — the only appointments across Tooth Town where a parent isn’t permitted to stay are those carried out under general anaesthesia, and a tongue or lip tie release in our rooms is not a general anaesthetic procedure.
If treatment is recommended
Where Dr Helen assesses that a tie is genuinely restricting function and that releasing it is likely to help, she will explain the options with you clearly, including what a release involves and what to expect afterwards. Any aftercare (such as gentle exercises or stretches) will be explained so you feel confident continuing at home.
A few things we’re always upfront about:
- A consultation does not guarantee that a release will be recommended, and we would never recommend a procedure your child doesn’t need.
- We can’t promise a same-day procedure. Whether, when and how any treatment happens depends on Dr Helen’s assessment on the day.
- We’re honest about outcomes. Tongue and lip ties can be one factor among several in feeding, speech, sleep or other concerns, so we won’t promise that a release will resolve a particular problem. What we can promise is a careful, honest assessment and a clear explanation of what’s realistic for your child.
If your child develops any signs of illness, feeding difficulty that worries you, or you’re unsure how to proceed at any point, please contact our team — and seek urgent medical care if you’re ever concerned about your child’s immediate health.
Frequently asked questions
Does my baby have a tongue tie?
The only reliable way to know is a functional assessment. Some signs — like feeding difficulty or a clicking sound during feeds — can prompt a check, but they have other causes too, so they don’t confirm a tie on their own.
Does a tongue tie always need to be treated?
No. Many ties never cause a problem and need no treatment at all. At Tooth Town, treatment is only considered when a tie is genuinely affecting function and a release is likely to help.
Will treating a tongue tie fix breastfeeding, speech or sleep?
Not necessarily. These are complex and usually have several contributing factors, so a tie is only ever one piece of the puzzle. Dr Helen will give you an honest, realistic picture for your child rather than a guarantee.
Can the release be done on the same day as the consultation?
We can’t promise this. The consultation is an assessment first; if treatment is appropriate, Dr Helen will discuss timing and options with you.
Can I stay with my baby or child during the consultation or release?
Yes. You’re welcome to stay with your child for the whole appointment, including during a tongue or lip tie release. The only time parents aren’t permitted to stay is during treatment carried out under general anaesthesia, in line with national standards across all hospitals — and a tongue or lip tie release at Tooth Town isn’t a general anaesthetic procedure.
What age can a tongue or lip tie be assessed?
Babies, toddlers and older children can all be assessed. Feeding concerns in newborns and movement, eating or speech questions in older children are all reasons families come to see us.
Do we need a referral?
No referral is needed to book an assessment, though you’re welcome to bring any information from your GP, lactation consultant, speech pathologist or child health nurse — it all helps build the picture.
Will my regular your dentist notice if my child has a tongue or lip tie?
All of the general dentists consulting at Tooth Town are well versed in screening for tongue and lip tie concerns as part of routine check-ups. If they notice something worth a closer look, they’ll refer you through for a full functional assessment with Dr Helen Fung.
Might we need to see anyone else as well?
Sometimes, yes. Depending on your child, Dr Helen may suggest working alongside a lactation consultant, feeding specialist or oral health/myofunctional practitioner, either before or instead of any procedure.
What to do next
If you’d like clarity about your child’s tongue or lip movement, the best step is a functional assessment with Dr Helen Fung. You’ll get a careful look at what’s actually going on and honest, practical advice — with no pressure and no assumption that treatment is needed.
Book a tongue and lip tie assessment by contacting our friendly team, or read more on our tongue and lip ties service page. If you’re not sure whether an assessment is the right step, we’re happy to talk it through with you first.
This guide is general information and doesn’t replace an individual assessment. Your child’s clinician will confirm what’s most appropriate for them.
Tongue and lip tie guides for families
- Does every tongue tie need treatment?
- What happens at a tongue tie assessment
- Tongue tie and breastfeeding: what the signs actually mean
- If a release is recommended: what it involves and what comes after
- Tongue tie beyond babies: toddlers, school-age children and teenagers
- Tongue tie treatment for older children, teenagers and adults
- It isn’t always a tongue tie
For health professionals: When to refer a child for tongue tie assessment
Our dedicated tongue tie site: Brisbane Tongue Tie Clinic — the same clinic and the same team, with Dr Helen Fung’s own feeding story, a fuller explanation of the anatomy, and what an appointment looks like.
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Thumb-sucking and dummy use: when it stops being harmless for developing teeth
July 25th, 2026 | by Dr Helen FungIf your child sucks their thumb or uses a dummy, you’re in good company — it’s one of the most common and completely normal ways babies and young children soothe themselves. It’s not a sign of anything wrong, and it’s not something to worry about in the early years. This guide explains why these habits are so common, when they start to matter for developing teeth and jaws, and some gentle ways to help your child move on from the habit — ideally well before their adult teeth are due.
Why thumb-sucking and dummy use are so normal
Sucking is one of the very first skills babies develop — it’s how they feed, and it’s also a natural way to self-soothe. Many babies discover their thumb or a dummy as a source of comfort well before their first birthday, and lots of toddlers keep the habit going through the early years, especially at nap time, bedtime, or when they’re tired, unwell or a little anxious.
There’s nothing to be concerned about here in a baby or young toddler. These are healthy, expected habits in the early years, and most children have plenty of time to grow out of them without any lasting effect on their teeth — provided the habit doesn’t continue on intensely into the toddler and pre-school years.
When can it start to affect teeth and jaw development?
The things that matter most are how long, how often and how intensely a child sucks their thumb or dummy — and, importantly, how old they are while the habit continues.
Current dental guidance recommends aiming to stop non-nutritive sucking habits well before your child’s adult (permanent) teeth begin to come through — as a general guide, working towards stopping by around three years of age, with dummy use ideally limited or reduced from around 18 months, when the canine teeth start to emerge, as this can help lower the risk of a crossbite developing.
A gentle, occasional habit in a toddler is very different from an intense, frequent habit that continues on into the years when the permanent front teeth are due. Changes that appear while a habit continues in the baby teeth — such as the front teeth tipping forward, an open bite (where the front teeth don’t quite meet when the mouth is closed), or a narrower dental arch — will often settle on their own once the habit stops, particularly if it stops early. However, the longer an intense habit continues beyond the toddler years, and especially if it’s still going once the permanent front teeth start erupting, the more likely these changes are to become a lasting part of how the arches and bite have developed — sometimes needing orthodontic treatment to correct later on.
Every child is different, and not every child who sucks their thumb or a dummy will experience these changes — it depends on intensity, frequency, duration and individual growth. But the clear, general message is: earlier is better. It’s worth actively working towards helping your child stop well before their adult front teeth are due, rather than waiting to see what happens.
Signs it may be worth a check
You don’t need to act on your own judgement alone — that’s what we’re here for. It may be worth booking a check if:
- Your child is still sucking their thumb or a dummy intensely and frequently as they approach, or move beyond, the toddler years — particularly once their adult front teeth are starting to come through.
- You’ve noticed a change in how their front teeth line up, or a gap between the top and bottom teeth when they bite together.
- You’re finding it hard to help your child stop the habit and would like some support.
- You’re simply unsure and would like reassurance either way.
There’s no need to feel anxious about bringing this up — it’s one of the most common things parents ask us about, and we’re always happy to take a look, confirm where your child’s teeth are at, and talk through next steps.
Gentle, non-shaming ways to help an older child who wants to stop
If your child is a bit older and keen to stop — or you’d like to gently start encouraging it, ideally well before their adult front teeth are due — small, kind, low-pressure steps tend to work best. Habits like this are almost always about comfort, so the goal is to support your child, not to make them feel bad about something so normal.
Notice the triggers. Thumb-sucking and dummy use often ramp up around tiredness, boredom, anxiety or big transitions (like starting school or a new sibling arriving). Once you notice the pattern, you can offer comfort in another way at those moments — a cuddle, a favourite soft toy, or some quiet time together.
Praise and encourage, rather than scold. Positive reinforcement — a sticker chart, small rewards for stretches without the habit, or simply warm praise when you notice your child managing without it — tends to work far better than telling a child off. Scolding or shaming a child about thumb-sucking or dummy use can create stress around something that was only ever a comfort habit in the first place.
Involve your child in the plan. Children who feel some ownership over the decision to stop — choosing their own reward chart, or picking a “grown-up” replacement comfort item — often do better than children who feel it’s being imposed on them.
Go gradually where you can. For dummies, some families find it easier to start by limiting use to sleep times only, then gradually phase it out altogether, rather than stopping all at once.
Be patient with setbacks. It’s normal for progress to be up and down, especially during stressful periods. A gentle, consistent approach over time works better than pressure.
Consider support from an orofacial myologist. If your child is finding it hard to stop, particularly as they get closer to the age their adult front teeth are due, our orofacial myologists offer gentle, structured cessation programs designed to support children away from thumb-sucking and dummy habits — using positive, guided techniques rather than aversive ones. This can be a helpful next step if the strategies above haven’t been enough on their own.
Some families find that a taste deterrent (such as a bitter-tasting, child-safe nail polish for thumb-sucking) helps as part of a broader plan — but please talk to us first before trying anything like this, so we can make sure it’s an appropriate and safe option for your child.
How we help at Tooth Town
At a check-up, we’re always happy to have a look at your child’s bite and talk through whether a thumb-sucking or dummy habit is having any effect on their teeth, and whether it’s time to actively work on stopping. Most of the time, reassurance and a gentle plan at home is all that’s needed. For children who need extra support, we can also discuss a referral to one of our orofacial myologists for a structured cessation program. If we do notice changes to the bite or the way the teeth are lining up, we’ll explain what we’re seeing and, where relevant, ongoing bite or orthodontic concerns are reviewed as part of our early interceptive orthodontic care pathway. Nothing is decided or recommended until your child has been assessed in person.
Frequently asked questions
Is thumb-sucking or dummy use bad for my baby or toddler’s teeth?
No — in babies and young children, these are normal comfort habits and aren’t something to worry about. It’s the intensity, frequency and how long the habit continues — particularly once it runs into the years the adult front teeth are due — that can matter.
At what age should my child stop sucking their thumb or using a dummy?
Current dental guidance points to aiming to stop well before your child’s adult front teeth are due to come through — as a general guide, working towards stopping by around three years of age, with dummy use ideally limited from around 18 months. The longer an intense habit continues beyond the toddler years, the more likely it is to affect the permanent teeth and jaw growth in ways that don’t reverse on their own. If your child is finding it hard to stop, we’re happy to help.
Will my child need braces because of thumb-sucking?
Not necessarily. Whether a habit has affected the bite varies from child to child, and depends heavily on how long and how intensely the habit continued, and at what age. If we notice any changes, we’ll talk you through it, and ongoing orthodontic concerns are reviewed as part of our orthodontic care pathway.
Should I use something to stop my child sucking their thumb?
Positive, low-pressure approaches — noticing triggers, praise, and involving your child in the plan — are a good place to start. If you’re considering a taste deterrent or any other product, please speak with us first.
Can an orofacial myologist help my child stop thumb-sucking or dummy use?
Yes. Our orofacial myologists offer gentle, structured cessation programs designed to guide children away from the habit using positive techniques, rather than aversive ones. This can be a useful option alongside the strategies in this guide, particularly if your child is finding it hard to stop as they approach the age their adult teeth are due. Ask our team for more information.
Is a dummy better or worse than thumb-sucking?
Both are common, normal comfort habits, and the same general principles apply to each — frequency, intensity, duration and the age the habit continues to all matter more than which one your child prefers. We’re happy to discuss your child’s individual situation at a check-up.
Should I be worried if my older child still sucks their thumb?
Try not to panic, but it is worth actively addressing — plenty of children take a little longer to stop, and shaming a child about it rarely helps. If your child is past the age their adult front teeth are due and the habit is still intense or frequent, please book a check so we can have a look, offer guidance, and talk about options — including support from an orofacial myologist — to help your child move on from the habit.
What to do next
If you’re at all unsure whether your child’s thumb-sucking or dummy habit is something to actively work on stopping, the simplest next step is to bring it up at their next check-up, or book an appointment with our friendly Coorparoo team. We’re always glad to take a look, offer reassurance, and talk through gentle next steps together — including a referral to one of our orofacial myologists if that would help — without any judgement.
This guide is general information and doesn’t replace an individual assessment. Your child’s clinician will confirm what’s most appropriate for them.
