Tethered oral tissues (ie. tongue, lip and buccal ties) are continually a top discussion among pediatric providers surrounded by intense controversy about the diagnosis, impact and treatment. Doctors of Chiropractic can join the conversation as a resource to the community by offering a conservative management approach. In this lecture, we will review biomechanics, anatomy and physiology of the structures of the mouth, head and neck. We will also outline the causes for dysfunctional tongue motion and how to evaluate for and communicate with pediatric providers about conservative management options as well as pre and post-surgical care when necessary.