Little Bird Pediatric Dentistry

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Little Bird Pediatric Dentistry Having learned and collaborated with pediatric health care experts from around the world, a new comprehensive airway centric assessment and approach was born.

Dr. Alison Sigal
Certified Specialist in Pediatric Dentistry
B.H.Kin, DDS, MSc (Ped Dent), FRCDC
Founder, Little Bird Pediatric Dentistry

Making airway-centric health care a global standard—shaping textbooks, curriculums, and future health-care models. Little Bird Pediatric Dentistry represents Dr. Alison Sigal’s vision of pediatric health care, creating an Airway Centric clinic that focuses on optimizing the growth, development and function of all children from birth on-wards. This vision of Little Bird grew from…

- A love for children and healthcare,
- A foundation in anatomy, physiology, and function,
- And a passion for research and global multi-disciplinary collaboration

Dr. Alison Sigal is a pediatric dentist with additional training that includes orofacial myofunctional therapy (OMT) and Buteyko breathing. We have a four-fold mission at Little Bird:

1. To optimize the growth, development and function of all children we care for from birth onwards, that is airway focused and comprehensive. For optimized growth, development and function, it is critical that we are breathing from our noses, having our lips sealed (closed) at rest, and with correct tongue rest posture (up against the roof of our mouths, behind the upper front teeth). Our philosophy of care at Little Bird is for optimization and prevention, to therefore avoid or minimize treatment and correction at a later, older age. This is why we work collaboratively with various health care providers and see babies within their first months of life - ensuring optimized tongue and lip rest posture, nose breathing, sleeping and feeding. Beyond babies, ALL new patients at Little Bird receive comprehensive airway centric examinations that include but are not limited to the evaluation of their breathing, sleeping, diet/chewing /swallowing and teeth. No matter how old your child is, identification and treatment can be beneficial. Dependent on the specific needs for each patient, our services at Little Bird may include (but are not limited to) Buteyko breathing re-education, orofacial myofunctional therapy (OMT - exercises for the muscles of your head, neck, & airway), tongue and/or lip tie releases (frenotomies) and more.

2. Provide a community-based family first center where care can be personalized to the unique needs of each individual. Little Bird has Snoezelen/Sensory integrated features throughout the entire office. At Little Bird, we aspire to meet the needs of each of our patients through our various spaces and design. From a natural waterfall feature, to live trees, calming rooms, rebounding therapy and a classroom space for our many airway centric programs!

3. To practice and contribute to evidence based health care; having created a secure electronic charting system, this will allow for on-going research to be conducted at LB, and used to assess and continually improve patient care.

4. To continually collaborate and learn from multi-disciplinary health care providers, and evolve our practices to best meet the needs of our patients. Please visit our website at www.littlebirddental.ca for further details and to use our Airway Centric Self-Assessment Checklists to evaluate your loved ones from home! We look forward to taking care of you,

Sincerely,

Dr. Alison Sigal

“Spread Love. Spread Kindness. Spread Your Wings!”

10/09/2026

Every day, building stronger evidence to support the standardization of tongue tie care. Protocols, surgical techniques, and beyond. With one of the largest living research databases, we know the difference complete tongue tie treatment provides. It is life changing. We won’t stop researching, capturing, sharing, teaching, and publishing, until it is common knowledge and common practice. Heart and data driven health care is the best medicine. Beyond excited to collaborate and share this work at TongueTime in Switzerland next year!! Stronger together!

09/20/2026

Always an emotional day. Remembering the legacy of Terry Fox. His courage, heart, determination, and bravery. I am named after Dr. Ruth Alison, who was one of the oncologists of both Terry and my Dad. Forever grateful to all of the researchers, the doctors, the evolving medicine. Grateful to our angels, the fighters, and survivors. Today we ran, biked, and walked in all of their honours and remembrance. Thank you Terry!!!

09/16/2026

TODAY. ❤️

My second peer-reviewed paper is officially PUBLISHED and LIVE.

And this one feels like my heart and soul on paper.

The Tool for Optimal Tongue Rest Posture (TOTRP): A Measurement-Based Surgical Technique and Checkpoint Derivation for Lingual Frenotomy Under General Anesthesia

This paper brings together so many parts of who I am:

My roots in Kinesiology and love of anatomy and physiology.
My surgical training.
Nearly a decade of caring for patients, palpating tissues, measuring, questioning, and relentlessly asking:

WHY?

For years, I knew when I had fully released a restrictive lingual frenulum because I could feel it.

Once the tongue could freely separate from the floor of the mouth, I repeatedly watched it passively suction, in its entirety, against the hard palate.

That observation became the foundation of my first paper examining the tongue as a muscular hydrostat.

But then came the next question:

How do I take something I can FEEL surgically and turn it into something objective, measurable, teachable, and reproducible?

So I kept measuring.

And years of clinical data revealed an objective relationship.

For patients undergoing lingual frenotomy under general anesthesia, TOTRP provides measurable surgical checkpoints associated with 100% complete passive palatal suction postoperatively.

To see something that began as a feeling beneath my fingertips become a measurable relationship in a peer-reviewed publication is incredibly emotional.

This paper represents:

Years of patients.
Years of measurements.
Years of questioning.
A surgeon’s hands.
A kinesiology brain.
A living clinical database.
And a question I simply could not stop asking.

Today, TOTRP is out in the world. ❤️

There is more work ahead, including our continued investigation of objective relationships for awake surgical care.

But today, I am letting myself celebrate this one.

TOTRP IS LIVE. ❤️
Please read it.
Please share it.
Please research it.
Please collaborate.

Heart-driven.
Data-driven.
Together.

Article link in bio / story. ❤️

An incredibly special day at Little Bird. ❤️My second peer-reviewed research paper is officially published and LIVE:“The...
09/16/2026

An incredibly special day at Little Bird. ❤️

My second peer-reviewed research paper is officially published and LIVE:

“The Tool for Optimal Tongue Rest Posture (TOTRP): Measurement-Based Surgical Technique and Checkpoint Derivation for Lingual Frenotomy Under General Anesthesia.”

This paper is deeply connected to the reason Little Bird exists.

When I founded Little Bird Pediatric Dentistry in 2017, I wanted to build more than a clinic. I wanted every patient we cared for to teach us something — to continuously evaluate our outcomes, question our protocols, refine our care, and better understand the relationships between tongue function, breathing, sleep, growth, and development.

Little Bird became a living clinical research database.
And TOTRP grew directly from it.

For years, the completeness of my lingual frenotomy surgery was determined largely through my hands: palpating the tissues and releasing restrictive fibers until the tongue could freely and vertically separate from the floor of the mouth.

But I knew that if this surgical endpoint was going to become teachable and reproducible, we needed more than feel.
We needed measurement.

My background in Kinesiology and love of anatomy and physiology led me to begin systematically measuring tongue mobility — including vertical tongue lift — alongside a stable anatomical reference unique to each patient: the length of the hard palate.

After years of collecting these measurements, the data revealed an objective relationship.

For patients undergoing lingual frenotomy under general anesthesia, surgical completeness was evaluated using two checkpoints: unrestricted tongue separation from a flat floor of mouth, followed by a free-tongue vertical lift at least 17 mm greater than hard-palate length.

Together, these measurements were associated with 100% complete passive palatal suction postoperatively.

That relationship became: TOTRP.

It builds directly upon my first publication examining the tongue as a muscular hydrostat.

The first paper helped answer:

What does the unrestricted tongue naturally do?

This paper begins answering:

How can we objectively determine whether enough mobility has been created surgically to allow it to do it?

Seeing work that began years ago inside my treatment rooms now published for clinicians, therapists, and researchers around the world to read is difficult to put into words.

It represents thousands of patient encounters, countless measurements, constant questioning, years of data collection, and an extraordinary Little Bird team who have helped make meticulous clinical documentation part of the care we provide every single day.

Most importantly, behind every data point is a patient and a family who trusted us with their care.

That is never lost on me.

TOTRP currently applies to the population studied undergoing lingual frenotomy under general anesthesia.

Our research continues, including data collection to investigate objective relationships for awake surgical care.
There is so much more to learn.

But today, I am incredibly proud to share this next piece of my research journey with you.

TOTRP is LIVE. ❤️

Please read it, share it, and join the conversation.

Article:
https://www.mdpi.com/2694-2526/52/2/15
Open-access PDF:
https://www.mdpi.com/2694-2526/52/2/15/pdf

Here is to continuing to ask WHY — and using heart, anatomy, physiology, clinical observation, and data to find better answers for the children and families we care for. ❤️

Stay tuned as something I have been working on for years, is about to come to life for all to read, use, and share! Lead...
09/12/2026

Stay tuned as something I have been working on for years, is about to come to life for all to read, use, and share!
Leading a clinician-researcher life is one that I am forever grateful to have! Be the change you want to see in the world. Heart driven health care is the foundation of airway centric health care.

During our pediatric years, everything above your neck is like paper-mache; easily shaped and molded. The tongue’s const...
09/11/2026

During our pediatric years, everything above your neck is like paper-mache; easily shaped and molded. The tongue’s constant pressure against the palate helps shape a wide, flat palate with maximum surface area—essential because the flip side of the palate is our nasal airway. Optimal transverse growth of the maxilla also supports the mandible growing wider and forward.

Without proper tongue suction against the palate, compensatory muscle activity can contribute to a narrow, rounded palate and compromised nasal airway.

Pacifiers and traditional sippy cups may soothe, but they encourage a low tongue posture and tongue-thrust swallow, potentially compromising development.

Instead, consider the Finger Latch, Infant Chew, or Elephant Lovey for soothing.

Ultimately, every child should develop three essential keys:
1. Tongue suctioned against the palate
2. Lips sealed at rest
3. Gentle nasal breathing—awake and asleep

📄 Read my open-access paper, Changes in Tongue Resting Posture Following Pediatric Lingual Frenotomy: Evidence for the Tongue as a Muscular Hydrostat: https://www.mdpi.com/3915252

09/08/2026

Back to school!! Sending so much love to all the kids starting their first days this week! Also to their families and parents - another season begins!
So proud of Evie and Sim - was a hearts full beautiful day back! Thankful to their amazing teachers that also helped start their school years with magic!
“Spread love. Spread Kindness. Spread your wings!”

Back to school!! Sending so much love to all the kids starting their first days this week! Also to their families and pa...
09/08/2026

Back to school!! Sending so much love to all the kids starting their first days this week! Also to their families and parents - another season begins!
So proud of Evie and Sim - was a hearts full beautiful day back! Thankful to their amazing teachers that also helped start their school years with magic!
“Spread love. Spread Kindness. Spread your wings!”

What are the Functions of the Tongue? Optimal infant anatomy begins with the tongue—the captain of cranio-facial-respira...
09/08/2026

What are the Functions of the Tongue?

Optimal infant anatomy begins with the tongue—the captain of cranio-facial-respiratory growth and development. It also plays essential roles in airway protection, chewing, swallowing, speech, and oral hygiene.

Yet the tongue has been largely sidelined in healthcare, partly because of its complex anatomy.

Think of the tongue in thirds: blade, body, and base. Unlike most muscles, the tongue is a muscular hydrostat—with no bones, functioning like an elephant’s trunk or octopus te****le. It can generate suction and pressure, allowing the full tongue to naturally rest against the palate.

However, most anatomical illustrations show the tongue resting on the floor of the mouth, largely based on cadaver anatomy. In living people, a wet oral environment enables this natural suction.

My clinical work and data from over 3,700 patients support this functional model, recently accepted for publication in the IJOM.

This brings us to the first essential key: At rest, the full tongue should be passively suctioned against the palate.

📄 Read my open-access paper, Changes in Tongue Resting Posture Following Pediatric Lingual Frenotomy: Evidence for the Tongue as a Muscular Hydrostat: https://www.mdpi.com/3915252

09/03/2026

How we breathe matters.

Habitual mouth breathing is not simply an open-mouth habit. It can influence sleep quality, oral health, craniofacial growth, nervous-system regulation, attention, behaviour, and overall health.

Nasal breathing, by contrast, helps filter, warm, and humidify the air we breathe, while supporting healthier airway function, sleep, tongue posture, and development.

In this conversation with Dr. Derek Mahony, we explore why breathing should be at the forefront of every child’s health assessment—and why recognizing mouth breathing early can create an opportunity to change a child’s trajectory.

The full podcast is now live, and I am so excited to share this rich conversation about airway-centric health care, tongue function, sleep, growth, and whole-person wellness.

🎙️ Watch or listen to the full podcast:
YouTube: https://youtu.be/tmgnZ3BKI0c
Spotify: https://open.spotify.com/episode/3quy61AZcP6kIqkjvo0I5k?si=ke_fjp_MSXmwBcbYjC-HOg
Apple Podcasts: https://podcasts.apple.com/au/podcast/tongue-ties-with-dr-alison-sigal/id1584591504?i=1000780137439

📄 Read my open-access paper, Changes in Tongue Resting Posture Following Pediatric Lingual Frenotomy: Evidence for the Tongue as a Muscular Hydrostat: https://www.mdpi.com/3915252

The mouth has many important functions—but breathing is intended to occur through the nose. ❤️

Address

345 Steeles Avenue E, Unit 200
Milton, ON
L9T3G6

Opening Hours

Monday 8:30am - 4:30pm
Tuesday 8:30am - 4:30pm
Wednesday 8:30am - 4:30pm
Thursday 8:30am - 4:30pm
Friday 8:30am - 4:30pm

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