Journal of the American Laser Study Club – Infant Laser Frenectomy Special Issue – 2021


Printed in full color. 15 contributing authors. Order your copy today.

Articles in this Issue

  • The Rising Tongue Tie
    Rajeev Agarwal, MD, FAAP; and Muneeb Mohiuddin
  • Functional Collaboration for Improved Patient Outcomes: The Importance of Interdisciplinary Teams to Infant and Toddler Frenectomy Outcomes.
    Anna Gross, MS, CCC-SLP; Chelsea Pinto, DDS; Leyli Norouz-Knutsen; and Chad Knutsen
  • The Team Approach in Treating Oral Sensory-Motor Dysfunction in Newborns, Infants and Babies with a Diagnosis of Tethered Oral Tissue
    Robyn Merkel-Walsh, MA, CCC-SLP, COM®; and Kristie Gatto, MA, CCC-SLP, COM®
  • Tummy Time – A Crucial Neurodevelopment Process
    Martin Rosen, DC, CSCP, CSPP
  • Rethinking Best Care Practice in Infants with TOTs
    Tess Townsend, PT, DPT, CAPP-OB
  • Breastfeeding, Bodywork, and Tethered Oral Tissues
    Cara Riek, DNP, RN, FNP-BC, IBCLC; and Stevanie Bahnerth, DC
  • Infant Laser Frenectomy Case Studies
    Martin Kaplan, DMD
  • Introduction to Soft Tissue Laser Surgery and Laser Safety Basics
    Peter Vitruk, PhD, MInstP, CPhys
  • CO2 Laser Surgery Post-Operative Pain and Healing. A Partial Literature Review.
    Anna (Anya) Glazkova, PhD; and Peter Vitruk, PhD, MInstP, CPhys

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The American Laser Study Club (ALSC) is pleased to announce the release of the Special Issue of the Journal of ALSC (April 2021) dedicated to Infant Laser Frenectomies. With contributions from many world-renowned experts and with a focus on the interdisciplinary functional approach, this Special Edition of the Journal would be of interest to both experts and newcomers to this very dynamic and rapidly developing field.

The Authors (in order of their contributing articles)

Rajeev Agarwal, MD, FAAPRajeev Agarwal, MD, FAAP (Agave Pediatrics, Phoenix, AZ)

Dr. Agarwal went to medical school at All India Institute of Medical Sciences, AIIMS, in New Delhi, which is the premier institution for medical training in India. After which, he came to the United States for his Pediatric Residency at the University of Texas Medical Branch at Galveston. Subsequently went on to join the Pediatric Nephrology fellowship at the University of Florida at Gainesville. Under the program, he also conducted bench research at Ohio State University.

Dr. Agarwal worked on the Eastern Shore of Virginia for eight years in general pediatrics before moving to Arizona to establish Agave Pediatrics in 2005.

Over the years Dr. Agarwal has developed his own style of practicing pediatrics, which is strongly supportive of natural ways of taking care of children and emphasis on breastfeeding. During his practice, he realized that one of the biggest impairments in breastfeeding was the presence of labial and lingual ties. Having performed some procedures during medical school, he re-educated himself about the procedure and started performing them in 2007. In the last ten years, Dr. Agarwal has performed more than 15,000 frenotomies. Now, along with a busy clinical practice, he has made it his goal to spread the awareness about the issues related to labial and lingual ties to pediatricians, lactation consultants, doulas, midwives -everybody who helps mothers with the process of breastfeeding and in taking care of children with feeding and speech difficulties.

Muneeb MohiuddinMuneeb Mohiuddin (Agave Pediatrics, Phoenix, AZ)

Muneeb is an aspiring physician who currently works as a scribe and research assistant for Rajeev Agarwal, MD. He studied History at Arizona State University and will be taking his MCAT in Spring 2021 before joining Teach for America for two years.

Anna Gross, MS, CCC-SLPAnna Gross, MS, CCC-SLP (The Breathe Institute, Los Angeles, CA)

As a licensed speech-language pathologist certified by the American Speech-Language-Hearing Association (ASHA) Anna offers evaluations and treatment for infant and toddler oral motor and feeding difficulties and disorders, as well as children and adults with orofacial myofunctional disorders. In addition to private practice, Anna enjoys lecturing on oral motor, feeding, and myofunctional disorders, and is a faculty member and collaborator at The Breathe Institute.

Chelsea Pinto, DDSChelsea Pinto, DDS (The Breathe Institute, Los Angeles, CA)

Dr. Chelsea Pinto is a skilled dentist and infant tongue-tie specialist at The Breathe Institute in Los Angeles. She received her Doctor of Dental Surgery (DDS) from the Herman Ostrow School of Dentistry of USC. Dr. Pinto is a proud member of The International Affiliation of Tongue Tie Professionals, The International Consortium of Ankyloglossia Professionals, The California Dental Association and The American Dental Association. Upon becoming a mother herself, and experiencing the challenges of motherhood and breastfeeding first-hand, Dr. Pinto decided to refocus her career and practice around supporting and guiding families facing tongue and lip tie related issues with their babies. She proudly offers a comprehensive and compassionate approach to treatment, providing families with education, personalized care, as well as bodywork and breastfeeding support referrals as needed to best address tongue function and its impact on the rest of the body.

Leyli Norouz-KnutsenLeyli Norouz-Knutsen (The Breathe Institute, Los Angeles, CA)

Leyli is the Co-Founder and Managing Director of The Breathe Institute. She is known for her uniquely fine-tuned ability to streamline organizational management structures, optimize collaboration and communication, drive impactful media and branding campaigns and to inspire innovation and entrepreneurship. Leyli has over a decade of experience in higher education, non-profit, board management and operations as a director at both the University of California Los Angeles (UCLA) and San Diego State University (SDSU). Since leaving UCLA’s Anderson School of Management in 2007, Leyli’s extensive background in healthcare-specific consulting and corporate strategy parlayed perfectly into co-founding The Breathe Institute, and now having the honor to serve on the Board of The American Academy of Physiological Medicine & Dentistry (AAPMD).

Chad KnutsenChad Knutsen (The Breathe Institute, Los Angeles, CA)
An award-winning filmmaker and producer in Los Angeles with over a decade of experience in the industry. Chad is an expert generalist, with an uncanny ability to digest and test new knowledge and identify and cultivate creative routes from problems to solutions. In 2012, Chad founded and captained a thriving eco-community deep in the jungles of Belize, teaching survival, permaculture and self-governance. Chad is also an Eagle Scout, has served as an Emergency Search and Rescue Team Leader in the Pacific Northwest, and is passionate about devoting his life to making a positive impact for future generations. He has consulted for and/or led successful projects in fields ranging from sustainable technology and agriculture, to construction, security and intelligence. Chad has also won awards from and been asked to present at international conferences by organizations such as MIT, The International Association of Science Parks (IASP), the Moscow Agency of Innovation, and SXSW. As Co-Founder and Chief Innovation Officer of The Breathe Institute, Chad’s diverse background and piercing curiosity have helped to keep TBI at the technological forefront.

Robyn Merkel-Walsh MA, CCC-SLP, COM®Robyn Merkel-Walsh MA, CCC-SLP, COM® (Diamond MYO by Robyn Merkel-Walsh, Ridgefield, NJ)

Robyn is employed by the Ridgefield Board of Education and owns her own practice. She’s also a consultant, author, lecturer and product developer for TalkTools®. Robyn has served in several volunteer positions and is the Board Chair of the Oral Motor Institute, CE consultant for Marshalla Speech and Language and the Associate Editor of the IJOM for 2020. She has published many articles, blogs, posters, and is the co-author of A Sensory Motor Approach to Feeding and Functional Assessment and Remediation of Tethered Oral Tissue(s).

Robyn is a member of the International Association of Orofacial Myology, The American Speech-Language Hearing Association, The New Jersey Speech and Hearing Association, The NJ Education Association and The International Consortium of Ankylofrenula Professionals.

Kristie Gatto MA, CCC-SLP, COM®Kristie Gatto MA, CCC-SLP, COM® (The Speech and Language Connection, Houston, TX)

Kristie is a certified orofacial myologist (COM®), feeding therapist, speech-language pathologist, published author, international speaker, and private practice owner in the greater Houston area. She has focused her clinical skills on treating children with issues in feeding, dysphagia, deglutition, oral sensory aversion, orofacial myology, and swallowing-related disorders, as well as articulation, phonological processing, apraxia, and early childhood intervention.

Kristie Gatto is the author of three books Understanding the Orofacial Complex: the Evolution of Dysfunction (Outskirts Press, 2016), Understanding the Orofacial Complex – Muscle Manual (Outskirts Press, 2014), and Sam the Super Chewer, Eats (Mindstir Media, 2016). She is the owner of The Speech and Language Connection in Houston, as well as an instructor for the International Association of Orofacial Myology.

Kristie Gatto is a member of the American Speech-Language-Hearing Association, the immediate Past President of the International Association of Orofacial Myology, a Board of Directors member for the American Academy of Private Practitioners in Speech Pathology and Audiology, and a member of the Community Advisory Board at the University of Houston.

Martin Rosen, DC, CSCP, CSPPMartin Rosen, DC, CSCP, CSPP (Wellesley Chiropractic Office, Wellesley, MA)

Dr. Rosen is a 1981 summa cum laude graduate of Life Chiropractic College. He practices with his wife Nancy Watson, DC and daughter Erin Rosen, D.C. in Wellesley, Massachusetts. His other daughter Emily Rosen, lives in Longmont, CO. For the past 38 years Dr. Rosen has run a successful family-oriented wellness care practice.

He is the President Emeritus of SOTO-USA, chairman of their pediatric committee and the past president of the SORSI research committee.

He has written, produced and contributed his expertise to numerous magazine articles, research papers, educational videos and technique manuals. His latest book “2nd Edition of Pediatric Chiropractic Care” is in its 3rd printing.

He has been a post graduate instructor for several chiropractic colleges as well as a lead instructor for SOTO-USA, the ICPA and currently runs Drs. Rosen Seminars. As a guest lecturer for a variety of organizations he has taught chiropractic technique, TMD evaluation and correction protocols, chiropractic philosophy and practice management, nationally and internationally since 1980.

As an addendum to his 40 years of teaching he has created an extensive library of DVD’s, and Streaming Videos for professional education. They are available to the chiropractic profession on his website

Dr. Rosen is a certified SOT®, SORSI, and SOTO-USA instructor, practitioner and craniopath, a past instructor for the ICPA and is on the post-graduate faculty of several chiropractic colleges.

If you would like to contact Dr. Rosen he can be reached at 781.237.6673, email at or on the web at (office website) or (professional website).

Tess Townsend PT, DPT, CAPP-OBTess Townsend PT, DPT, CAPP-OB (Tess Townsend Physical Therapy LLC, Millis, MA)

Dr. Tess Townsend is a licensed physical therapist in the greater Boston area who specializes in pre-crawling infants. She graduated from Cornell University with a Bachelor’s of Science in biology and holds a Doctorate in Physical Therapy from The MGH Institute of Health Professions. Her focus is on empowering parents to optimize outcomes (including relationships) with their infants through using neuro-facilitation, the polyvagal theory and social nervous system optimization. She is available for both telehealth and clinic sessions. When she is not in clinic, Tess can usually be found trying to keep up with her children while they outrun her on bikes. She finds cooking stressful, yoga a necessity for sanity, and folding laundry over-rated.

Cara Riek, DNP, RN, FNP-BC, IBCLCCara Riek, DNP, RN, FNP-BC, IBCLC (Arizona Breastfeeding Medicine & Wellness, Scottsdale, AZ)

Dr. Cara graduated from Arizona State University with a Doctor of Nursing Practice degree. She is a board-certified Family Nurse Practitioner in addition to having her IBCLC certification. Dr. Cara is also a diplomate of the American Board of Laser Surgery, specializing in “Oral Surgery in Infants, Toddlers, and Adults.” She is also a Certified Specialist in Orofacial Myology (CSOM).
Dr. Cara describes her career as a diversifying adventure: research, teaching, nursing, and now breastfeeding medicine specialist. She strives to provide meaningful, evidence-based care to mother-baby dyads. Her mission is to support mothers where they are at and help them journey into the breastfeeding relationship they desire. She strives to make sure that each patient is able to reach their desired goal and have an amazing breastfeeding relationship.

Stevanie Bahnerth, DCStevanie Bahnerth, DC (Healthy Images, Cave Creek, AZ)

Dr. Stevanie Bahnerth is a family chiropractor with over 14 years of experience. She earned her Bachelor of Science degree from Purdue University and then attended Palmer College of Chiropractic in Davenport, Iowa. Her practice revolves around providing ongoing care and treatment for patients with TOTS: infants through adults. In her free time, Dr. Stevanie enjoys spending time with family and friends, yoga, and traveling.

Martin Kaplan, DMDMartin Kaplan, DMD (Bolton, MA)

Dr. Kaplan earned his dental degree at Tufts University School of Dental Medicine in 1975. While attending dental school, he became involved with pediatric dentistry and was captivated by the comprehensive nature of the specialty and the ability to treat the youngest of patients and direct them to better oral and physical health.

Upon graduating from Tufts he was accepted into a pediatric dental residency program at Montefiore Hospital and Medical Center in New York where he received his certification as a pediatric dentist.

Following the residency, he opened his pediatric dental practice in Stoughton, Massachusetts. In 2003, Dr. Kaplan became an early adopter of the soft and hard tissue dental lasers. He has been a volunteer laser instructor at Tufts Dental School in the post-graduate pediatric dental department. During 2015-2017 he developed the first in the country “Pediatric Laser Frenectomy” training class through the continuing education departments at Tufts University and Boston University. Dr. Kaplan continues to teach his program now through the American Laser Study Club. His courses were attended by thousands of dentists and physicians from around the globe.

Dr. Kaplan is a 2020 recipient of the prestigious Kumar Patel Prize in Laser Surgery awarded for his outstanding contribution to laser dentistry education.

Dr. Kaplan is a member of the American Dental Association, Massachusetts Dental Society, the Academy of Pediatric Dentistry, the Massachusetts Academy of Pediatric Dentistry, the Academy of Breastfeeding Medicine, Massachusetts Breastfeeding Coalition (Bolton and Hanover, MA), Breastfeeding USA plus multiple other professional organizations, including the American Laser Study Club. Dr. Kaplan has authored several articles and book chapters both dental and breastfeeding related.

Peter Vitruk, PhD, MInstP, CPhysPeter Vitruk, PhD, MInstP, CPhys (American Laser Study Club & LightScalpel Inc, Bothell, WA)

Dr. Peter Vitruk is a Member of The Institute of Physics, UK, and a founder of the American Laser Study Club, and LightScalpel, Inc (, both in the USA. Dr. Vitruk can be reached at 1-866-589-2722 or

Anna (Anya) Glazkova, PhDAnna (Anya) Glazkova, PhD (LightScalpel Inc, Bothell, WA)

Dr. Anya Glazkova is the clinical continuing education coordinator at LightScalpel, Inc. Dr. Glazkova can be reached at

Additional information

Weight1 lbs
Dimensions12 × 9 × 2 in

April 2021


Paperback in Full Color

Page Size

8 1/2 x 11 inches

# of Pages



Only available as a printed journal. Digital copies (PDF) are not being sold. Articles are not individually sold.