Tongue-tie and Lip-tie
What is a Tongue Tie or a Lip Tie?
A tongue-tie is when the thin tissue underneath the child's tongue called the lingual frenum, limits movement and range of motion of the tongue.
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Note: Appearance only does NOT give the diagnosis of a lip or tongue-tie.
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A lip-tie is when the thin tissue located is between the upper front teeth called the maxillary anterior frenum, limits upper lip mobility.
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Most common mom and baby symptoms: mother's feels pain when nursing, mother's nipple distorted, or the baby falls asleep at the early mid parts of the nursing experience, clicking or smacking noises, dry lips, mouth breathing, excessive hiccups, excessive gassy (from swallowing air while nursing), rubbery-like gum line, are some of the symptoms.
Come for an examine to see the additional signs and symptoms of a tongue-tie or lip-tie.
For older children and adults, common signs and symptoms include: speech sounds difficulty, preference to only soft foods (can't tolerate meats, chicken, and paradoxically can't tolerate mashed potatoes), pocketing of food, slow eater, mouth breather, facial and shoulder pains.
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If the frenum need is limiting function of the patient, then a procedure to remove the piece of tissue is indicated. And that is call a frenectomy, which is a minor in-office surgical laser procedure that involves the removal of either the connective tissue located under the tongue (lingual frenum) or the band of tissue that attaches the upper lip to the gums (labial frenum). This is done in order to correct problems that arise as a result of a tongue tie condition or a lip tie condition, respectively.
Limited to minimal bleeding occurs, and healing is improved whenever a corrective-tie surgery is done.
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Infants need to be seen by a lactation consultants before and after treatment. Children and adults need to see speech therapist or oro-myofunctional therapist before and after treatment.
Tongue Tie Before
Tongue Tie After
What age is best for a Frenectomy Treatment?
At Little Champions, we treat as early as one-week-old infants. It is never too young to have your baby assessed by a Board Certified Lactation Consultant (IBCLC). Babies as young as a day old can be examined and when indicated, a frenectomy should be done as early as possible. To find an IBCLC,
follow this link: USLCA Resources
**Most parents with babies that need frenctomies are seen and treated within a week when referred to our clinic by either their pediatrician or an IBCLC.
When should a Frenectomy be performed on an infant?
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In infants, a lingual frenum that is either short and thick or long and thin restricts the movement of the tongue, which can make it difficult for the infant to breastfeed or take a bottle. The condition is also known as a "tongue-tie" in some instances. If the problem isn't fixed until the baby is older, it's possible that the child will have trouble talking compared to other kids their age.
It is possible that the condition will not be discovered during routine checkups. Sometimes, it is only identified after the child has reached the age of eligibility for school. In children, a frena that is abnormally lengthy may hinder the tongue from developing normally. In the direst of circumstances, the infant may have a difficult time swallowing. Within the first few weeks following birth, a frenectomy on an infant can be performed expeditiously and with just minimal levels of discomfort.
When there is a problem, such as an extended maxillary labial frenum, the worry that follows is typically about the potential for orthodontic problems. An elongated labial frenum can impede the normal growth of the two front upper teeth and the normal spacing between them. The gap between a child's teeth is a common source of concern for many parents, who mistakenly believe that it necessitates the use of orthodontic treatment. However, it is best to hold off on orthodontic treatment until after the permanent adult teeth have come in. If, after using braces, the abnormal spacing problem is still present, a labial frenectomy is a procedure that can be performed to correct the problem. In some cases, the gap caused by an enlarged labial frenum will close on its own as the permanent teeth come in.
Signs your child might need a Frenectomy
Your child may need a frenectomy if they have any of the following problems:
Problems with breastfeeding/feeding: a tongue-tie makes it difficult for infants to swallow because their tongue is significantly restricted, and this can result in some of the following: clicking, falling asleep while nursing, poor weight gain, pain on mothers (among other symptoms).
Speech problems: the tongue and lip are crucial for proper speech development. In cases where their movement is restricted, children will have problems pronouncing certain sounds, and speech impediments such as lisps are common.
Sleep issues: a tight labial frenum could cause your child to sleep with their mouth open because of the inability of their lips to come together at rest, predisposing them to dental problems such as an anterior open bite. Sleep apnea may also occur because there is improper muscular tone of the tongue causing it to lie in a more posterior position and potentially restrict the airway.
Dental problems: the presence of a lip or tongue-tie increases the risk of cavities on the front surface of incisors and gum recession (causing teeth to look abnormally large). Additionally, cavities in the pits and fissures of molars are more likely as the tongue is unable to remove food from these sites.
Two Types of Frenectomy
A lingual frenectomy is performed when the lingual frenulum (the frenulum that connects the bottom of the tongue to the mouth’s floor) is too short or thick. An ill-formed lingual frenulum can result in ankyloglossia, commonly known as tongue-tie. Tongue-tie often prevents a patient from eating or speaking correctly and can be especially troublesome for developing children.
A labial frenectomy is performed when the frenulum attaching the top lip to the gums surrounding the top teeth is malformed. A problem with this frenulum may lead to gum recession in the area if it is not addressed.
Tongue Tie / Lip Tie
Tongue-tie: A tongue-tie is when a thick band of tissue under the tongue binds an infant’s tongue to the bottom of their mouth. This tissue, the lingual frenulum, generally separates before birth, but sometimes does not, for unknown reasons. This can lead to difficulties and pain when breastfeeding, as well as other issues with overall oral comfort and speech development. If your child has had problems breastfeeding or an older child complains about tongue discomfort, then tongue-tie might be the culprit.
Lip-tie: Lip-ties are very similar to tongue-ties but are a result of the tissue behind the upper lip, the labial frenulum, being too thick and inflexible instead, preventing the upper lip from moving freely. This condition can make breastfeeding very difficult, resulting in pain and discomfort for the mother and a lack of healthy weight gain for the infant. If you have noticed that your infant is not gaining weight, is constantly hungry but never seems to be satisfied, often falls asleep while nursing or other complications, please contact us today.
Frenectomy Procedures
The most frequent and customary method for repairing a tongue or lip tie is to perform a frenectomy or frenotomy, which involves using scissors or a scalpel to snip, cut, or remove the tissue. These terms refer to the same surgical technique. Fortunately, using these techniques results in a reasonable amount of blood and a considerable amount of discomfort. As a result of this surgery, there is also a higher chance that the limb will reattach, and there is also a higher chance that scar tissue will form.
The laser procedure can be performed on children of any age, even infants, if it is performed correctly and in a safe manner. The tissue can be removed in a matter of minutes by the laser, with minimal to no bleeding and significantly reduced levels of discomfort for your child. In addition, it stops scar tissue from forming and makes it much less likely that the frenum will reconnect itself.
In younger children, the discomfort associated with a lip or tongue tie procedure typically lasts about 24 hours, but it can last for as long as 48 hours in older children. It is extremely important that you follow all of the instructions given to you following your child's procedure, including any stretching or massage exercises. It is essential to the children's recovery that the exercises be carried out, despite the fact that children typically do not enjoy the exercises and may cry or fuss during them. One week after the procedure, a follow-up appointment will be scheduled to check on the healing of the tissue. Depending on how quickly the tissue heals, you may need to come back for more appointments after the first one.
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Some parents choose to treat their children on the same day if they are having difficulty breast-feeding or bottle-feeding their children, or if the child is not gaining enough weight. On the other hand, the initial appointment might just be a consultation, and the parents might have to make a second appointment to actually get the procedure done.
It is recommended that parents bring their infants to the appointment with an empty stomach so that the child can nurse immediately after the procedure. This is something that is recommended to help make the infant more comfortable and to encourage and foster the correct pattern of latching and sucking. During the procedure, infants are swaddled to help them remain still, and a gentle hold is applied to the infant's head to ensure their safety. Swaddling is one way that this is accomplished. The actual surgery itself normally only takes a few minutes, and once it is through, the parents are brought back into the room to soothe the baby and nurse it once they have finished the procedure.
It is important that parents discuss pain treatment options with their child's pediatrician before the procedure is carried out. In most cases, a dose of Tylenol is all that's needed for infants, but it still needs to be given at least 30 minutes in advance of the surgery.
Benefits of frenectomy treatment
Frenectomies can help to improve the health of your child by making it easier for them to feed (there is often immediate improvement in breastfeeding), allowing their speech to develop properly, and reducing their likelihood for developing serious orthodontic issues like misaligned teeth which would exacerbate problems with eating and speaking.
Having a frenectomy done will also relieve pain that breastfeeding mothers may be experiences because of their baby’s lip or tongue tie.
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Labial frenectomy: The tissue that connects the gum tissue that is located between the two front teeth to the upper lip is called the labial frenum. It is possible for there to be a space between the two front teeth if this frenum is positioned too deeply within the gum tissue. Additionally, because it separates the gums from the jawbone, it can lead to gum recession. The following includes the benefits of labial frenectomy:
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Contributes to a reduction in both pain and discomfort.
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It fills in the space between the two front teeth to eliminate the appearance of a gap.
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Enhances the function of the bite
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It instills young adults and teenagers with a sense of self-assurance.
Frenectomy of the lingual fold: The tissue that connects the underside of the tongue to the floor of the mouth is referred to as the lingual frenum. It is possible for the lingual frenum to impede movement of the tongue if it is situated too far forward on the tongue. In the absence of treatment, it can impair a child's capacity to eat and communicate normally. Having a lingual frenum, often known as being "tongue-tied," can make it difficult for an infant to latch on to a breast or a bottle when they are trying to nurse or feed themselves.
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It facilitates better speech function.
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increases consumption as well as appetite.
Frenectomy Aftercare
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Watching your infant: Even though a frenectomy is far less invasive than other treatments, it is still a minor operation. If at all possible, spend a few days at home with your infant to watch over them as they heal. It's a good idea to let your infant rest and take it easy after their frenectomy, just as with other therapies. When your baby's lip or tongue is up, check to see if the wound appears to be healing appropriately. Your baby may experience some little bleeding and have somewhat darker-than-usual stools due to small amounts of blood that were swallowed. Call your child's pediatric dentist immediately if the bleeding hasn't stopped or the surgical site appears to be still very red and swollen many days after the procedure.
Maintaining Your Baby's Comfort: Your child's mouth will be numbed before the frenectomy in order to prevent pain for them. The anesthetic usually wears off a few hours after the treatment, and your child could be a little cranky for the following several days as they recover. You can provide an infant pain reliever as directed if your baby is old enough to do so. If they are too young for liquid painkillers, you can soothe them by snuggling them frequently, giving them smaller and more frequent feedings, and skin-to-skin contact. You can also get specific recommendations from your child's dentist.
Giving Your Baby Food: A newborn can usually start breastfeeding or drinking formula almost right away after having a frenectomy. Breastmilk and formula both include healthy nutrients and antibodies that can support your infant's recovery. Remember that they could require smaller feedings at first. For a few days following surgery, refrain from giving older children hot or spicy foods, as these could aggravate the surgical site. Likewise, make sure they restrict or stay away from crunchy foods until the wound is fully healed.
Frenectomies can help your child restore complete lip and tongue mobility, which will significantly enhance their quality of life. They are a simple and quick procedure. With the help of these simple but important tips, your child can start to get better and heal quickly from treatment. Contact us today to see if a frenectomy is right for your child.