Release of Tongue and Lip Ties
Early intervention of an infant’s lip or tongue tie can improve breastfeeding and help prevent potential challenges related to feeding, speech, and dental development. At The Kids Dentist, we prioritize the well-being of your child by providing prompt treatment following a consultation, often performed on the same day.
What to consider about tongue tie release
For infants, lip and tongue-ties are closely associated with difficulties while feeding, whether it’s with a breast or bottle. Often, the baby will struggle to latch and create a steady flow of milk or formula. They may end up gumming the nipple, which can be extremely uncomfortable for breastfeeding mothers. During this process, they often accidentally swallow a lot of air, creating digestion problems including excessive gas or bloating. Slow weight gain or excessive fussiness while feeding are also two common signs.
One of the earliest signs a child might have a lip or tongue-tie which was missed in infancy is difficulty transitioning to more solid foods. They may find it very hard to take bites and swallow properly. Even though most children have their own quirks while learning to speak, certain impediments like a lisp may develop and be persistent. A parent might also notice their child primarily breathes through their mouth or snores, this could be due to the restricted tongue partially constricting their airway.
Benefits of a laser frenectomy
A laser frenectomy involves separating the tissue that connects the tongue to the rest of the mouth. When this tissue is too small, the movement of the child’s tongue is restricted, leading to difficulty speaking and suckling.
The procedure is safe enough for children and adults alike. It can be performed on infants, allowing dentists to address issues with a child’s frenum before it significantly impacts their development. For example, a tight frenum can end up leading to a lifetime of speech impediments since it hinders the child’s speech development.
The use of a laser makes the process more comfortable and faster for your little one. The laser gently removes the restrictive oral tissue with precise control and cauterizes at the same time, meaning your infant should experience minimal bleeding or discomfort and no need for suturing.
The benefits of a laser frenectomy include:
- Performing the treatment with a laser leads to shorter recovery times
- The laser eliminates the need for an anesthetic
- Reduced risk of infections since there are not cuts made with a surgical knife
- Lasers stimulate healing via bio-regeneration
- The laser seals blood vessels as it cuts which reduces bleeding
- The procedure can be completed in minutes, so it is not a stressful experience for the child
- There is no need to stitch anything up after the procedure
- The treatment has a high success rate
- It improves the child’s ability to breastfeed
Preparation before a lingual frenectomy consultation
Tongue and lip ties occur when the tissue connecting the tongue to the bottom of the mouth, known as a tongue tie, or the tissue connecting the lip to the gum, referred to as a lip tie, is overly tight. This condition can hinder a baby’s ability to breastfeed effectively. At The Kids Dentist, we prioritize prompt treatment, often providing care on the same day as your consultation. Early intervention can significantly enhance the likelihood of successful breastfeeding. The information provided here serves as a helpful guide to understanding tongue and lip ties in infants, what to anticipate during and after the procedure, and how to support your baby’s healing and development.
Pre-surgery stretching & strengthening exercises
Babies with ties often have weak or uncoordinated sucking. Doing these exercises before your appointment can help build your baby’s strength and your confidence. These movements also help with faster recovery and prevent the ties from reattaching.
Try these exercises 4 times a day leading up to the procedure. We recommend working with your lactation consultant or myofunctional therapist for personalized exercises, but here are some suggestions:
- Finger Sucking with Pressure: Let your baby suck your finger. Gently press down on their tongue with the back of your nail. Your baby will push back. When they break the seal, put your finger back up to encourage sucking again. Repeat as tolerated.
- Tug-of-War Sucking: While your baby sucks your finger, gently try to pull it out as they try to suck it back in. This strengthens their tongue. You can also do this with a pacifier.
- Gum Line Rub: Slowly rub your baby’s lower gum line from side to side. Their tongue will follow your finger, strengthening its side-to-side movement.
- Cheek Massage: Place one index finger inside your baby’s cheek and your thumb outside to gently massage their cheeks. This helps release tension.
Day of the procedure
We suggest giving your baby acetaminophen (Tylenol) 30 minutes before the procedure. This helps prevent discomfort afterward, allowing you to focus on your baby. Use the dropper from the Tylenol packaging and ensure it’s the 160mg/5mL dosage (not the concentrated form).
You can also use other pain relief methods that work for your family, or none at all. We’ll apply a numbing medicine during the procedure, so not every baby needs medication beforehand.
Post-surgery care and healing
Once your baby is home, call us immediately if you notice:
• Active bleeding
• A fever over 101.5°F
• Your baby refusing to nurse or take a bottle
Healing Process: a few days after the procedure, you may notice a whitish scab developing at the surgical site, which can sometimes take on a yellowish tint if your child had high bilirubin levels after birth. This is completely normal. This scab will come off around days 5-7, revealing tiny red spots that might bleed a little. By day 14, the surgical site will be mostly healed. It is common for the scab to detach itself around days 5-7, revealing tiny red spots that might bleed a little. By day 14, the surgical site will be mostly healed.
Before
Same day post-op
Three weeks post-op
1 month post-op
Post-surgery exercises and stretches
The crucial phase has arrived following a frenectomy, as the primary concern becomes the possibility of the lip or tongue tie reattaching. As surgical sites heal, they can tighten or contract, and given the rapid healing process in children, there is a risk that the previously freed tissues may close prematurely. This may lead to the resurgence of prior difficulties and symptoms. To reduce the likelihood of reattachment, it is vital to follow the prescribed exercises and stretches diligently.
POST SURGERY, TONGUE AND LIP TIE EXERCISES AND STRETCHES.
Video Credit: A big thank you to our friends over at La Petite Dent Pediatric Dentistry and Orthodontics in Nanuet, NY for letting us share this awesome video!
Perform the below exercises 6 times a day for the first 4 weeks, then taper off over the next two weeks. Stretching and strengthening your child’s lip or tongue may be challenging at first, but it will become easier. We are here to support you, just a phone call away. Keep a calm and positive atmosphere, making sure your child sees this as a playful activity rather than a stressful one. The stretching exercises should be firm and gentle, not quick or forceful.
How to position your baby: sit directly behind your baby (at the “12 o’clock” position) with your baby in your lap or on a table/bed.
Upper lip stretches
Position your two fingers beneath their lip and gently lift it as high as it can go, imagining the motion as if you are guiding their lip toward the nose. Next, softly move your fingers side to side for 6 to 8 repetitions. Keep in mind that the purpose of this movement is to stretch the surfaces of the lip and gum that were previously connected by the lip tie.
Under the tongue stretches
- Lift the Back of the Tongue: Once your fingers are under the tongue, lift the very back part of the tongue as high as it will go towards the palate. Hold for 3 seconds, relax, and repeat 6-8 times. This helps fully lengthen the diamond shape so you can see the area under the tongue.
- Circular Stretch: Place your finger in the middle of the diamond and gently stretch in a circular motion for several seconds to open up the diamond.
- Rolling Pin Motion: Turn your finger sideways and use a “rolling pin” motion to keep the diamond as deep as possible. Start at the center fold of the diamond and move to either side (top and bottom) to loosen the tongue muscles and the floor of the mouth.
Ongoing Support
It’s very important to follow up with your lactation consultant, myofunctional therapist, or physician after the procedure. They can identify if your child is using compensatory movements and guide both you and your baby on the best path forward. We are always available by phone if you need any help or have questions or concerns. Your baby’s well-being is our priority, and we are here to support you.
Our caring team is available answer any questions or concerns. The health and happiness of your child is a priority and we are committed to guiding you every step of the way.