Children may be born with a combination of conditions called a tongue-tie (ankyloglossia) and/or a lip-tie. These may cause restrictions in movement that can lead to difficulty with breastfeeding, and in some instances, other health problems like dental decay or spacing, speech and airway difficulties, and digestive issues.
During a frenotomy, laser light removes the frenum under the tongue or upper lip to allow for better range of motion. With very little discomfort and almost no bleeding, some babies and children sleep through the procedure. The laser sterilizes upon touch, reducing the chance of infection and stimulating healing.
Ankyloglossia, or tongue-tie, is the restriction of tongue movement as a result of the tongue adhering to the floor of the mouth. Normal tongue function allows a baby to latch adequately and breastfeed efficiently, promotes normal speech development, makes it possible for a child to self-cleanse the mouth during eating, allows adequate swallowing patterns, allows for proper growth and development. It also makes possible fun little things like eating ice cream, kissing or sticking your tongue out to catch snowflakes.
A lip-tie occurs when the upper lip remains attached to the upper gum. It can lead to problems with speech and eating habits, jaw pain and protrusion, clicking jaws, difficulty kissing, licking lollipops or ice cream, a gap between teeth, pain with breastfeeding, and other oral health issues.
Both Tongue-ties and/or Lip-ties can create issues related to breastfeeding. A frenectomy can help mothers relieve the pain of breastfeeding and regain healthy nipples and breasts, stimulate milk production by adequate stimulation, encourage bonding with her baby, and ensure adequate feeding and growth of the baby.
Tongue tie occurs between 4% – 10.7% of the population. There is a genetic predisposition as well.
The procedure is super quick and usually takes less than 10 minutes from start to finish. Furthermore, mom can nurse right after.
In order to get the best results and to ensure healing occurs properly, parents or caregivers need to complete the post treatment stretches with their baby which you will be instructed to perform.
Older children and adults can also benefit from lip tie and tongue tie correction. There are many benefits, from better oral hygiene to less orthodontic severity, especially from lip tie treatment. It can help with speech as well!
With using a laser, there is significantly less pain, minimal bleeding, and most likely sutures are not needed. This allows for fast healing and the benefits are seen almost instantly. This form of treatment usually requires using just a numbing anesthetic such as topical and occasionally a local anesthetic can be used.
Take a look at this comprehensive video from Dr. Fatina:
Aftercare is an essential part of the surgical management of Tethered Oral Tissues (TOTs). Our aftercare protocol ensures long term and low rates of reattachment and scar formation. These aftercare exercises are not the same as, or a replacement for, the functional exercises that are given by your therapist (lactation consultant, feeding/speech therapist, OP/PT, etc.) Some regimens of aftercare are customized depending on the individual patient’s needs.
Your goal is to have the area heal and re-form as far back as possible to give the most mobility.
STARTING TOMORROW: With a clean or gloved finger, push down behind the teeth in the floor of the mouth, and swipe/push into and up the tongue (on the diamond), lifting the tongue at the top of the diamond in the middle of the tongue. Your goal is to see the whole diamond open up and lengthen. It may bleed slightly when it is stretched or re-opened. This is not a concern. Try to make a game of it if possible and keep it playful, or bribery can work too ☺.
Repeat this 2-3 times a day for 3 weeks. Quality stretches are the key.
Encourage the child to move the tongue as much as possible by sticking it out and holding for 10 sec, out to the left, right, open wide and lift up and paint the roof, make clicking noises, and clean off the teeth. Do these exercises as often as possible, but try for 3 times a day or as directed by your therapist.T
he child can eat whatever foods he or she can tolerate. Pain relief is needed the first few days. Give Motrin (ibuprofen) or Tylenol as directed on the package based on weight. If the lip-tie was released, the child’s lip may swell up slightly that evening or the next day. It is normal and will go down after a day or two. The wound will be sore for a few days, at one week look much better, and at two weeks look almost normal. A slight fever is normal the first day. They should eat and sleep normally. If you’re concerned it is growing back together, come back for a visit or email a picture. Treatment with a myofunctional therapist and bodyworker (Chiropractor, CST) is recommended for full rehabilitation.
The goal is for the lip to heal and be able to lift as high as possible.
STARTING TOMORROW: Pull the lip up as high as possible, high enough to press against the nose. You want to see the whole white diamond open up. Press gently but firmly right on the wound to massage it and keep the diamond open. It may bleed slightly when this is done, but this is not a concern. Try to make a game of it, and keep it playful, or bribery can work too ☺.
Repeat 3 times a day for 3 weeks.
The released area will form a wet scab after the first day. It will appear white or yellow and soft because it is wet (not infected). This area is what you will be pressing against. The healing will be happening under the scab, just like a scrape anywhere else on your body. The white area will get smaller each day, but healing is still happening! So even though the white scab will heal you MUST continue the stretching or the new frenum will not be as long as possible and the surgery may need to be repeated.
The child can eat whatever foods he or she can tolerate. Pain relief is needed the first few days. Give Motrin (ibuprofen) or Tylenol as directed on the package based on weight. If the lip-tie was released, the child’s lip may swell up slightly that evening or the next day. It is normal and will go down after a day or two. The wound will be sore for a few days, at one week look much better, and at two weeks look almost normal. A slight fever is normal the first day. They should eat and sleep normally. If you’re concerned it is growing back together, come back for a visit or email a picture. Treatment with a myofunctional therapist and bodyworker (Chiropractor, CST) is recommended for full rehabilitation.