Lip or tongue tie is not uncommon in babies. When it is left untreated, however, it can cause major problems. Eating is difficult for a baby, and feeding becomes a stressful, frustrating experience for the parents. Frenectomy provides the solution for lip or tongue tie, and Dr. Ta is certified in performing the procedure. He has performed many frenectomies in office. Keep reading to learn more about the procedure here at Pediatric Dentistry of Colleyville!
What is Lip/Tongue Tie?
Lip or tongue tie occurs when a frenulum or the bit of tissue that keeps parts of the body from moving too far from each other is too tight. A frenulum beneath the upper lip or below the tongue restricts movement and can make eating difficult for babies. Proper overall development may be delayed due to poor nutrition. Later on, speech may be difficult, and orthodontic issues could arise because of improper development of the palate.
If your baby experiences any of the following, he or she may have lip/tongue tie.
- Poor latch
- Falls asleep while attempting to latch
- Slides off nipple while attempting to latch
- Colic symptoms
- Reflux symptoms
- Poor weight gain
- Gumming/chewing the nipple while nursing
- Unable to hold pacifier in mouth
- Unable to use a bottle
- Short sleep episodes and re-feeding every couple or few hours
Of course, lip/tongue tie doesn’t just affect baby. If the feeding mother has experienced sore, chafed, blanching nipples, intense pain, poor or incomplete breast drainage, plugged ducts, nipple thrush, or oversupply, those are also signs that a frenectomy is needed.
What is the Procedure for a Frenectomy Like?
Addressing frenums is simple in children less than 9 months old. Older children can require the use of general anesthesia or conscious sedation that would be referred to the oral surgeon or require an anesthesiologist to be brought in. The procedure itself takes less than a minute each frenum. Dr. Ta uses a laser that cuts and seals the tissues resulting in very little to no bleeding. The laser procedure takes slightly longer than a clipping procedure but is the preferred method of Dr. Ta due to the minimal bleeding and lower probability of healing back together. We start by using a topical anesthetic even though there is minimal nerve development in that area. We expect the baby to able to nurse immediately after the procedure. After the topical is placed, the baby is swaddled and placed in our dental chair while being stabilized by an adult to minimize movement during the procedure. Then the laser procedure is completed and aloe vera gel placed on the site. The baby and mom are left in the room to nurse. Babies will cry during the procedure, not because they are in pain, but because they are being wrapped up and something is in their mouth that is not food.
The alternative to laser treatment includes scalpel surgery using local anesthesia and/or sedation. The other alternative is to do no treatment. No treatment could result in some or all of the conditions listed under “Symptoms” above. Advantages (benefits) of laser vs. scalpel or scissors include lower probability of re-healing, less bleeding, no sutures (stitches) or having to remove sutures.
Post Op InstructionsDownload the Post Op Instructions here
Following the procedure the baby may be fussy and may not nurse much at first. Breastfeeding will have to be retrained so that may be difficult at first. Some swelling and/or a fever may occur during the first 24 hours but then should go down. Children’s Tylenol can be administered to help with this. Some aloe vera gel will be dispensed, and should be placed on the wound area 2-4 times a day. Keeping the lip and tongue mobile is important during the healing time. When nursing make sure to flange the upper lip up and over the breast to stretch the area and lift the tongue with a tongue depressor or your fingers to keep the tongue mobile. Doing this at least two times a day is sufficient. A way to help retrain the nursing can be to use a bottle nipple, which is more rigid than the breast. Pushing the bottle deeper in the baby’s mouth and flanging the lips over will force the tongue forward and create a proper sucking habit. A white patch around the lasered area is normal and this is the clotting material in the mouth. Keep the area stretched and mobile until all the white is replaced by pink tissue.