What is a Tongue-tie or Lip-Tie?
If you take a look under your tongue and lips, you’ll see small bands of fibrous tissue which attach your tongue and lips to your mouth, called frenum. For some infants and children, this attachment is too tight or thick which restricts movement of the tongue and lips. This excessive attachment of the tongue, commonly known as a tongue-tie, is also called ankyloglossia and for the lip may be referred to as a lip-tie. Tongue and lip-ties can be treated through a procedure called a frenectomy which releases the frenums under the tongue and lips therefore increasing range of motion within the mouth.
How Do I Know if My Child Needs a Tongue-tie or Lip-tie Release?
A tongue-tie or lip-tie release, also called a frenectomy, may improve nursing if your infant has:
- Inadequate or painful latching
- Difficulty gaining weight
- Excessive fatigue while breastfeeding
- Short, frequent unproductive feedings
- Colic symptoms
A frenectomy may improve speech and oral health if your child has:
- Difficulty with the T, D, L, N, R, TH, SH and Z sounds in English
- Difficulty with the rolling R sounds in Spanish
- A heart-shaped tongue when extended out of the mouth
- Food frequently trapped between lips and teeth
- Gingival recession or exposed roots of teeth
How Would a Tongue-tie or Lip-tie Release, or Frenectomy, Benefit My Child?
After a tongue-tie or lip-tie release, or frenectomy, an infant may be able to nurse more easily, and mom may be relieved of nipple pain or infections. For a young child, a frenectomy may contribute to resolution of speech delays and help to keep his or her mouth healthy and teeth clean.
What Should I Expect if My Child Needs a Frenectomy?
A few types of specialists can perform frenectomies including otolaryngologists (ear, nose, and throat specialists), plastic surgeons, oral surgeons, and pediatric dentists. While visiting the pediatric dentist for a routine infant or child oral health exam the oral frenums can be evaluated and easily monitored to ensure proper healing after the procedure.
A variety of surgical tools, including lasers, may be used for a tongue-tie or lip-tie correction. While no technique has been shown to be superior, we have found that when performed with a laser there is typically limited, or no bleeding and no sutures are needed. The tissue of the frenums may be anesthetized with a small amount of local anesthetic to ensure the infant or child is comfortable during the procedure. For infants, often the mother or father can hold and comfort their baby in their lap with the baby’s head reclined in the lap of the doctor. Children can recline in a dental chair and if they are nervous, may benefit from some nitrous oxide, also known as laughing gas. The entire procedure is generally completed in 10 to 20 minutes.
For infants, a Board-Certified Lactation Consultant can help develop strategies to improve nursing before and after a frenectomy is performed. For children with speech delays or disorders, a speech-language pathologist may determine if the tongue can be appropriately placed and speech therapy should continue after the frenectomy.