Tongue-tie / Frenectomy
EAST MADISON DENTAL | Tenafly NJ
Why a Laser Frenectomy May Be Needed
A frenum is a muscular stretch of tissue that connects and holds other tissues in place. Tongue tie is caused by a lingual frenulum (the membrane under the tongue) that is either too short or too thick.
Sometimes a frenum might be short, thick, or tight, and might extend too far down along the tongue or the gum to results in lip tie or tongue tie. When a frenum is positioned in a way to interfere with the normal alignment of teeth, speech or constricts the movement of the tongue or lips, it can be corrected by a surgery called a frenectomy.
For a newborn, lip tie or tongue tie can make breastfeeding difficult for the infant and painful for the mother because the lip’s or tongue’s limited movement prevents the infant from properly latching on. Babies with lip tie often have difficulty flanging their lips properly to feed and don’t make a good seal at the breast when latching. This can cause them to take in excess air during breastfeeding which often makes these babies gassy and fussy. If left untreated, it can eventually impair the child’s speech and proper tooth alignment.
What is a Laser Frenectomy?
Laser frenectomy is the use of a laser beam to detach the frenulum from the lips and/or tongue. This may be done with a simple topical anesthetic, no injections are necessary and it is usually completed in a few minutes.
The benefits of using a laser for the frenectomy are, less bleeding, less scarring, less postoperative pain, shorter healing time, less risk of reattachment, and fewer functional complications.
Symptoms and Indications
Infant’s symptoms may include failure to gain weight, excessive fussiness after feeding, shallow latch-on, and loud clicking sounds during nursing.
Mother’s symptoms may include severe pain with latch-on during breastfeeding, incomplete breast drainage, mastitis or nipple thrush, constant or chronic pain during nursing, infected nipples, plugged ducts, or nipple trauma.
Child/Adult symptoms may include discomfort or pain when extending tongue, difficulty maneuvering mouth (such as when eating lollipops), painful catching of the frenulum in between teeth or on eating utensils, speech impediment, difficulty brushing, flossing, kissing, or orthodontic complications.
Healing and Recovery
The mouth heals very quickly and bleeding after a frenectomy is usually minimal. Afterwards it is important to stretch and massage the tongue at least 2-3 times a day for 2-3 weeks to prevent the tongue from reattaching as it heals.
Pain relief Most babies experience only minimal discomfort after the procedure, and breast-feeding provides natural pain relief. If, however, your baby seems uncomfortable, Chamilia (teething section of pharmacy) can be given to help with discomfort. Please speak with your pediatrician if you are unsure about what dose of medication to give, and remember that medication dosages should always be based on baby’s weight.
Notice You may notice some dark streaks of blood in your baby’s diaper during the 24hrs after the procedure. This is from the small amount of blood that your baby may swallow during the procedure, and it is not a cause for concern. If you are noticing blood in your baby’s diaper and it persist for more than 24hrs after the procedure, or you are concerned, then contact your doctor. If a laser tool was used for the procedure, you may notice small burns on your child’s lips or tongue (small white areas). Although every effort is made to ensure that this does not happen, the potential for these small burns is unavoidable since babies don’t understand the need to stay still during the procedure. These marks heal quickly and don’t cause any lasting damage.
Healing exercises Your baby’s mouth heals quickly, and stretching exercises are very important after the procedure to make sure the area that was released doesn’t heal back together. Exercises should always be done when your baby is calm and alert, not tired or hungry. If your baby is resisting the exercises, then stop and try again later. Lift your baby’s tongue using fingers or a tongue depressor while gently pushing back at the same time so that you can see the diamond shaped area where the cut was made, and hold it for 3 seconds. There may be a small amount of blood as the area stretches but this is normal. Do the stretching exercise 2 times a day for about 2 weeks after the procedure.
Tongue mobility Breastfeeding is the most effective exercise for encouraging effective sucking. For breastfeeding babies under the age of 3 months, sucking issues related to tongue-tie often resolve spontaneously after the tongue-tie is released, with no other intervention needed. If breastfeeding has not greatly improved by about day 5 after the procedure, there are other exercises that can be done to help encourage your baby to use his/her tongue effectively. These exercises should be tailored to your baby’s specific needs with the help of an International Board Certified Lactation Consultant (IBCLC).
For additional exercises please watch Frenectomy Exercises with Melissa Cole of Luna Lactation on Youtube.com.