Many babies have lip-tie and tongue-tie. 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. Lip-tie or tongue-tie release, also known as frenectomy, provides the solution for lip-tie or tongue-tie, and Dr. Doan is certified in performing the procedure and has performed numerous frenectomies in office.
Lip-tie 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, 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-tie and/or tongue-tie.
Of course, lip-tie or 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.
Frenectomies are typically done on children younger than 6 months of age or once they are cooperative. The procedure itself takes less than a minute each frenum. Dr. Doan uses a laser that both cuts and cauterizes, resulting in very little to no bleeding. The laser procedure takes slightly longer than a clipping procedure that is done historically. However, using a laser is the preferred method of Dr. Doan because of minimal bleeding and reducing the probability of the frenum healing back together. The baby is swaddled and placed in our dental chair while being stabilized by an adult to minimize movement during the procedure. 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. 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.
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.