Lip and Tongue Ties Release for Infants

 Laser Assisted Tongue Tie and Lip Tie Release for Infants

 

 At DP Dental, we are devoted to providing comprehensive care for our patients. We look at the body as a systemic whole and we believe in solving the root cause and treating it as early as possible. With this firm belief, DP Dental has been in search of the root cause of common issues like misaligned teeth, bad bite, grinding and clenching, TMD issues, etc.

 

Studies and researches have linked these dental issues back to infancy problems which were left undetected or untreated. One of the infancy problem that we have been looking very much into is the Tongue and Lip Tie problem where the tongue (lingual) and/or lip (labial) frenum is too tight causing restrictions in movement. The lack in functional movement of the tongue and lip hinders infants from feeding effectively, and it also hampers proper speech, swallowing, eating and breathing functions as the infants grow older.

As of date, we have performed a number of Tongue and Lip Tie Releases with Laser on grown-up individuals to help them regain their tongue and lip functionalities.

 

Tongue-tie, professionally known as ‘Ankyloglossia’, is a congenital condition in which the lingual (tongue) and/or labial (lip) frenum (sometimes called frenulum) is too tight, causing restrictions in movement of these parts. This in turn can cause significant difficulty with key functions of this area of the mouth including speech, swallowing, eating and breathing. For infants, the key function of the mouth region is to breast-feed so restrictions of the motion of tongue and position of lips can have a significant impact on successful breastfeeding. 

In providing some preliminary information about tongue tie, it is important to note that each mother/baby pair is very unique and hence tongue/lip ties issues can present differently for everyone. Some common symptoms that may be associated with infant tongue/lip tie includes those in the adjacent table. 

Some mothers and their babies manage to cope with some or all of these issues. For many, however, it is very impactful on successful breastfeeding. Hence, in addition to a thorough clinical examination of the lip and tongue area, it is critical to assess and consider the influence of a restrictive frenum on normal function. It is compromised tongue mobility and function that are the main concern. While DP Dental’s Clinical Director, Dr. Yue Weng Cheu is in a position to diagnose the presence of a lip/tongue tie and perform the laser surgery, a lactation consultant with the knowledge and experience of observing infants with lip/ tongue ties would be in the best position to observe proper functioning during feeding.

 

 

The Sample photo of baby with Tongue Tie and Lip Tie

 

 

What are the common Signs of Infant Tongue /Lip Tie ? 

  • Poor / inability to latch
  • Sliding off the nipple
  • Fatigue during feeds
  • Sleepy feeds
  • Irritability while feeding
  • Poor weight gain
  • Clicking during a feed
  • Dribbling milk at the breast/ bottle
  • Digestive issues (such as increased gassiness, reflux, colic, vomiting, distended stomach)
  • Maternal nipple pain/ damage (feels like the infant is compressing, chewing, gumming, pinching the nipple)
  • Increased maternal nipple/ breast infection
  • Compromised maternal milk supply 

 

Tongue or lip ties present in many different shapes and forms. Most health professionals dealing with infants and toddlers are only familiar with very physically prominent, classic tongue-ties that end on the tip of the tongue or cause a heart-shaped tongue. However, tongue ties can be deceptively hidden at the underside of the tongue at the base and cannot be easily visualised. These less obvious ties (often under the mucosa or skin) are called a posterior tongue tie. Proper assessment and evaluation from a clinician or health carer who is experienced with their identification is critical. There are many assessment tools and tongue tie classification scales published but there is still no universally accepted standard of assessment and care in this area.

The variance in assessment and treatment standards can be challenging for parents trying to seek evaluation and care for their potentially tongue and lip tied infant. Families report greater support from professionals who have sought greater learning, training and experience in this area so that they can identify ties effectively and help families to seek treatment where necessary.

lip functionalities.

 

At DP Dental, our consultation consists of: 

  •  Gathering information about the infant/mother’s challenges (past and present).
  •  A visual examination to observe the limitation(s) of movement and position of the frena.
  •  A manual examination to identify and evaluate the presence of ties and form a diagnosis. 
  •  A thorough discussion to provide information and answer any questions about the condition, its treatment and expected outcomes.

 

 

Laser Surgery (Frenectomy) of Tongue and lip ties 

A frenectomy refers to the surgical removal/ freeing of the fold of skin under the tongue or the upper/lower lip (frenum/frenulum). This is often referred to as freeing or revising a tongue tie or lip tie.

 

Lasers are an excellent alternative to scissors or a scalpel as a means to treat soft tissue. In laser terms, the tissue is “ablated”. Light energy is used to remove tissue rather than cutting that occurs with scissors or scalpels. The use of lasers in surgery has a distinct advantage over other methods for a number of reasons including:

  •  Reduced collateral damage (it is more precise, removing tissue layer by layer) 
  •  It is bactericidal (kills bacteria as it works)
  •  Reduced discomfort/pain during and after surgery
  •  Reduced bleeding (cauterises as it works)
  • Reduced oedema (swelling) and inflammation after treatment
  • Allows for better healing through the concept of photobiomodulation (or low level 

Laser Therapy).

 

All methods of surgery require a good knowledge of the condition, its treatment as well as the necessary post-operative care. Use of lasers requires additional training in laser physics, laser safety and laser use for different techniques.

 

Treating the breastfeeding infant is not merely a quick “snip”. It involves a thorough removal of any tissue inhibitive to proper tongue and lip functioning to allow full motion and optimum positioning of the oral structures during breast (or bottle) feeding. It is our experience that through laser surgery the inhibitive structures can be removed more completely to allow optimum outcomes. 

 

 

After Treatment Care and what to expect

 

We understand that coping with feeding challenges in a tongue/lip-tied infant can be an emotional and physical roller coaster for families. As such we share the information in this article so that all families receive the care they need. We have found a few steps that have resulted in better outcomes for patients and they are included in this section.

  • Continue to breast feed as normal where possible, squeeze breast milk onto area/s of the mouth and lip before and after feeds. Breast milk is sterile and will help to keep the area bacteria and infection free, while speeding up the healing process. If your baby refuses to feed for a period, try a warm bath for mum and baby and attempt to feed in the bath when both are relaxed.
  • Having gone through a surgical procedure, you can expect that your infant will likely be irritable, tired or very unsettled for the remainder of the day. This may continue for next few days depending on the healing process and on the infant.
  • Please note that a degree of bleeding is normal for a few days following surgery and a little blood goes a long way amidst saliva. If you are concerned, please contact us. 

 

Pre and Post Surgery with Lactation Consultant 

Usually most patients arrive for a frenectomy after having already seen a lactation consultant whom they will visit shortly after the surgery. The infant who has difficulty latching on may need the supportive care of a lactation consultant after surgery.

 

If you suspect that your little one or any of your family and friends’ infant are suffering from the tongue and lip tie problem, please contact us at 6653 5665.