Thank you for choosing Mt. Airy Children’s Dental Associates for the care of your child. Laser lip and tongue tie release, or “revision,” can help some babies have the full range of lip and tongue mobility that they require to properly nurse or use a bottle. Revision of the tie is only a small part of the total solution to enhancing the nursing experience. Other professionals involved usually include the baby’s pediatrician and an International Board Certified Lactation Consultant (IBCLC), but can also include an ENT physician, oral surgeon, speech-language pathologist (S/LP), and others.
This simple in-office procedure can also help older children and teenagers with certain speech issues, in conjunction with professional speech therapy services. Information regarding tongue tie release (lingual frenectomy for ankyloglossia) for older children can be found at the bottom of this page.
Laser Lip and Tongue Tie Release for Nursing Infants
Nearly everyone has tissue connecting their upper lip to the gums above the upper front teeth, and tissue connecting the tongue to the floor of the mouth. This tissue varies in degree from thin to thick, wide to narrow. The simple presence of this tissue in the mouth does NOT necessarily mean that a baby is “tongue tied” or “lip tied.” What does indicate a “tie,” however, is the presence of symptoms, combined with the appearance of the tongue or lip.
These symptoms may occur in both mother and baby. Some symptoms that a baby may be tongue or lip-tied include one or more of the following, although some of these symptoms may not necessarily be related to a lip or tongue restriction. We will work with you, your pediatrician, and your lactation consultant to formulate a conservative plan of care that is appropriate for your baby
- Slow weight gain or failure to thrive
- Poor latch to breast or bottle
- Seems unsatisfied after feedings (still hungry)
- Early release from the breast
- Excessively gassy/colicky
- Spitting up frequently
- Lip blistering
- “Clicking” sound during feeding
- Feeling frustrated with the nursing experience
- Visibly shallow latch
- Incomplete emptying
Benefits to laser lip and tongue tie revision in babies can include improved infant weight gain; a happier, more content baby; a more confident, relaxed mother; and a better overall nursing experience. We are only a part of the overall team that should guide you and your baby to achieve a more positive feeding relationship. For the best success, it is important that you follow up on a regular basis with an International Board Certified Lactation Consultant (IBCLC).
The Laser Lip and/or Tongue Tie Release Procedure for Nursing Infants
Your baby’s comfort and safety is of our utmost priority. We believe in a conservative approach and will take care of your baby as if he or she was our own. The surgery is ONLY done if nursing issues exist. Some providers choose to perform the same procedure using surgical scissors. Using scissors versus a laser is a matter of provider choice, and both are acceptable ways to complete the procedure. Our office has chosen to use a Diode Laser for the procedure. Laser lip and tongue revision has a very low risk of any complications.
We typically divide the treatment into three separate appointments: a consultation, the actual laser appointment, and at least one follow-up visit. We encourage both parents to be present during both the consultation appointment and the actual procedure. If another parent is unable to come to the appointment, we ask that a second adult accompany you and your baby. The short procedure is done on a pillow in the parent’s lap, in one of our private rooms. Everyone in the room, including the baby, will wear protective glasses. Topical numbing jelly will be used on the surgical area(s) prior to the revision to minimize any discomfort. The procedure takes from 10 seconds to one minute to complete. You will be given a great deal of time afterwards to privately nurse your baby. We have a “Boppy” nursing pillow for those mothers who would like to use it.
What To Expect Afterwards (Infants):
Because a laser is used, bleeding during the procedure will either not occur at all, or be very minimal. No stitches are used. A small diamond-shaped wound will exist for several days. This tells us that the tie has been completely released. There will be a dark yellow appearance to the area for the first few days. A yellowish film will then form within 48 hours. Think of it as a scab that has become wet, such as while swimming.
It is expected for your infant to have some mild discomfort and swelling in the treated area(s) afterward, but most of the discomfort usually wears off after the first 24 hours. Nursing is the best way to help your baby, and some parents also choose to give their baby acetaminophen (Tylenol). The Food and Drug Administration has recently advised that homeopathic or other teething gels or “teething tablets” should not be used because of safety concerns. It is extremely important that, before giving your baby any new medication, you check with your pediatrician FIRST in order to ensure your baby’s safety.
You will be given written instructions for daily massaging stretches to perform in the area(s) for approximately four weeks following surgery. We will demonstrate these exercises to you and make sure you feel comfortable doing them with your baby prior to leaving our office.
We will follow up with you on a regular basis via phone to ensure that you and your baby are safe, comfortable, and happy with your new nursing experience. If your baby experiences a concerning level of pain, swelling, or discharge from the surgical site, or you have ANY other concerns, we insist that you call us immediately. We will re-assess the surgical area(s) seven to ten days after the initial procedure to make sure your baby is healing normally.
Older Children and Speech/Language Therapy:
Speech and language therapists work with children to help them through difficulties involving speaking and swallowing. Our office is proud to maintain a relationship with many of the area’s speech therapists. Sometimes, a tongue restriction (ankyloglossia) contributes to speech and/or swallowing challenges. If a licensed speech therapist identifies that a tongue restriction exists, we can often help by performing a simple procedure known as a lingual frenectomy. It is important to understand that we are only a part of the solution. The release that we do in the office is ONLY an adjunct to professional speech therapy. Further speech therapy is absolutely necessary after the procedure.
The procedure in older children is performed much like any other routine dental procedure. As always, your child’s safety and comfort are always of the utmost priority. Older children usually benefit from local anesthesia and sometimes mild oral sedation or “happy air” (laughing gas/nitrous oxide) to help alleviate any anxiety.