Is your newborn baby having difficulty latching, nursing, and/or gaining weight? Is your baby very gassy or frequently fussy? Do you hear clicking sounds during feeding, or are you in pain while breastfeeding?
These can be common signs of a tongue or lip tie, which limits the tongue’s range of motion and makes it difficult and possibly uncomfortable for your baby to feed effectively. Treating a tongue or lip tie by “releasing” the tie with a contactless CO2 laser revision procedure can allow your infant to grow, develop, and thrive.
What is a Tongue or Lip Tie?
Everyone has tissue that connects their tongue to the floor of the mouth. In situations where this tissue, called the frenum, is restricted, it is known as ankyloglossia. Commonly called a “tongue tie,” ankyloglossia may lead to a range of symptoms affecting your child’s overall health and development in the early months of life, as well as impacting the mother-baby nursing experience. Tongue ties can be “anterior” or “posterior.”
Similarly, everyone has tissue that connects their upper lip to their gums, and this tissue can also be restricted. However, the presence of either tissue- tongue or lip- is only considered a “tie” if there are symptoms associated with a restriction.
Working as a team with your pediatrician, nurse practitioner, and lactation consultant, we can help diagnose your baby’s tongue and/or lip tie and provide appropriate treatment to release the restricted tissue. Our dental care team can help your infant nurse or bottle-feed efficiently, gain weight, and follow their normal growth pattern.
Treating Tongue Ties: Laser Frenectomy
Mt. Airy Children’s Dental Associates offers advanced laser treatment to release a tongue or lip tie. Not all dental lasers work in the same manner. Dr. Michael Virts has had advanced training in using a special type of carbon dioxide (CO2) laser that can vaporize the restricted tissue and help begin healing earlier for a faster recovery with minimal discomfort.
The CO2 laser we use promotes a minimally-invasive approach by generating low-wattage light energy to release the tongue or lip tie without touching the tissue. The benefits of carbon dioxide laser frenectomy include less discomfort, less impact on surrounding tissues, and rapid healing.
The safety and health of your infant are our most important priority. Before seeing any baby for a tongue or lip tie consultation appointment, we require a written referral from a physician, PA, dentist, lactation consultant, chiropractor, nurse practitioner, or certified nurse midwife. This referral aids our team in confirming a diagnosis and formulating a proper treatment plan.
Preparing for the Appointment
Prior to the surgery appointment, we require two items to ensure your child’s safety: 1) that your baby has been given Vitamin K to prevent serious bleeding complications, and 2) a physician has seen your child. Babies are not to be given any herbal or homeopathic pain medications before surgery or during the healing period unless specifically prescribed by a physician.
There may be minor swelling, or your child may appear to be uncomfortable, especially when feeding for the first 24-48 hours. A small wound will exist for several days. There will be a dark yellow appearance in 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.
Tongue and Lip Tie Revision: What to Expect
The laser revision procedure is completed in a calm and quiet private room. You are invited to remain with your baby during their care. During the procedure, we will place your swaddled baby on a padded infant positioner on the dental chair so they can be comforted by your presence and voice.
They will not be in your lap. The laser treatment is completed in a few seconds, and there is typically little or no bleeding from the use of the laser. No stitches are required. We will allow ample time after the procedure for you to sit quietly with your child and nurse or bottle-feed.
Afterward, we will work with your family, pediatrician, and lactation consultant to support the outcome of the revision with “infant playtime” facial exercises. These should begin the day after the procedure. Please do not wake your baby up at night to perform the exercises; they need their sleep.
Dr. Virts is always available via phone if you have concerns or questions. We will re-assess the surgical area(s) within a month of treatment. This allows us to ensure that your baby is healing normally, and any questions or concerns you may have may be promptly addressed.
“Reattachment” of the tissue is extremely rare with CO2 laser surgery, as the restricted tissue is vaporized and not simply cut. You can expect to see a new lip and/or tongue frenum form after treatment, but the healed frenum is not normally restricted.
Tongue Tie Revision for Speech Development
Sometimes, a child is diagnosed with a tongue tie through the process of speech therapy. Tongue tie revision can allow your older child to receive a greater benefit from speech therapy and develop normal speech patterns. When a laser frenectomy is performed on an older child, we will use a local anesthetic to numb the area and keep your child comfortable during the procedure.
Similar to the process for a young baby, we will perform the treatment in a private room where you can accompany your child. After the revision, you must follow up with your speech/language pathologist to support speech development and ensure a successful outcome.
Tongue and Lip Ties FAQs
Learn more about tongue and lip ties with answers to these common questions:
How is lip tie and tongue tie treated?
Mt. Airy Children’s Dental Associates uses a CO2 laser to correct fix the restricted tissue. Known as a laser frenectomy, the procedure does not require cutting or the use the stitching. This allows the patients to experience minimal discomfort, to recover faster, and experience less bleeding.
Is surgery the only treatment option for tongue tie?
No, surgery is not the only treatment for tongue tie. However, it is the only treatment that will quickly resolve the issue effectively. Your doctor may suggest speech therapy, osteopathic or chiropractic treatments, or stretching exercises that may help with the issue. However, the effectiveness of these treatments will vary depending on the patient.
At what age should tongue tie be treated?
We suggest that tongue tie be treated as soon as possible, even in infants. This condition affects the way they eat and swallow. Without treatment, infants will get inadequate nutrition. As children age, tongue tie will lead to speech problems, oral hygiene issues, and other functional problems. For these reasons, the sooner you have tongue tie treated, the better.
Can lip or tongue tie cause dental problems?
Yes, lip and tongue tie can lead to dental problems. In most cases, the person will experience malocclusion, or improper bite, and difficulties keeping their teeth and gums clean due to limited movement of the tongue or lips. Then the patient will have an increased risk of developing gum disease and tooth decay.
Are lip and tongue tie genetic?
There may be some genetic predisposition for some patients to develop lip and tongue tie, however it is not fully understood. We have seen several family members with these conditions but we have also seen patients with zero family history have it as well.
Can tongue tie be resolved without treatment?
Only in very mild cases is there a chance for the condition to resolve on its own. As the child grows, their oral structures may develop further and the tie becomes less of a problem. In most cases, especially in babies that are struggling to thrive, it is very important that they seek treatment. Even if the tongue or lip tie seems to be mild, it is always best to be evaluated. This could prevent possible problems in the future and many long term effects on their health.
Are there any long-term effects of untreated tongue tie?
Untreated tongue or lip tie can have many long-term effects on a patient’s health. The most concerning long term affect would nutritional issues. Infants with tongue tie or lip tie cannot eat, breast feed, or swallow properly. This leads to weight problems and nutritional concerns. Other long term affects are speech problems, oral hygiene problems, swallowing problem, eating difficulties, and dental problems.