Tongue & Lip Tie Revisions
What is a tongue or lip tie?
A Tongue tie is a condition present at birth that is an unusually short, thick, or tight band of tissue that tethers the tongue to the floor of the mouth. This restricts the tongue’s range of motion which can cause difficulty with breastfeeding, and a wide variety of other issues like tooth decay, spacing, speech difficulties, and digestive issues.
A lip tie is an unusually tight or thick piece of connective tissue that keeps the upper or lower lip tethered to the gum tissue restricting the range of motion and function.
To correct these issues, a procedure called a Frenectomy, or Revision is suggested.
What is a Frenectomy?
A simple, quick procedure done with topical anesthetic and our Solea Laser to release the restrictive tissue.
What makes our laser so special?
At Dental Health Associates, we invest in the best and most cutting-edge dental technologies to help our patients. We use the Solea Laser for our tongue and lip tie revisions.
The Solea Laser is a true CO2 laser and does not touch the tissue at all. The restricted tissue dissolves in a few seconds, with no bleeding and minimal discomfort.
I suspect my child may have a tongue or lip tie. Do I need a referral?
No- you do not need a referral to have your child evaluated for ties, however, most of our children are referred to our clinic by their pediatrician, OBGYN, Midwife, Lactation Consultant, speech therapist, or chiropractor.
What to Expect
In general, the procedure is very well-tolerated. We take every measure to ensure that discomfort and stress during the procedure is minimized.
Due to laser safety regulations, parents are not allowed in the treatment room during the procedure. One of our assistants will carry your baby to and from the room, and the approximate time away from you is under 8 minutes. The actual time of lasering is 15-30 seconds.
A topical numbing cream is applied to the area that will be treated. This medication works very quickly.
Crying and fussing are common during and after the procedure.
The doctor and assistant will discuss post-operative stretches & care.
You may breastfeed, bottle-feed, or soothe your baby in any manner you’d like following the procedure. Make yourself comfortable & stay as long as necessary.
After Care
Keeping up with post-operative exercises is one of the most important aspects of a tongue or lip tie revisions.
These exercises are required for approximately four weeks after treatment, and they will ensure that the released tissue doesn’t reattach during the rapid healing process. Reattachment can cause new limitations in mobility and the return of tongue or lip tie symptoms.
We feel that post-operative stretches are key to getting an optimal result. These stretches are NOT meant to be forceful or prolonged. It’s best to be quick and precise with your movements.
You may use Tylenol or Ibuprofen if the child is 6 months of age or older, arnica, or other measures to help with pain control. Another alternative would be coconut or vitamin E oil, which can be safely used in the mouth following the procedure.
Stretches
These are best performed with the infant’s feet pointing away from you with their head in your lap. Be sure to wash your hands prior to beginning.
Upper lip
The upper lip is the easier of the two sites to stretch. If you must stretch both sites, we recommend that you start with the lip. Typically, babies don’t like either of the stretches and may cry, so starting with the lip allows you to get under the tongue easier once the baby starts to cry.
For the upper lip, simply place your finger under the lip and move it up as high as it will go, until you feel resistance. Then, gently sweep from side to side for 1-2 seconds. The main goal of this stretch is to insert your finger between the raw, opposing surfaces of the lip and the gum so they can’t stick together.
Tongue
The goal with this stretch will be to completely open up the surgical site underneath the tongue.
Using your two index fingers, insert them underneath the tongue with fingertips touching. Locate the diamond-shaped surgical site and push into this area and lift the tongue all the way up, exposing the diamond-shaped surgical site. Hold for 1-2 seconds.
Focus on getting your index fingertips mentally glued together – this forces you to stay in the middle, right on top of the diamond-shaped surgical site. As you push into the diamond and then lift the tongue up, the top half of the diamond will ideally come away from the bottom half of the diamond. It is attention to separating the fold across the diamond that results in a successful post-operative stretching regimen.
With one finger propping up the tongue, place your other finger in the middle of the diamond and turn your finger sideways and use a lifting motion from low to high to try and keep the diamond as deep as possible. Use a lifting motion when you sweep through the diamond, trying to separate the horizontal fold across that diamond. Make sure your finger starts within the diamond when doing this stretch. This stretch should not be forceful or rough within the wound.
Massage on either side of the to loosen up the musculature of the remainder of the floor of the mouth. You can use more pressure when doing these stretches because you aren’t in the wound at this point.
Sucking Exercises
When babies are born with a tongue or lip tie, they learn how to suck incorrectly to adapt to the ties. This can cause babies to have disorganized or weak sucking patterns.
Once the ties are revised, these simple exercises can be done to retrain and improve the suck quality.
We suggest starting these on the third day following the procedure and spend 30-45 seconds on each exercise prior to the wound stretches.
Slowly rub the lower gumline from side to side and your baby’s tongue will follow your finger. This will help strengthen the lateral movements of the tongue.
Let your child suck on your finger and do a tug-of-war, slowly trying to pull your finger out while they try to suck it back in. This strengthens the tongue itself. This can also be done with a pacifier.
Let your child suck your finger and apply gentle pressure to the palate. Once the baby starts to suck on your finger, just press down with the back of your nail into the tongue. This usually interrupts the sucking motion while the baby pushes back against you. Listen for a seal break and then put your finger back up into the palate to re-stimulate sucking. Repeat as tolerated.
With one index finger inside the baby’s cheek, use your thumb outside the cheek to massage the cheeks on either side to help lessen the tension.
Healing
Starting several days after the procedure the surgical site will look white or yellow, very similar to pus.
This is a completely normal inflammatory response and how active healing appears in the mouth. If you think an infection exists, please don’t hesitate to reach out. (320) 762-1551.
Follow up
Revising ties and resolving breastfeeding issues is a team effort. We highly recommend that you follow up with whoever referred you to us once the ties are revised. We feel that this is essential for ensuring optimal success.
