Tongue Tie / Lip Tie

Lip and Tongue Tie

 

Diagnosis

You may have been told that your newbornf son or daughter has a lip and/or tongue tie. These ties can be very problematic for infants and children. In infants, these ties can make breastfeeding very difficult and painful. In children, these ties can lead to problems speaking and swallowing, as well as dental and orthodontic issues.

In some cases tongue ties can have systemic effect on the body due to sleep apnea that may be cause due to the tongue tie. It is very important to get your child evaluated by someone who is knowledgeable and appropriately trained in the diagnosis and treatment of tongue and lip tie.

Lip Tie

A tight upper lip frenum attachment may compromise full lip flanging and appear as a tight, tense upper lip during nursing. This can result in a shallow latch during breastfeeding. Additionally, the tight upper lip may trap milk, resulting in constant contact of the milk to the front teeth. This can result in decalcification and dental decay can develop when the milk is not cleaned off of these areas. This same issue can occur with bottle-feeding. If the frenum attaches close to the ridge or into the palate a future diastema (gap between the teeth) can also occur.

Lip Tie

 

Tongue Tie

Tongue Tie

 

A tight lower tongue frenum attachment may restrict the mobility of the tongue and appear as a cupping or heart shaped tongue when the tongue is elevated. This can result in an inability to get the tongue to the roof of the mouth to create a suction to draw out milk. Long term a tongue tie can result in speech problems, facial growth problems and/or issues later in life with transferring food around the mouth for chewing.

Symptoms

Some babies can have ties and not be symptomatic. To know if the ties are a problem we ask two major questions: “Is the baby getting enough to eat?” and “Is nursing comfortable for the mother?” Symptoms can be as follows:

For Babies

  • Slides off nipple/falls asleep while attempting to latch onto nipple
  • colic symptoms
  • reflux symptoms
  • poor weight gain
  • continuous feedings
  • gumming/chewing of the nipple
  • unable to take a pacifier/bottle

For Moms

  • creased/cracked/bruised/blistered nipples
  • bleeding nipples
  • incomplete breast drainage
  • infected nipples or breasts
  • plugged ducts
  • mastitis (inflammation of the breast)

Treatment

Frenectomy Procedure

Addressing lip and tongue ties is relatively simple for infants and young children. The procedure is called a frenectomy. The procedure itself takes less than three minutes for each site. Dr. Tartibi uses a laser that cuts and seals the tissues resulting in very little or no bleeding. The laser procedure takes slightly longer than a clipping procedure (commonly referred to as a frenotomy) but is the preferred method of Dr. Tartibi due to the minimal bleeding and lower probability of healing back together. This procedure can often times be done in the office without the need for sedation or general anesthesia.

We start by using a topical anesthetic on the upper lip and tongue. Local anesthetic is then used if the patient is over 1 year. The infant is swaddled and placed on a changing table pad in our dental chair while being stabilized by an assistant to minimize movement during the procedure. The parents are escorted to the waiting room for the short procedure. Then the laser procedure is completed. The parents are brought back immediately after treatment is completed and mom is encouraged to nurse (if still breastfeeding). Babies will cry during the procedure even if they are numb in the area. They calm quickly after the procedure is complete and they are out of the swaddle.