Tongue & Lip Revisions by Dr. David Draper
Between 4% and 10% of children are born with some degree of frenulum restriction, also known as tongue-tie or lip-tie. This means that their tongues and lips are attached to the mouth with excessive connective tissue webbing. This excess tissue impedes the movement of the tongue or lips to various degrees, and can cause anything from moderate inconveniences (e.g. inability to lick your ice cream cone), to more severe impairments (such as inability to nurse during infancy, or significant speech impediments later in life). When this restricted mobility interferes with nursing, bottle feeding, or causes discomfort to mother or child, a laser frenectomy may be recommended for infants.
For children, adolescents and adults who do not undergo frenectomy in infancy, later complications may include: impaired oral hygiene, cavities, difficulty brushing and flossing, orthodontic maladjustments (gapping and tipping of teeth), as well as significant speech impediments and resultant issues with self-esteem.
Better Dental is proud to be the only dentist in the Triangle (and one of only a few in North Carolina) who offers laser frenectomy in infants (some as young as 24 hours old) as well as adults, all with high levels of satisfaction.
Symptoms and Indications
Common clues to look for
Infant Symptoms: Weight loss or slow weight gain, frequent feedings (2 hours apart or less), shallow latch on the breast or bottle, clicking & popping sounds during nursing, significant reflux or gassy tummy, the presence of a sucking callus on the lip, or becoming fatigued quickly during feedings.
Mommy Symptoms: Painful breastfeeding, breast still full of milk at conclusion of feeding, mastitis or thrush infection, or nipple trauma (such as cracking, bleeding, bruising, creasing or flattening).
Child/Adult Symptoms: Limited ability to extend tongue, gap between front teeth, painful catching of the frenulum between teeth, delayed speech, difficulty making certain sounds (such as T, R, and L sounds), difficulty swallowing solid food, or a very strong gag reflex.
If any of these symptoms are present, a laser frenectomy may be recommended for you. Please schedule your consultation today.
What is Laser Frenectomy?
Laser surgery to remove excess tissue in the mouth
for infants, children, teens or adults
Simply put, a laser frenectomy is the use of a soft-tissue, hand-held laser to detach the frenulum (connective tissue webbing) from the upper lip or tongue by a trained dentist. This may be done with the aid of local anesthesia and often takes only 1-2 minutes to complete.
Conventional frenectomies consist of cutting the frenulum with a scalpel or a pair of surgical scissors. The problem, or limitation, with the conventional frenectomy is that these older instruments can cause a great deal of bleeding, and consequently these treatments tend to not be as thorough, leaving the connective tissue still partially intact for fear of causing a scary bleeding episode. Sometimes it’s not enough to solve the problem.
Why Should I Choose Laser?
Benefits of a modern approach
The results of modern laser frenectomy are excellent. Lasers provide various benefits over steel instruments, including the following:
Cauterization: Virtually no bleeding, even in cases with thick tissue ties.
Sterilization: The laser kills bacteria and other microbes making infection virtually impossible.
Precise: The laser tip is small and easily guided where needed and nowhere else, unlike clunky scissors.
Thorough: With bleeding under control, the laser can go as far as needed to eliminate 100% of the restriction.
Laser Frenectomy Aftercare
Healing quick, healing well
Most adults and children report only minimal discomfort during the first 24-72 hours after the procedure. In infants, the recovery time is similarly quick, but it should be advised that infants, who have limited ability to express their displeasure over their sore lips and tongues, may cry and fuss more than usual during the first few days. With the help of frequent breastfeeding and skin-to-skin contact, you can make it through just fine and enjoy the benefits of improved feeding with your baby.
Analgesics to the rescue
If your baby seems uncomfortable, Children’s Tylenol (acetaminophen) can be administered every 4-6 hour as needed. It is a common practice for our parents to dose regularly within the first 72 hours. Ibuprofen (Motrin or Advil) is especially effective but has not been approved for children younger than 6 months. Remember that proper infant dosage depends on their weight. Consult your physician if you are unsure about which medications are safe for your baby.
Children’s Tylenol dosage chart
Infant over 6 lbs = 1.25 ml
Infant over 12 lbs = 2.5 ml
Infant over 18 lbs = 3.75 ml
Infant over 24 lbs = 5.0 ml