WHAT ARE TONGUE AND LIP TIES?

Everyone has a band of tissue known as a lingual (tongue) frenulum that helps anchor the tongue to the floor of the mouth and a lip frenulum that connects the lip to the mouth. When that frenulum is either too short, thick, or tight, it restricts the lip and tongue movement. When the tongue is prevented from moving properly and freely, it will have a negative impact on breastfeeding, sleeping, eating, speaking, oral development, oral stimulation, and more, just to name a few.

Infants born with lip or tongue ties often have difficulty latching with other symptoms, leading many mothers to abandon their breastfeeding efforts and goals. Breastfeeding is important in delivering nutritional and immunologic protection for the child, and also helps with mom and baby’s bond. Approximately 3-15% of babies are negatively affected by a tongue tie in which they cannot move their tongues freely due to its tightness. Our hope is to help bring education to your family to help catch these restrictions in the mouth early to help babies thrive at a younger age.

Dr. Bethany has taken many courses that are tongue-tied focused and truly understands that releasing your child’s restriction in the mouth is only one part of a successful treatment outcome. Dr. Bethany is all about a team approach for you and your baby. She believes in getting a functional assessment by a specialist to help provide exercises to retrain tongue movement or tension relief prior to the frenectomy procedure.

We know this is crucial as well as receiving care for yourself if you are experiencing any physical discomfort during breastfeeding. Part of your team can consist of one or a combination of an International Board of Lactation Consultant Examiner (IBCLC), chiropractor, occupational therapist (OT), cranial sacral therapist, feeding therapist, myofunctional therapist, and/or speech language pathologist (SLP).

Dr. Bethany can help assemble a team for you if you do not already have one or if you would like some recommendations. Moms and babies need personalized care plans as the tongue tie process is not a “one size fits all” situation. What works for one baby, may not work for another, and we are here to help!

WHAT ARE THE SIGNS AND SYMPTOMS OF A TONGUE TIE IN INFANTS?

Tongue ties in infants varies but symptoms include:

• Sliding on and off breast when latching/feeding

• Falling asleep while nursing

• Upper lip curls inward when latched

• Mouth open at rest

• Gumming/chewing of the nipple

• Noisy suckling or clicking sounds while nursing

• Milk leaking from mouth while feeding

• Unable to hold pacifier in mouth

• Reflux or colic symptoms

• Gagging/choking while eating

• Slow/poor weight gain

• Breathing sounds (snoring, snorting)

• Lip blisters

• Gas pain

• Noisy breathing/snoring sounds when sleeping

• Frustrated at the breast

• Disorganized tongue movement

WHAT ARE THE SIGNS AND SYMPTOMS A MOTHER EXPERIENCES WHEN THEIR BABY HAS A TONGUE TIE?

Tongue ties in infants varies but symptoms include:

• Nipple pain and damage

• Lipstick shaped, creased, bleeding nipples

• Decreased/low milk supply

• Mastitis

• Flattened nipples after breastfeeding

• Prolonged feedings

• Poor breast drainage

WHAT ARE THE SIGNS AND SYMPTOMS FOR TODDLERS WITH TONGUE TIES?

You might hear a lot that children will “grow out” of these concerns about being tongue tied. However, their body will learn to compensate to achieve what appears to be normal functioning, but is not.

• Difficulty swallowing certain textures of foods

• Choking/gagging on certain solid foods

• Digestive difficulty

• Speech delay/articulation issues

• Tongue Thrusting

• Mouth Breathing

• Insufficient development of the palate

• Dental teeth crowding

• Retruded lower jaw

• Teeth grinding

• Early signs of cavities

• Forward head posture

• Low oral tone

HOW DO I KNOW IF MY BABY OR CHILD NEEDS A FRENECTOMY?

If feeding your newborn has not been easy and if you are experiencing any of the common signs and symptoms of a tongue tie, an evaluation of function and structure is the first step in getting to the root cause of your concerns.

Working with a lactation specialist first will provide feeding support and recommendations for if a frenectomy is needed for your baby, you have a feeding plan to help you feel supported after the procedure.

If you have any care providers say to you that “baby is gaining weight” or that “baby can stick their tongue out” and gives no recommendations while you are also experiencing the symptoms below, seek an evaluation with a lactation specialist and/or Dr. Bethany.

If your provider is not taking any extensive considerations of what happened with birth, symptoms you and your baby are experiencing, and not doing a full functional evaluation as well as looking at baby as a whole of what’s impacting the function to feed, listen to your mama intuition if you don’t feel comfortable with that provider’s answer is or something just does not feel right, just know that support to help you is there.

WHAT KIND OF LASER DOES DR. BETHANY USE FOR INFANT FRENECTOMIES?

Dr. Bethany will treat your child’s tongue tie by releasing the restriction utilizing the latest CO2 laser technology from LightScalpel.

LightScalpel CO2 Laser for infant tongue tie removal

Our LightScalpel CO2 laser is a device that produces a concentrated beam of light. The highly focused CO2 laser beam vaporizes cleanly and precisely while sealing blood vessels at the same time. Here are some of the amazing advantages when using a LightScalpel CO2 laser for the procedure:

• Minimized Bleeding:
  As it vaporizes the tissue, the LightScalpel laser seals small blood vessels. The resulting reduction in bleeding makes a frenectomy a quick and easy procedure.

• Less Swelling and Discomfort:
  The LightScalpel CO2 laser beam seals lymphatics, resulting in less post-operative swelling and discomfort associated with traditional scalpel procedures.

• Reduced Risk of Infection:
  The sanitizing effect of the laser minimizes the risk of infection and means faster healing.

• Shortened Procedure Time:
  Less bleeding ensures the improved visibility of the treatment area. This helps to minimize the duration of the procedure.

• Faster Recovery:
  Reduced trauma, minimal to no bleeding, and less swelling and discomfort means the infant can breastfeed immediately after the procedure.

For babies, Dr. Bethany will apply a topical anesthesia gel in the area of the release to provide extra pain control and for older children, local anesthesia will be done. By using the CO2 laser, we know it helps minimize any discomfort during the procedure.

WHAT IS THE FOLLOW-UP CARE PROCEDURES GIVEN WITH DR. BETHANY?

Healing can happen very fast for these little ones!  Follow-up care is important to see how healing is progressing and to help answer any questions that occurred after the procedure as well as helping with any of the stretches that need to be done to prevent reattachment of the healing site.

The minimum follow up care is as follows:

• 24/7 text support for the first two weeks with Dr. Bethany

• 2 in-office follow up appointments with Dr. Bethany to help manage the wound care and provide any support to the families during this time

Our goal for these frequent follow-ups is to make sure you’re comfortable and that the baby’s new tongue freedom is going to where it needs to go!  Subsequent follow-ups will be dependent on what is observed as each baby heals differently.  

With these follow-ups, we also want to assess and see if any additional care is needed to help you or your baby.  Dr. Bethany truly wants to see that you are given the support you need during this postpartum time as well.  You will receive her cell number to contact her if you have any questions for 2 weeks following the procedure date, as she wants to make sure you are comfortable and empowered with what needs to be done for you and your baby.

HOW OLD SHOULD A BABY BE FOR A FRENECTOMY?

There’s no minimum age. Dr. Bethany has done releases on babies who are 24 hours old and older. It all depends on her detailed assessment and evaluation as well as your collaborative care team that’s supporting you during this time. It’s always a discussion with the families and your care team of when is the most optimal timing of release and what are the goals that we want to accomplish together by doing the release.

WHAT IS THE RISK OF INFECTION?

Very low. The sanitizing effect of the laser minimizes the risk of infection and means faster healing.

You may purchase your own latex free gloves if you would like for the wound care stretches, but it’s not necessary to if you have the proper hand hygiene before doing the wound care stretches. When doing the wound care, you want to make sure that you are always washing your hands with soap and water and that your nails are short and not sharp.

Following Dr. Bethany’s recommendations in how to do the wound care stretches is also crucial so we are not irritating the tissues in the wrong way.

WHAT HAPPENS IF WE WAIT TO DO THE TONGUE TIE REMOVAL?

This is a good discussion to have with Dr. Bethany as she wants to make sure that your decision to do the procedure is right for your baby and your family. A frenectomy can always be done later and Dr. Bethany will give you a care plan of what to do to help provide other support in the meantime.

Just know that if a frenectomy is recommended, the lingual frenulum will not stretch over time (which is what a lot of pediatricians say who don’t understand the basic anatomy of the tissues made up of collagen fibers and are not taking into consideration of the anatomical location of where the frenulum is on the tongue). The tight lingual frenulum impacts the tongue’s range of motion from functioning, not eliminating any of the signs and symptoms you may be experiencing and can cause your baby to compensate in function. If you decide to delay the frenectomy, it just means there’s a potential for more pre-therapy intervention to prepare your baby before the procedure. Dr. Bethany always wants to make sure that if she does any frenectomy to give your baby’s tongue more range of motion that you and your baby are set up for success to improve function and to help you on a better path of your feeding journey.

HOW MUCH DOES IT COST?

Your investment is $250 for a 60-minute consultation.  If a frenectomy procedure is indicated, that investment is $600 regardless how many areas need treatment (lip, tongue, and/or cheek).  Total investment with the procedure is $850.

If a consultation is done and Dr. Bethany feels a frenectomy is not the right choice or we need additional care first prior to the frenectomy, you will always get a detailed email from her about what was discussed, what path you would like to take in the care for you and your baby, and any referrals needed to provide you a plan to reach your goals.

DOES IT HURT THE BABY?

Dr. Bethany takes all precautions to make sure your baby is comfortable during the procedure.  Dr. Bethany applies a safe numbing gel in the area where she will perform the procedure.  By using the CO2 laser for the procedure, we know it helps minimize any discomfort.