A tie is a congenital malformation which restricts the movement of the tongue and a speech impediment.
Tongue-tie is congenital (present at birth) and may be hereditary (often more that one family member has the condition). It results when the frenulum (the band of tissue that connects the bottom of the tongue to the floor of the mouth) is too short and tight.
Although it is often overlooked, tongue tie can be an underlying cause of speech difficulty because there will be a restricted movement of tongue. While the tongue is remarkably able to compensate and many children have no speech impediments due to tongue-tie, others may.
The application of anesthesia will depend on the age of the patient and nature of the procedure. The procedure is usually done by a trained pediatric dentist under monitored anesthesia care by a qualified pediatric anesthetist.
The conventional method uses blade (scissors or scalpel) to release a tie however in recent days the procedure is done using a laser diode under local anesthetic gel.
When a tongue tie is causing problems with breastfeeding, the baby often does not open his mouth widely, thus not latching on to the breast at the correct angle. Instead he may latch onto the nipple, and 'gum' or chew it, causing severe pain and eventually, nipple damage.
There is certainly some discomfort associated with any procedure in the oral environment, regardless of the tool. Our laser procedure is customized to provide the best outcomes for each patient depending on their age. The procedure is painless as it is performed under local anesthetic.
Pain is very subjective and patients report a variety of pain levels following a frenectomy. For a procedure that is carried out thoroughly, some pain can be anticipated. Standard analgesics may be of comfort in the days following surgery.
There is always a possibility of reattachment. However, tongue stretching exercises are taught by reducing the potential chance of reattachment.
We have a well-planned protocol to ensure that our infant and toddler patients will have the shortest surgery time possible and to enable them to breast feed straight away. The surgical aspect of the visit generally takes 3-5 minutes.
A frenectomy is a relatively non-invasive procedure. By keeping the number of people in the surgery to a minimum we are able to be most efficient, focus on our patient, and provide care in a less emotionally charged environment. This is especially true for mothers who will be breastfeeding immediately after the procedure.
Given the importance of breastfeeding in strengthening the tongue and other mouth and face muscles and the important role of the tongue in encouraging correct tongue posture (where we place our tongue at rest), the inability or ineffectiveness of many tongue tied infants to breastfeed adequately may led to poor tongue positioning. Even after breastfeeding has ceased, the establishment of tongue posture and the patterns of tongue movement may be limited by a tongue restriction. The effects of a “descended tongue posture” and “tongue thrusts” has a direct effects on the development of the jaws, positioning of the teeth, certain breathing dysfunctions
There are minimal restrictions on travel or other activity after surgery, however carer should bear in mind that our active wound management protocol requires stretches to be performed every 6 hours for up to 4 weeks post-treatment so travel plans will need to be considered carefully to ensure this regime can be maintained.
As soon as it is diagnosed would be the ideal time to treat it, if normal functions have been compromised
After care includes gentle exercise that would encourage tongue movement and prevent reattachment followed by assistance from a lactation consultant / craniosacral therapist / body worker