A mother and her newborn struggle with breastfeeding; a child is unable to pronounce certain sounds; there is a large gap between an adolescent’s two front teeth. What do all of these people have in common? They could be experiencing problematic effects of a tongue-tie or lip-tie.
What are Tongue-Ties and Lip-Ties?
Underneath the tongue, there is a small piece of soft tissue that connects the tongue to the floor of the mouth. This is called the lingual frenulum. When the lingual frenulum is short or thick, it can limit the tongue’s ability to move. This is known as ankyloglossia (or, more commonly, a tongue-tie).
The labial frenulum is the tissue that attaches the center of your upper lip to the gum between the top two front teeth. While many infants naturally have a prominent labial frenulum, sometimes the frenulum is too wide or large and can inhibit a proper seal on a breast or bottle when feeding. This is called a lip-tie.
How Can a Tongue-Tie or Lip-Tie Affect My Child?
Tongue-ties and lip-ties are only treated if they cause problems.
In infants, tongue-ties and lip-ties can inhibit an effective latch on the breast or bottle. This can result in problems for the infant like reflux or gas from swallowing too much air, poor weight gain, and milk leaking from the mouth during feeding. It can also lead to persistent nipple pain and/or damage for the breastfeeding mother.
In toddlers and older children, a tongue-tie that is severely restrictive can cause speech disorders, since the tongue requires a range of mobility to create sounds. A trained speech-language pathologist can identify a tongue-tie when it contributes to a speech issue. In some cases, tongue-tie can also lead to gum recession. Lip-ties that are wide and prominent could potentially interfere with closing the gap between a child’s two front teeth through orthodontics.
Correcting the Problem: Tongue-Tie Laser Surgery and Lip-Tie Laser Surgery
When a child is experiencing a problem due to a tongue-tie or lip-tie, a pediatric dentist can work closely with the child’s pediatrician, orthodontist, speech therapist, and/or lactation consultant to determine the best course of treatment. Sometimes, the frenulum needs to be removed to release the tongue or lip for easier movement; this procedure is called a frenectomy.
Many newborns do not need anesthesia for the tongue-tie laser procedure. Breastfed infants often experience an improved ability to latch beginning on the very same day as the procedure.
Older babies and children may require anesthesia for laser lip-tie surgery and laser tongue-tie surgery, but still recover quickly. There are no stitches to remove, and the laser makes the healing process less painful for your child.
Tongue-Tie and Lip-Tie Laser Surgery: Post-Operative Care
Daily stretching is critical after a frenectomy to prevent the tongue and/or lip from reattaching. Your child’s pediatric dentist will provide you with specific instructions on how to properly perform the correct stretches for your child.
If your child is an infant, keep in mind that, while many infants have a corrected latch immediately following a frenectomy, others need more time to learn how to breastfeed effectively. If your infant falls into the latter category, it is important to continue working with your lactation consultant and to always remember that your infant is learning a new skill that may take practice.
If your child is older, certain dietary restrictions will be necessary during the first few days following the lip- or tongue-tie laser surgery. Your child’s pediatric dentist will discuss specific dietary restrictions with you at your child’s appointment.
About the Author
Dr. Jin Lin is a board-certified pediatric dentist with a passion for helping children achieve healthier, more beautiful smiles. He earned his Bachelor of Science degree from Cornell University and his Doctor of Dental Medicine (D.M.D.) degree from the Harvard School of Dental Medicine. After graduating cum laude from dental school, he completed his post-doctoral pediatric dentistry training at Boston Children’s Hospital and the Harvard School of Dental Medicine, where he served as chief resident and worked with children with a wide variety of special medical and dental needs, including children with rare syndromes.
This article is intended to provide general information about oral health topics. It should not be used to diagnose or treat any medical condition or as a substitute for the advice of a healthcare professional who is fully aware of and familiar with the specifics of your case. Always seek the advice of your dentist or other qualified healthcare provider with regard to any questions you may have relating to a medical condition or treatment.
