Summerlin Pediatric Dentistry

Ashley E. Hoban, DMDNV Specialty License S6-105
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Frenectomies

Tongue -Tie and Lip-Tie….What are they and what can be done?

Most importantly, please know that the diagnosis of a tongue or lip tie is a relatively common condition and a child can be diagnosed at any age. Some people learn to function with their tie(s) whereas others need revision in order to perform simple required movements for breastfeeding, speaking, and/or licking an ice cream cone.

The strong cord of tissue that is centered at the upper lip or under the tongue is called a ‘frenulum’ or ‘frenum’. It is visible if you lift the upper lip or tongue.  As we develop, the tissue usually recedes and thins. However, in some children, the frenum can be short or tight causing a restriction with the mobility of the tongue or lip. Lip ties have been related to cavities on the upper front teeth, permanent gap between the two front adult teeth, low smile line of the top lip, and breast feeding problems as an infant. Tongue ties are related to speech difficulties, poor oral hygiene, food texture issues, and breastfeeding. Not all ties need to be revised.

For Infants:

If the frenum is too short or too tight, infants may have trouble with breastfeeding leading to poor weight gain. Limited movement of the lip and/or tongue may prevent your infant from properly latching on and drawing milk from the breast. When a baby cannot get a good seal on the nipple, they may swallow air which can cause excess gas and stomach bloating.  Nursing mothers sometimes experience pain.  For mom, the frustration of unsuccessful breast-feeding is emotional and exhausting.

For Children (age 3 and older) :

If left untreated, they can eventually impair the child’s speech, affect tooth alignment, and may cause cavities. Speech problems and the inability to articulate letters or sounds become noticeable around the age of three.  Although there is no way of determining if your child will have speech problems, the following characteristics are common with lip or tongue tie patients:

-‘V’ shaped notch at the tip of the tongue

-Inability to stick out the tongue past the upper gums

-Inability to touch roof of mouth

-Difficulty moving tongue side to side

-Significant spacing or gap between upper or lower front teeth

Uncorrected tongue ties are also linked to gastro-esophogeal reflux (GERD) and some breathing and sleep difficulties. From the restriction or pressure of the frenum, there could be gum recession on the teeth, esthetic issues due to the gap between upper and lower teeth, tissue sensitivity, or a trap for bacteria which could lead to decay issues.

Procedures

Conventional methods for a frenectomy or frenotomy include using scissors or scalpel to snip, cut or remove the tissue. There is a moderate amount of bleeding and significant discomfort with the conventional methods. Also, there is a greater incidence of scar tissue and a more likely chance of reattachment.

Due to advanced technology, the method Dr. Hoban utilizes for correcting ties is using a Diode laser. Accompanied by all of the safety recommendations required for the procedure, the laser can be used on all ages including newborns. The laser procedure gently removes the frenum tissue within minutes. It is fast, with virtually no bleeding and much less discomfort. Your child is less likely to have tissue reattachment or scar tissue.

Discomfort from a lip or tongue tie procedure usually lasts 24 hours, although for the older child it could last up to 48 hrs.  It will be important to follow all the directions provided for your child, including the stretching or massage exercises. Children do not typically care for the exercises or stretching and may cry or fuss, but they calm down quickly once done.  A 1-week follow up appointment will be scheduled to check the healing of the tissue. Depending on how your child is healing, additional appointments may be recommended.

Typically parents bring their child in for an initial consult visit with Dr. Hoban after being referred by a lactation consultant, mid-wife, chiropractor, pediatrician, friend, etc. If it is determined that your child needs revision, a medical clearance form will be provided at your consult and must be signed by your pediatrician before treatment can be rendered.

We recommend that your infant come hungry so that you can nurse immediately following the procedure. This is to help comfort your infant after treatment and to encourage proper latch and suck pattern.  We typically swaddle your child to help them hold still as well as provide gentle holding of the head to make sure they are safe during the procedure. Dr. Hoban uses a laser and has safety glasses for your child.  The procedure itself usually takes just a few minutes.  Once the procedure is done one of the assistants will retrieve the parents and the room will be yours to comfort your baby for the remainder of the visit.

Consult with your pediatrician regarding pre-treatment options for pain management. Tylenol is usually sufficient for younger babies and should be given at least 30 minutes prior if you choose to give it. Dr. Hoban will discuss specific stretching exercises as well as recommendations to manage post-operative pain for your child during the visit.

Please be aware that we are a dental office, and cannot submit claims to any medical insurance. To avoid any confusion regarding dental coverage, please check with your H.R. department or insurance provider to confirm that your newborn has been added to your dental policy; some insurance’s allow enrollment within the first 30 days following birth.

If you’re interested in meeting with Dr. Hoban for a consultation, please contact our office. We will be more than happy to answer any additional questions you may have!

Dr. Ashley E. Hoban

(702) 838-9013

DRHOBAN@SUMMERLINPEDIATRICDENTIST.COM


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653 N. Town Center Dr. Suite 104

Las Vegas NV 89144

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Phone: 702-838-9013

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DrHoban@summerlinpediatricdentist.com

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