Lip & Tongue Tie Release in Danville, CA

Our bodies were designed to breathe through our nose, where we can efficiently humidify and filter the air, and improve oxygen circulation throughout our bodies! In order to direct airflow in and out of the nose, the tongue must be able to rest up against the roof of the mouth. A tongue tie physically pulls the tongue down towards the floor of the mouth, making it challenging and sometimes impossible to achieve a tongue to palate seal. Low tongue posture may lead to snoring and disrupted sleep patterns.  As we like to say, children should be silent and still when they are sleeping!

‍

At rest, the consistent pressure of the tongue against the palate, balanced by the pressure provided by proper lip seal, serves as a guide for the growth of our upper jaw. Literature shows children with untreated tongue ties may develop abnormal tongue function early in life with a secondary impact on orofacial growth and sleep disordered breathing.  Our goal here is prevention - if we can use proper positioning of the tongue to help prevent harmful changes to the development of the mouth we’d be ahead!

Similar to the tissue beneath the tongue, every newborn comes into the world with connective tissue beneath the upper lip known as the labial frenulum. This tissue serves to secure the lip to the jaw, promoting appropriate facial movement and development. Nearly 90% of babies have a labial frenulum that connects to the lower edge of the gum line, and this is considered a typical anatomical feature. As children grow and their jaws develop, research has indicated that the attachment of the labial frenulum tends to migrate upwards.

‍

An abnormally tight labial frenulum can disrupt the seal around the breast or bottle nipple, leading to increased air intake – contributing to reflux and gas symptoms or breast pain from the tight upper lip. The lip should play a passive role when a baby is feeding, gently flanging out to maintain the seal at the breast or bottle nipple so milk doesn’t spill out. In toddlerhood, a short labial frenulum may impact a child’s comfort forming a seal on a straw or clearing food from a spoon. It can also impede brushing easily in the area, creating a high risk area for cavity formation. 

‍

In around 4-11% of infants, the separation of the tongue and floor of the mouth during prenatal development can be disrupted, resulting in an abnormally short frenulum. This shortened piece of tissue in the mouth can vary in thickness, flexibility, and location, potentially completely tethering the tongue to the lower jaw. The degree of restriction in tongue movement can vary, impacting a baby's oral motor development, feeding, and even their breathing habits from infancy. This condition is medically termed "ankyloglossia," and it can be hereditary. It's essential to base a tongue tie diagnosis and treatment recommendation on a genuine functional limitation, as merely observing a frenulum under the tongue doesn't necessarily indicate restricted tongue movement. A comprehensive evaluation by experienced specialists is needed to assess anatomical presentation and associated symptoms accurately.

‍

During infancy, the tongue's ability to move freely is crucial for creating the necessary suction to extract milk from the breast. The front-mid part of the tongue plays a role in drawing in, forming a cup shape, and compressing breast tissue, while the mid-back portion of the tongue requires both strength and flexibility to generate the negative pressure required for milk extraction.

‍

A baby with a tongue tie might struggle to latch deeply onto the breast, potentially causing nipple discomfort and damage. When the tongue cannot fully extend over the lower jaw, the baby's latch can be uncomfortable, and maintaining a good latch can be challenging!  Some babies with a tongue tie may remain attached to the breast for extended periods without consuming enough milk.

‍

When suction is compromised and a baby repeatedly loses the seal at the breast or bottle, milk can consistently spill out of the sides of the mouth, and the baby may swallow air, resulting in excess gas and fussiness. A tongue tie can have an impact on oral motor coordination and feeding efficiency, whether at the breast or with a bottle.

‍

Everyone is born with a lingual frenulum, or frenum! During the developmental process, the tongue initially begins its journey completely fused to the floor of the mouth. As the tongue fully takes shape in the womb around the 8th week of gestation, it gradually detaches from the mouth’s base, allowing it to gain mobility. The lingual frenulum, a connective tissue remnant beneath the tongue, serve the purpose of both supporting and restricting the movement of the tongue.

Prior to having a tongue or lip tie evaluation, children should be assessed by an International Board Certified Lactation Consultant (IBCLC) or feeding specialist (a trained SLP or OT).

‍

Lactation consultants are experts in guiding mothers throughout their feeding journeys and addressing concerns regarding milk supply, latch comfort, breast and bottle feeding techniques, infant feeding patterns, positioning and so much more.

‍

Some speech language pathologists or occupational therapists have special training to become experts in pediatric feeding and swallowing; they can assess and address concerns regarding oral tone, strength and oral motor coordination in infancy and childhood.

‍

Working with a functional specialist provides important insight on oral reflexes, postural habits, or speech (if age appropriate) to help differentially diagnose the root cause of the child’s symptoms or to clarify a potential link between a short frenulum and the symptom presentation.

After listening to your concerns and conducting a comprehensive assessment, we’ll help you get to the root cause of the issues your child is experiencing. If a tongue- or lip-tie is the culprit, we’ll go beyond a traditional snip or clip and release it completely the first time. We do not use sedation or general anesthesia for this quick procedure. With laser dentistry, your child will experience minimal bleeding, and they will be able to recover from tongue and/or lip tie treatment quickly and with low levels of post-operative discomfort.

Tongue and lip ties are collectively known as “tethered oral tissues” or TOTs. They occur when the bands of tissue that connect the tongue or the lips to the mouth become overdeveloped to the point that proper mouth movement is restricted.

‍

They are uncommon in infants and toddlers, and sometimes do not need treatment. Minor tongue and lip ties may not cause any feeding problems, or contribute to speech impediments.

‍

However, serious tongue and lip ties can make it hard for your child to breastfeed or use a bottle properly, resulting in poor feeding and inadequate nutrition. If you think that your child is having trouble feeding because of tongue or lip ties, you should get help from a pediatric dentist right away.

Feeding problems are the most common signs of tongue and lip ties. Your child’s lips and tongue need to be able to move properly to latch onto the nipple and stimulate it for proper feeding. If they seem to be having trouble making a proper seal, milk dribbles out from their mouth while feeding, or they frequently stop and start feeding, they may be having latching issues due to tongue or lip ties.

‍

You can also look for visual signs of tongue and lip ties. For the lips, you can fold back your child’s upper lip and look at the frenulum. If it is difficult to lift the lip or it seems like your baby is unable to move their upper lip on their own, they may have a lip tie.

‍

Signs of tongue ties include an inability for your child to stick their tongue out past their front teeth, or problems moving the tongue from side to side. Tongue ties can also be identified visually. A common sign of tongue ties is a “heart-shaped” tongue. When your child sticks their tongue out, the restriction caused by the tongue tie may cause it to look “notched” or heart-shaped, instead of appearing as a smooth “U” shape.

Infant Tongue Tie: The Research

Plan for increased cuddles and snuggles with your baby after the procedure. We will give you recommendations on homeopathic and medicinal remedies should you want to utilize something more to make your child comfortable. We will also provide a list of the stretches we would like performed to help ensure the best healing possible.

Frenectomies are usually identified in infants and young children before they grow older, so the treatment is primarily done on younger children. However, it’s not exclusively provided to infants and young children.

‍

In older children and teens, we perform a different procedure called a functional frenuloplasty. In these cases, the wound is not left open, we place sutures to allow for primary intention. As babies and young children can not tolerate a longer procedure, sutures are not used.