Tongue-tie & Frenectomy

What is Tongue-tie?

Tongue-tie is a medical condition, which mainly affects infants, in which the tongue has restricted motion. The lingual frenulum is the short and tight band of tissue that restricts tongue movement. It is located between the tip of the mouth’s floor and the bottom of the tongue.

Tongue-tie limits the feeding of the infant, explaining why some children with tongue-tie gain weight slowly compared to normal children. Full movement of the tongue aids speaking and swallowing. When the movement of the tongue is restricted, your child can experience difficulties in breastfeeding, eating, swallowing, and speaking.

Signs of tongue-tie

Several signs can show you that your child might have tongue-tie. You will notice physical and behavioral features that are not normal in other infants. As a parent, these signs may be easier to notice if you have other children. Some of these signs include:

  • Restricted movement of the tongue either upwards or sideways.
  • A heart-shaped tongue when it is stuck out.
  • The tongue cannot pass the front teeth when stuck out.
  • The baby cannot normally latch during breastfeeding.
  • The infant appears to be hungry every time.
  • Instead of sucking, the infant chews during breastfeeding.
  • The infant slowly gains weight or does not gain weight at all, as is expected.
  • The infant produces clicking sounds during breastfeeding.

Causes of tongue-tie

The exact causes of tongue-tie are yet to be discovered. Normally, the lingual frenulum detaches from the tongue before birth. In tongue-tie, the lingual frenulum fails to separate from the tongue. Genetics is the currently known cause of tongue-tie. Your baby is more likely to have tongue-tie if someone in your family was also born with tongue-tie. Studies have also shown that gender is associated with tongue-tie; boys are three times more likely to have the condition at birth compared to girls.

Complications of tongue-tie

If not treated, tongue-tie can lead to various complications.

  • Feeding problems.

As earlier mentioned, your baby will be unable to latch appropriately and also fail to suck the nipple. In turn, the baby cannot get enough milk and is at risk of getting nutritional deficiencies.

  • Problems in speech.

You child will have difficulties in making certain sounds that have “l”, “d”, “s”, “z”, “t”, “th” and “r”.

  • Eating

Difficulties in performing certain oral activities such as swallowing or licking ice cream cones. It can cause the child to choke on solid foods.

  • Dental problems.

The tongue helps clean the teeth from food debris and generally contribute to proper oral hygiene. Due to restricted movement, the tongue is unable to wash away debris which can cause the formation of plaques or cause problems such as gingivitis and tooth decay.

Diagnosis

Before your child can be diagnosed with tongue-tie, the pediatric dentist will make some examinations. They will inquire on the child’s feeding and examine the movement of the tongue using a tool called a tongue depressor.

Treatment of tongue-tie

Once your child has been diagnosed with tongue-tie, the doctor will suggest two main treatment options; frenectomy and frenuloplasty.

What is Frenectomy?

Frenectomy is a surgical-like procedure that involves cutting the lingual frenulum. The lingual frenulum has very few blood vessels and nerves; therefore, the procedure involves little pain and few drops of blood. The procedure can be done with or without anesthesia in the doctor’s office or hospital nursery. Most doctors recommend that the procedure be done before the infant, and the mother leaves the hospital. At SuperKids, Dr. Merdad is able to perform this procedure at the Sterling, VA, location. Contact us at (703) 774-0014 for more information or to schedule an appointment. 

There are two types of frenectomy:

  • Traditional oral frenectomy

Traditional oral frenectomy involves the use of sterile scissors or scalpel to snip the lingual frenulum.

  • Laser frenectomy

Laser frenectomy is different from traditional oral frenectomy in that it uses a laser to cut the lingual frenulum. It is considered safer than traditional oral frenectomy because there is minimal risk of bleeding.

The entire frenectomy procedure takes less than 15 minutes, whether a laser, scalpel  or sterile scissor is used. During frenectomy, you will need to hold your child’s head facing upwards. The doctor then applies topical anesthesia to the area then snips the lingual frenulum using sterile scissors or a cauterizing instrument. The incision is then stitched up with the number of stitches varying depending on the severity of the tongue-tie. If no stitching is required, which is more common in younger children, the procedure is considered a frenuloplasty.

Doctors sometimes prescribe antibiotics after the procedure to prevent infections and complications. Complications that may result from frenectomies include salivary gland or tongue damage. The wound starts to heal within a few days, and after a week, a small scar will form over the area.

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