Early Diagnosis of Tongue-Tie is Key

Sleeping baby clenches his parent's fingers; Soft focus and blurry

Labial frenum and lingual frenum refer to the soft tissue in your mouth that either connects the upper lip with the upper gum (labial), or the base of your tongue with the floor of your mouth (lingual). Babies are sometimes born with one or the other or both being too short, or taut, impeding mobility of the tongue or lip; hence the terms tongue-tied or lip-tied.

Breastfeeding issues related to tongue-tie

Dr. Timothy Voss is a pediatric dentist with a practice in Maumee, Ohio. He has much experience in treating infants and children with tongue or lip-tie. According to Voss, infants with tongue-tie have great difficulty nursing because the upper lip and tongue have such restrictive movement that the infant is unable to latch on correctly. Tongue-tie can also cause issues with swallowing, breathing or speech as the child gets older.

First and foremost, Voss stresses the importance of working with a lactation consultant. Voss said Northwest Ohio has some of the best lactation consultants around and could not stress enough the importance to work with them first before taking the next step.

If bottle feeding, a different type of nipple may work for your baby. After all efforts and possible solutions have been exhausted, a procedure may be needed to resolve the issue. 

Toddlers and adults may have issues related to tongue or lip-tie

Though rarer than infants experiencing feeding difficulties, occasionally toddlers develop difficulties with speech due to tongue or lip-tie. Some adults may develop issues with lip-tie because the frenum may be so tight it actually begins to pull the gums away from the teeth. These patients are far less common than infants under four months of age. 

Frenectomy sounds scarier than it is

After working with pediatricians and lactation consultants the next step is to see a pediatric dentist who treats tongue and lip-tie. A frenectomy is a procedure that simply removes the frenum. Voss has remained a leader in this practice having started using a non-contact laser in 2015.  The laser works quickly and painlessly and is over in less than two minutes.

Voss performed over 600 frenectomies in 2022. He travels to watch the best work, as well as travels to lecture about tongue and lip-tie and the procedure to fix it. 

“They {infant patients} end up with us usually in their first four months,” said Voss.

The procedure takes place right in the dental office. The infants are swaddled and a topical anesthetic is applied. Immediately following the couple minute procedure, the infant is given to mom to nurse immediately. There are no sutures or bleeding since a laser is used, rather than a scalpel.

Quick recovery

After the procedure it may take the infant a bit of time to figure out the correct way to nurse, but working closely with a lactation consultant will help get them nursing properly very soon. Though the infant will not feel pain during or after the procedure, their tongue will feel fatigued as it is being used more than it has ever been used before.  “It’s a lot like finding new strength in muscles. The tongue gets sore from over utilizing muscles,” said Dr. Voss.  Frequent breaks/rests while nursing will help give the tongue as rest at first.  The soreness goes away relatively soon as the tongue adjusts to its new mobility. 

Whether or not your child needs a frenectomy will be determined after evaluating several factors and many people have been consulted.  Parents will work with their child’s pediatrician, lactation consultants, and the pediatric dentist to be sure of the best course of action.