At Dino Dental, we regularly support families throughout the region to help their infants who have trouble nursing due to lip-tie and tongue-tie issues every day.
These parents can be under tremendous stress with a child who cannot nurse effectively and are often nervous about a surgical procedure in such a young child. For Dr. James, seeing the relief and joy on parents’ faces once the procedure is completed and the child’s nursing improves is priceless. Dr. James and Dr. Lauren utilized the procedure on their own infant daughter to allow Dr. Lauren and the baby to continue breastfeeding without excruciating pain.
A frenectomy (or frenotomy) is a procedure used to correct a congenital condition where the tongue frenum or upper lip frenum is too tight. When the tongue frenum is too tight it is commonly called tongue tie (or ankyloglossia). When the lip frenum is too tight it is commonly called a lip tie. Both can cause restrictions of movement of the tongue or lip preventing normal positioning during breastfeeding. A tight lingual or labial frenum may also be related to dental decay, spacing, speech difficulties or and digestive problems.
Tongue or lip ties can cause difficulties with breastfeeding. Tongue and lip-ties are relatively common – they can affect anywhere from 5-10% of the population. Your lactation consultant, doula and/or doctor will look at your baby’s tongue and/or lip to determine if they have a tie. If your baby has a tie and you are having pain with breastfeeding, your practitioner may refer you for an infant frenectomy. At your dental visit, the severity of the lip and/or tongue tie will be assessed. A frenectomy may help improve symptoms, decrease breastfeeding pain and/or improve your infant’s latch.
A tongue-tie can be the hidden reason behind nursing difficulties in babies, feeding problems in toddlers, speech issues in children, and even headaches or neck pain in adults. Are tongue-ties the cause of all the world’s ills? No. But it is too often overlooked, misdiagnosed, and written off by many healthcare providers. We know what it’s like to struggle with nursing or feeding issues. So, we accept same-day appointments and, if we see a problem, can often address it during your first visit. The process of diagnosing a tongue-tie involves taking an in-depth history, completing in-person pretreatment assessments, and examining the mouth, head, and neck structures. Tongue-ties are the root cause of so many frustrating secondary symptoms, we partner with a team of specialists, including lactation consultants, speech therapists, and chiropractors, to provide the comprehensive care your family deserves. Often, a snip or a clip with scissors leaves thick tissue behind. With our innovative technique, we remove all of the restriction quickly, easily, and as gently as possible. Plus, in the rare chance that it grows back within a year, we’ll fix it again, free!
Infants with Tongue-Ties and Lip-Ties
If you or your infant have more than a few of these symptoms, even with good weight gain, your child should be properly evaluated for a tongue- and lip-tie. Mother’s Symptoms can include: Painful nursing, creased or flattened nipples, blistered or cut nipples, incomplete breast drainage, plugged ducts or mastitis, inability to nurse without using a nipple shield and/or decreased milk supply.
Baby’s symptoms can include: poor latch, poor weight gain, reflux or frequent spitting up, frequent gassiness and fussiness, clicking or smacking noises when eating, dribbling milk out of mouth, frustration when eating, inability to hold a pacifier and/or prolonged nursing or bottle-feeding sessions.
Toddlers and Older Children with Tongue-Ties and Lip-Ties
There are many children who have difficulties related to tongue-ties and lip ties, but unfortunately, these conditions are often not identified until later in life. They can cause speech and feeding difficulties, sleep issues, and a wide-range of other concerns.
If your child is unable to touch the roof of the mouth with his or her tongue when opening widely, is struggling with speech delay, or speech issues that aren’t resolving, has difficulty eating or getting a good night’s sleep. They may have a lip and/or tongue tie.
Speech
A tongue restriction affects speech differently in each individual. Some children with a to-the-tip tie can articulate well (but may struggle with increased effort when speaking). Other children, with a less visible or posterior tie, may have a speech delay or difficulty producing the sounds for L, R, T, D, N, TH, SH, and Z.
Feeding
Children that are tongue-tied often have eating issues from infancy, such as trouble nursing or taking a bottle. When transitioning to solid foods, they may choke, gag, or have difficulty swallowing certain textures.
In childhood, these eating difficulties can persist and are evidenced by only eating small amounts of food, slow eating, packing food in the cheeks like a chipmunk, and pickiness with textures (soft, mushy foods and meats are typically the most difficult, but children can struggle with other foods as well).
Sleep
A tongue-tied child will often grind his or her teeth at night, snore, or experience other sleep-disordered breathing problems. Releasing a tongue-tie can help a child to sleep more soundly because the tongue will be able to rest on the palate, as it was designed to do, rather than falling back to narrow or block the child’s airway. Sleep-disordered breathing can cause frequent waking, restlessness, bed-wetting, failure to feel refreshed upon waking and accompanying difficulty focusing (which is sometimes misdiagnosed as ADD or ADHD).
Because multiple factors contribute to the problem, such as large tonsils and adenoids, a narrow palate and tongue-tie, often a child will be seen by multiple specialists to try to remedy the problem. In addition, children with tongue-ties often have a history of multiple ear infections and needing ear tubes. They may have had tonsils and adenoids removed. All of these can be complicated by the mouth-breathing that frequently occurs in tongue-tied individuals, due to the low resting posture of the tongue. We have found that when there is a tongue-tie, sleep often improves dramatically after a simple in-office procedure.
