150 E. 77th Street
Suite 1E
(212) 355-1003

Tongue Ties, Lip Ties, & Frenectomies – Oh My!

Sep 21, 2018

If you’re a parent of a child under the age of 12, you’ve likely heard the terms ‘tongue-tie’ and ‘lip-tie’ in passing conversation.  This blog post is meant to educate you on the basics of tongue-ties, lip-ties, and the frenectomy procedure used to treat both conditions.  So tune in!

Let’s start with the tongue-tie or ‘ankylossia’, a congenital condition restricting the tongue’s range of motion.   We are all born with a lingual frenum, a band of tissue attaching the tongue to the floor of the mouth.  But a child with a true tongue-tie has an especially short, thick, and/or tight lingual frenum attachment. Children with a tongue-tie are less able to fully extend their tongue outwards, sideways, and upwards towards the roof of the mouth.  When they do attempt to extend the tongue, it tends to fold in on itself, appearing notched or heart-shaped. Tongue-ties may interfere with infant breastfeeding and speech/swallowing/eating patterns for older children.

A lip-tie is also a congenital condition, this time located in the upper jaw area.  Again, we are all born with a labial frenum, a band of tissue connecting the upper lip to the upper gums.  But a child with a true lip-tie has an especially short, thick, and/or tight labial frenum attachment.  A lip-tie is commonly the cause of a tight lip and/or large gap between the front teeth.  A lip-tie can sometimes make brushing between the top front teeth a sensitive experience, and can be more prone to tearing with any sort of traumatic blow to the mouth.    Finally, prominent lip-ties, like tongue-ties, can interfere with breastfeeding, specifically the ability for an infant to latch and feed well.

FYI: Both tongue and lip ties can cause poor oral hygiene.  Moving the lips and tongue out of the way are important in keeping the teeth and gums clean.  When tongue and lip-ties inhibit the normal range of motion, plaque can get trapped more easily in nooks and crannies of the mouth!

A frenectomy procedure is often the solution to a problematic tongue or lip-tie.  Although traditionally, a frenectomy involves the use of a scalpel or scissors, here at Fountain Pediatric Dentistry, we use a fabulous laser to get the job done! The frenectomy procedure involves the release of the tissue tie, and the laser allows us to do so in a way that is relatively painless and fast.  The procedure usually takes only a couple minutes! Lasers allow for a less ‘messy’ procedure and have been shown to promote more rapid healing.

If you’re wondering whether your child has a prominent tongue or lip-tie, rest assured that this is something we check for during routine visits.  The frenectomy procedure is not necessarily recommended for every child with a tie, but rather for those that present with issues in basic functionality: breastfeeding, bottle-feeding, eating, swallowing, speech, poor hygiene, and orthodontic issues.  We often work in coordination with speech therapists, orthodontists, pediatricians, oral surgeons, ENTs, and orthodontists to determine if the frenectomy procedure is beneficial and/or necessary for your child.

The goal here is to maintain a happy mouth, mind, and body.  Feel free to ask us about tongue and lip-ties at your child’s next visit!

References: mayoclinic.org, AAPD Guideline on Management Considerations for Pediatric Oral Surgery and Oral Pathology

How to have a Happy, Healthy, Cavity-Free Summer!

Jul 13, 2018

SUMMER!! It’s the word that gets the whole family in a good mood.  Summer is a time for ‘letting loose’, easing up on the typical routines, and allowing ourselves the flexibility to have fun and relax on a whole new level. BBQs, trips to the pool/beach, late nights out on town, kiddie sleepovers—what more can you ask for?

We wish you a safe and super fun summer, but we also encourage you to keep it healthy!  Yes, by exercising and staying active—luckily, this comes more naturally in the summer. But, also, and just as importantly, by maintaining a FUN, HEALTHY DIET! Our routines during the school year tend to keep our diets more disciplined, yet there is a tendency to abandon those routines when the warm weather and longer days roll around.

Here at Fountain Pediatric Dentistry, we CHALLENGE YOU to a CAVITY-FREE SUMMER!

Here are some awesome ideas to get you on track:

  • Before we get to diet, let’s not forget about our recommended brushing routine! Once in the morning for ‘good breath’, and once in the evening to keep the sugar bugs away. We challenge you to brush (and floss) 30 minutes after dinner and dessert instead of waiting before bedtime. The idea here is that you’ve ‘crossed it off your list’ and can continue to enjoy the evening without having to worry about it later on when we’re all tired out and settled into ‘lazy mode’.  IF your kiddo is really craving a last-minute snack before bedtime, we recommend non-cavity causing snacks like veggies (i.e. baby carrots, cucumbers) or cheese (i.e. string cheese), and then washing it all down with a tall cup of water.
  • Promote wholesome, healthy, CLEAN meals in your household this summer. We encourage you to incorporate lots of fresh fruits and vegetables on each plate, as well as whole grains and any good, lean sources of protein.  We recommend avoiding processed foods as much as possible. Remember, the more colorful the plate the better.  There are plenty of healthy summer meal ideas online that will make your kids excited to head to the table.   We also support the new and improved guidelines set forth by USDA’s MyPlate: choosemyplate.gov/MyPlate.  Check it out!
  • Healthy summer snacks: FRESH fruits (avoid dried fruits, fruit roll-ups, fruit snacks, etc.), FRESH veggies (try pairing with a healthy dip, i.e. hummus), olive oil-based all-natural popcorn (available in stores or easy to make at home), string-cheese, yogurt, and nuts.
  • Beware of the not-so-healthy go-to snacks (consume in moderation): pretzels, Goldfish, crackers, chips. We call these the ‘sneaky snacks’, because, although they seem harmless, they have been shown to cause cavities the same way as candy! Crazy, we know.  Simple carbohydrate snacks stick into the grooves of your teeth, break down into sugars, and become a feast for cavity-causing bacteria living in your mouth.  If you choose to buy these snacks, we recommend the whole grain or multigrain versions, which are less appealing to cavity-causing bacteria.
  • The celebrated summer snacks (consume in moderation): ice cream, ice pops, milkshakes, and smoothies. Who can say no to these delicious treats on a hot summer day? Go ahead and enjoy these foods, but remember that they are high in sugar content and that consuming them too much or too frequently can do a lot of damage to the teeth (and body).
  • Drink LOTS of water!! This is important especially in the summer, when our eating routines may be a little out of whack.   Water is a natural cleanser for our mouths and overall bodies.  Keeping a ‘wet’, hydrated mouth will help wash away meal/snack leftovers AND lower the overall activity of cavity-causing bacteria (aka ‘sugar bugs’) by neutralizing the acidity level in our mouths.  Many marketing companies are promoting ‘flavored’ waters, but here at Fountain Pediatric Dentistry, we recommend just plain ol’ water.  Some ideas to make water-drinking more appealing is by making your water jug or glass more colorful with cucumber slices or mint leaves.  Avoid adding lemon (for its acidity) and sugary fruits (we don’t want our teeth soaking in sugar water).  Another idea is buying your kiddos playful summer water bottles with cool straws or special designs on them.

We hope you found these ideas helpful. AND WE HOPE YOU HAVE A WONDERFUL SUMMER!

Bye-Bye Binky!

Jun 22, 2018

We’ve touched on pacifiers before in the blog (here), but since it is a frequent topic of discussion in the office, our associate Dr. Marisa thought she would share some words of wisdom!

The sucking reflex is natural and normal, beginning with breastfeeding or bottle feeding in early infancy.    The pacifier (or ‘binky’) often serves as an additional soothing mechanism for a baby.  For many young children, the pacifier quickly becomes a significant attachment until they are ready to let go.

‘Ready to let go’ is the key phrase here!  For some toddlers, giving up the pacifier can be very difficult.  (And, let’s face it–maybe for parents, too. Your babies are growing up!) Keep in mind that the pacifier habit affects each child to a different extent, often dependent on the cumulative time of use per day.  We recommending scheduling your first dental visit around age 1, so we can monitor habits like this and help you wean off when the time is right.  The pacifier may look innocent—but did you know it has potential to morph the shape of the mouth? The pacifier can push the top front teeth up and out, often causing backward tilting of the bottom front teeth, too.

In general, it is recommended that your child begin to wean off the pacifier before age 2.  Talking to your child should be the first step and is often the most effective.  In fact, some children will wean off naturally as they reach ‘big boy’ or ‘big girl’ status.  Others may need more help.

At the end of the day, it’s a teamwork approach! And we’re here to be a part of that.  To give you a head start, below are some ideas to kick the pacifier habit:

  • Snip the tip! Snipping the tip gets rid of the suction effect, and your child will be less interested in having it around.
  • Lock them in a Build-a-Bear. Now the binkies are held safe inside a cute, cuddly stuffed animal that your child can take to bed!
  • Send them to the Binky Fairy. She may ‘mail’ something in return!
  • Swap the binkies for a new toy that your child has been wanting.
  • Avoid ‘gifting the binkies’ to the newest baby in the household—remember if the binkies are still around, they are still up for grabs.

Talk to us about your child’s pacifier habit next time you’re in for a visit!

Athletic Mouth Guards

May 16, 2018

Did you know that baseball and basketball are the two sports with the highest incidence of dental injuries in children between the ages of 7 – 17?

Athletes can help prevent oral trauma through the use of a properly fitted appliance, such as an athletic mouth guard. Although mouth guards will not always prevent injuries, they do redistribute the forces of collision, thereby minimizing the risk of injury to the teeth.

There are 4 basic types of mouth guards, and they do not provide equal levels of protection.

  • The least protective type is the stock mouth guard. The stock mouth guard requires that an athlete hold it in place by biting down; it does not adapt to the teeth or stay in place easily. Therefore, when a blow to the mouth happens, this type of mouth guard shifts around and provides poor protection to the teeth.
  • The 2nd type of mouth guard is a “boil-n-bite”, and is similar to the stock mouth guard in the sense that it is sold over the counter and in a variety of sizes. While these mouth guards offer a slightly better fit that the stock mouth guard, they are still overall not great at providing an even amount of protection to the teeth.
  • The 2 most protective types of mouth guards are custom made mouth guards that are fabricated using a model of the athlete’s teeth. These mouth guards have excellent shock absorbing properties, and maximize protection by evenly distributing forces across the mouth. They typically are also the most comfortable (since they are custom made to the patient’s mouth), resulting in the athlete actually wearing the mouth guard most frequently.

Mouth guards are already mandatory in several sports such as: football, ice hockey, field hockey, and lacrosse. However, there are many sports that do not require mouth guards such as: basketball, baseball/softball, and soccer.

If you would like to learn more about mouth guards for your child, please contact our office – we would be happy to discuss!

© 2014 Dr. Jennifer Fountain, DDS.
All rights reserved.