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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

© 2014 Dr. Jennifer Fountain, DDS.
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