What is a Tongue Tie?

Tongue-tie (ankyloglossia) is a condition present at birth that restricts the tongue’s natural range of motion. A tongue-tie, an unusually short, thick or tight band of tissue (lingual frenulum) tethers or ties the bottom of the tongue’s tip to the floor of the mouth, so it may interfere with breast-feeding and speech. If an infant cannot breast feed properly, its development and immune system may be affected since the baby cannot drink its mothers antibody rich breast milk. We recommend checking out the following link to BreastfeedingUSA to see how a tongue-tie can impact breastfeeding and childhood development. 

 

This condition is often treated with a CO2 Laser with a procedure called a Frenectomy. Dr. Alexa Previti has a passion for the treatment of infant tongue ties and helping to improve the mother-infant bond created during breastfeeding early in life.  She has received formal training in this field of dentistry and utilizes a specialized CO2 Laser dedicated to tongue tie releases in infants and adults.

 

An infant tongue-tie often looks normal to the untrained eye. More important than the way it looks is to assess tongue movement, symptoms, and feel of the tongue. Early treatment is crucial to minimize the effects of a tongue tie.

There are several classes of tongue-ties and some are harder to assess than others. A trained professional such as Dr. Previti will feel the area below the tongue to asses for an anterior tongue-tie and posterior tongue-ties. Range of motion and function will also be assessed.

 

 

Signs of a Tongue Tie:

Inability to Breastfeed and Failure to Latch:

Without treating tongue-tie, it can affect the health of your child through different ages in their life. During infancy an untreated tongue-tie can make breast feeding difficult or impossible. 
Poor bonding between mother and baby as well as sleep deprivation for both the mother and baby. Sleep deprivation can cause problems with a child’s growth and development and well as impair brain development and learning. 

This can be frustrating and painful for the mother of the child and may even give the mother the feeling of a sense of failure. This often makes forming that initial bond with the baby more difficult to achieve. An infant tongue-tie is very easy to miss and is often not examined in the hospital setting. It is more likely than not caught by lactation consultants or during an infant tongue-tie evaluation at a dental office.

 

Formula feeding is often considered a replacement for breastfeeding but this is not without consequences. Bottle feeding has been associated with adverse health outcomes for both mothers and infants, ranging from infectious morbidity to chronic disease. Given the compelling evidence for differences in health outcomes, breastfeeding should be acknowledged as the primary source for infant feeding. Allergies and respiratory illnesses are far more common in formula fed babies.  Read this article by John Hopkins for more information.

 

Brain Development and Attention Deficits:
Children with a tongue-tie often develop breathing issues in their sleep and the lack of sleep may present with attention and behavioral issues and often lead to the misdiagnosis of Attention Deficit Disorder. So if your child is taking Adderall or diagnosed with ADHD we suggest a tongue-tie and sleep study to rule out sleep apnea. 
Studies suggest that as many as 25% of children diagnosed with ADHD actually may have symptoms of OSA and that much of their learning difficulty and behavior problems may be due to chronic, fragmented sleep.
Speech Impediments:
According to an article written by the Mayo Clinic a tongue-tie can interfere with the ability to make certain sounds — such as “t,” “d,” “z,” “s,” “th,” “r” and “l.”
Mouth Breathing and Sleep Apnea: 
According to an article in International Journal of Pediatric Medicine, a short lingual frenulum may lead to abnormal orofacial growth early in life, a risk factor for development of Sleep Disordered Breathing and Obstructive Sleep Apnea. Careful surveillance for abnormal breathing during sleep should occur in the presence of short lingual frenulum.
Adulthood Possible Side Effects:
Breathing and Sleeping: As we age a tongue tie continues to cause problems and will often go unnoticed until late in  adulthood. If a tongue is tied it cannot rest on the roof of the mouth. This will cause teeth crowding and affect the development of roof of the mouth and  floor of the sinuse, this cane cause breathing issues such as snoring, sleep apnea, and mouth breathing, all of which are major health concerns for brain function and development.

Do adults get tongue ties released?

Adults often do undergo treatment to release the tongue. This is dependent on the symptoms present. Common tongue tie symptoms may include headaches, TMJ, neck soreness, mouth breathing, and poor sleep and speech issues. Adults undergoing treatment also typically will consult with a myofunctional therapist to ensure  the tongue relearns how to properly function without all the strain and tension that was present since infancy.

What exactly is a Frenectomy?

A frenectomy is a minor procedure used to correct a lip or tongue-Tie. It consists of using the Light Scalpel CO2 Laser to loosen or remove the restrictive tissue, allowing a patient’s lips/tongue to move freely. Releasing a tongue from its restriction ensures the patient is able to eat, speak, and breathe with ease again.

Post Operative Care:
  • Wound Care: Your provider will provide you with detailed post operative instructions.
  • Parental Instructions: First and foremost immediate breastfeeding is crucial to prevent reattachment and allow your baby to learn to properly utilize their tongue in swallowing and breastfeeding. Your provider will show you how to properly care for the surgical site.
  • Myofucntional Therapy: tongue exercises are important both before and after the procedure to prevent reattachment. This will help you learn to properly utilize your tongue the way it was designed since you will need to unlearn all of the poor habits you developed trying to compensate for a tongue-tie. Faceology is a good resource for more information.

Why do we only do Laser Frenectomies?

Doctors have been performing frenectomies for decades, but in the past, instead of using a laser, they relied on scalpels and sutures. Even when performed by a skilled clinician, using these methods could be uncomfortable, leading to bleeding and a lot of pain/swelling post operatively. It’s also very hard to be accurate with these instruments, especially when treating tiny infants. Thankfully, modern-day lasers make all of these concerns a thing of the past, as they give dentists maximum control while offering maximum comfort for the patient.

How does a laser frenectomy work?

The LightScalpel laser emits an extremely focused beam of light that can be used to precisely cut or remove unnecessary oral soft tissue. The instrument itself generates practically no heat, sound, or vibration, so for the patient, they barely feel anything throughout the treatment.

The laser cauterizes and sanitizes as it goes which prevents bleeding and the laser also promotes faster healing times. This not only makes recovery faster and more comfortable, but it also greatly reduces the risk of any complications.

LightScalpel laser frenectomy system

What make the Light Scalpel different?

There are many types of lasers available today that can be used to perform frenectomies, and the LightScalpel stands head and shoulders above them. It can achieve a level of accuracy far beyond typical diode lasers, which allows our dentists to take an extremely conservative approach. This means we only remove as much tissue as needed and no more. This reduces bleeding, pain, and swelling significantly.