What is a Tongue-tie?

Unique to our office and the Northern California area, Dr. Robles specializes in the use of a CO2 Laser for soft tissue modification, preventive care, and frenulum procedures.  Dr. Robles has attended extensive continuing education courses regarding tongue and lip tie release procedures.

What is a frenectomy?

A frenectomy is a procedure used to correct a congenital condition in which the lingual (tongue) or labial (upper lip) frenulum is too tight, causing restrictions in movement.  These restrictions have the potential to cause health problems like dental decay or spacing, speech difficulties and digestive issues.  When it affects the lingual frenulum, this condition is commonly called a tongue tie (the medical term is ankyloglossia).  Approximately 50% of the population has this condition, so your doctor may feel that a procedure is warranted in order to improve symptoms.

Parents and patients choose frenectomies for a range of reasons, and at various ages.

In infants, both lingual and labial ties can cause problems with breastfeeding and potentially bottle-feeding.  Symptoms of a possible tongue-tie or lip-tie in a newborn are: prolonged breastfeeding, difficulty latching onto the breast (causing sore nipples on the mother), and excessive gassiness.  More and more, parents are opting for a safe, fast-healing frenectomy to help their babies establish a good seal while eating.

In other patients, both adults and children, frenectomies can be a solution to eating or speech issues.  A dentist may also recommend it as part of a patient’s overall orthodontic treatment.

Types of frenulum procedures:

Labial Frenectomy (upper lip): A labial frenectomy involves the frenum attaching the upper lip. The problem of the upper labial frenum is primarily one of aesthetics, but not always.  If the frenum is too short or tight, there are a few common issues.  For one, the ligament tissue can extend toward the two upper front teeth and cause a diastema, or gap in the teeth.  It can also create an “open mouth posture,” by limiting the movement of the lip and preventing the mouth from properly sealing.  This can lead to open mouth breathing, which in children impairs the development of nose breathing and by extension proper airway and jaw development. It can also commonly cause gum recession.

Lingual Frenectomy (tongue tie): The lingual frenum is the tight tissue underneath the tongue that tethers the tongue in its resting position.  In most cases, there is sufficient flexibility that the tongue can move around and perform its functions for speaking and eating.  But again, if it’s too tight or short it restrains the tongue too low.  This is commonly referred to as being “tongue-tied.”  This has a couple of problems associated with it.  One, it can keep the tongue from pressing properly against the upper palate during swallowing, pressing it instead between the teeth and preventing the bite from closing all the way.  Second, if the tongue is held too low, in young children it will hinder correct growth of the jaw and cause long-term orthodontic problems and sometimes sleep apnea.  Finally, being tongue-tied is a common reason for lisping.

Labial Frenectomy (lower lip): The lower lip frenectomy is done for similar reasons as the upper lip, generally to stop periodontal problems and gum recession. But it is also performed in older adults who are being fitted for dentures. When the lips move, the frenum can pull the dentures loose, leading to improper fit.

What to expect after the procedure (Newborn to 6 months):

*** Please be aware that healing timeline below may not apply to every baby ***

What to expect after the procedure (6 years and older):

Slight swelling of the area is not unusual. Even bruising and chapped lips may occur.

A reusable ice bag wrapped in a soft towel, may be applied to the area to help minimize the swelling if needed. Alternating 20 minutes on and 20 minutes off for the first 24 hours will be adequate.

Applying Vitamin E Oil or Coconut oil on surgery site while doing exercises can help with sensitivity and discomfort. There are no restrictions on eating, however acidic foods may be sensitive. If so avoid until not.