Tongue Tie Treatment Explained

One of the services we offer at Gold Coast Holistic Dental Care is tongue tie and lip tie treatment. Dr Dan Hanson dedicates his days at the practice to treating patients of all ages with these conditions.

What is a tongue tie and a lip tie?

Tongue-tie, or also known as ‘Ankyloglossia’, is a congenital condition in which the lingual (tongue) is too tight causing restrictions in the movement of the tongue.

A lip tie means that the lip (labial) frenum is too tight which decreases lip mobility.

Both conditions can cause significant difficulties performing key functions of the mouth. This includes speech, swallowing, eating and breathing. It also limits the growth of the jaws which may lead to crowded teeth.

Who can be affected by a tongue tie or lip tie?

People of all ages can have tongue tie or lip ties. For infants, the key function of the mouth region is to breast-feed, so restrictions in tongue mobility and position of the lips can have a significant impact on successful breastfeeding. For this reason, the surgery is often performed early on to allow the infant an increased tongue (or lip) mobility.

In addition, tongue or lip ties present in many different shapes and forms. Many health professionals dealing with infants and toddlers are only familiar with very physically prominent, classic tongue ties. This type of tie presents on the tip of the tongue or causes a heart-shaped tongue.

However, tongue ties can be deceptively hidden in the underside of the tongue at the base and cannot be easily visualised. These less obvious ties (often under the mucosa or skin) are called a posterior tongue tie. Proper assessment and evaluation from a clinician or health professional who is experienced with their identification is critical.

There are many assessment tools and tongue tie classification scales published, but there is still no universally accepted standard of assessment and care in this area.

Common signs of infant tongue tie or lip tie

Some common symptoms that may point to your infant being tongue or lip tied are:

• Poor latch/inability to latch
• Sliding off the nipple fatigue during feeds
• Sleepy feeds
• Irritability while feeding
• Poor weight gain
• Clicking during a feed
• Dribbling milk at the breast/bottle
• Digestive issues (such as increased gassiness, reflux, colic, vomiting, distended stomach)
• Maternal nipple pain/damage (feels like the infant is compressing, chewing, gumming, pinching the nipple)
• Increased maternal nipple/breast infection
• Compromised maternal milk supply

Tongue tie / lip tie treatment process

The tongue tie or lip tie treatment consists of several steps. A consultation process, the treatment in form of laser surgery (frenectomy) and the after-treatment visit.

The consultation process

Your first visit at our practice will be a consultation. This stage consists of the following steps:

Gathering information about the infant/mother’s or adults’ challenges (past and present)

• A visual examination to observe the limitation of movement and position of the frenum ­ photos will be taken
• A manual examination to identify and evaluate the presence of ties and form a diagnosis
• A thorough discussion to provide information and answer any questions about the condition, the treatment and expected outcomes.
• The treatment is carried out with a Waterlase (not scissors or scalpel) and is usually relatively straightforward, not requiring general or local anaesthesia, sutures or complex oral medications.

You will also receive pre-treatment documentation including links to further reading and videos which you may find useful. We will also inform you about the option to work with other practitioners and health providers for pre-surgery sessions.

For infants, it is very helpful to see a lactation consultant pre and post-surgery. Usually most patients arrive for a frenectomy after having already seen a lactation consultant, whom they will also visit shortly after the surgery. The infant who has difficulty latching on may need the supportive care of a lactation consultant after surgery. It is highly recommended that you see a Lactation Consultant, or other feeding specialist within the week after surgery.

The laser surgery

After your consultation, our team will book you or your infant in for the frenectomy. This refers to the surgical removal/freeing of the fold of skin under the tongue or the upper/lower lip (frenum/frenulum). It is also called freeing, releasing, or revising a tongue tie or lip tie.

Lasers are an excellent alternative to scissors or a scalpel to treat soft tissue. In laser terms, the tissue is “ablated”. Light energy is used to remove tissue rather than cutting that occurs with scissors or scalpels.

The use of lasers in surgery has distinct advantages over other methods for several reasons including:

• Reduced collateral damage (it is more precise, removing tissue layer by layer)
• It is bactericidal (kills bacteria as it works)
• Reduced discomfort/pain during and after surgery
• Reduced bleeding
• Reduced oedema (swelling) and inflammation after treatment
• Allows for better healing through the concept of photobiomodulation (or Low Level Laser Therapy).

All methods of surgery require sound knowledge of the condition, its treatment as well as the necessary post-operative care. The use of a laser requires additional training in laser physics, laser safety and laser use for different techniques.

Our practitioners have undertaken the necessary training for this and have good experience with treating all ages – infants, children, and adults.

After treatment care

Infant/toddler patients will experience varying degrees of discomfort or pain for the first one to three days following the procedure. This can depend on the severity of the lip and tongue tie, the temperament and state of health of the infant and mother and other factors.

We recommend attempting to breastfeed in a relaxed setting, plenty of skin to skin contact, taking relaxed baths together to provide natural pain relief. If your little one seems uncomfortable, you may choose to use your chosen pain relief substance per the advice of your health practitioner. It can be a good idea to administer pain relief about an hour prior for a more comfortable feed.

You will receive further after care instructions from your practitioner prior to the treatment.

Tongue tie / lip tie appointments

Please don’t hesitate to contact or call us if we can provide you with any further information about tongue and lip ties. To book an appointment, please call our friendly team on (07) 5644 6000.