What is a Lip or Tongue Tie?
Also called Ankyloglossia or a Tethered Oral Tissue (TOT), a Tongue-tie is a condition in which the bottom of the tongue is tethered to the floor of the mouth by a membrane (frenulum) that restricts movement of the tongue. Similarly, an upper lip-tie is a frenulum attachment that restricts movement of the upper lip.
The condition is present at birth and can result in various oral developmental issues including feeding, speech and swallowing as well as interfering with adequate breastfeeding. Somewhere between 4-10% of all babies are born with a tongue tie. There are degrees of tongue and lip ties, depending on where the frenulum attaches to the tongue
Why does it matter?
Tethered oral tissues limit the range of motion of the tongue and lip that can cause problems with feeding, swallowing, speech and the formation of the jaw and palate.
Babies who are tongue-tied may have problems achieving a secure latch to the breast. They will often overcompensate with increased suction or using the jaws which causes nipple damage and pain. Once the baby can no longer maintain latch in this manner, there is often clicking and loss of suction or even complete detachment from breast. This may not only cause pain to mom, but also affect the baby’s ability to adequately drain the breast, leading to supply issues and/or infections. Some babies may not be able to latch at all.
- Poor or incomplete latch
- Slides off nipple while attempting to latch
- Clicking noises while nursing
- Gumming or chewing on nipple
- unable to hold pacifier
- Poor weight gain
- Colic or Reflux symptoms
- Short sleep episodes/frequent feedings
- Snoring, heavy breathing, or sleep apnea
- Creased, flat or blanched nipples
- Cracked, bruised or blistered nipples
- Bleeding nipples
- Severe pain when infant attempts to latch
- Poor or incomplete breast drainage
- Infected nipples of breasts
- Plugged ducts or mastitis
- Nipple thrush
- Over-supply or diminishing supply
Left untreated, tongue and lip ties can cause development or speech problems and oral hygiene issues down the road, not to mention the loss of the breastfeeding relationship between moms and babies.
Beyond breastfeeding, tongue tie has been linked to impeded growth and development. Symptoms such as mouth breathing, snoring and sleep disordered breathing, enlarged tonsils, forward head posture, restricted upper airways and malocclusions such as crossbite or open bites can all be related to the function of the tongue. Children with tongue-ties may have difficulty swallowing or speech problems and delays. Adults diagnosed with tongue-tie have reported a lifetime of poor sleep, chronic neck and back issues, clenching and grinding of teeth, sleep apnea and digestive problems. There is also a link to poor oral health and history of numerous fillings and/or crowns of the back molars.
How is it treated?
Tongue and lip ties are easily corrected with a simple, safe and immediately effective procedure called a frenulectomy. Dr. Jordan is one of six preferred providers in the state of Ohio for revision of a tongue and lip tie via dental laser. The dental laser is the safest and least invasive of treatments available for the revision.
If you child is diagnosed with a tongue or lip tie, it is important to get the right kind of support. Depending on your child’s age and symptoms, your support group may include a Lactation Consultant, Craniosacral Therapist, Speech Therapist, Myofunctional Therapist, Chiropractor or Osteopathic Doctor. We are only one piece of the puzzle in correcting developmental issues related to tongue and lip ties.
How to Prepare for Your Appointment
Our office schedules approximately one hour of time for consultation and treatment of tongue/lip ties. When you arrive for your appointment, you will be greeted by one of our friendly staff members and asked to complete some basic paperwork. You can also access the required paperwork here on our website. This will save you the time and added stress of completing after your arrival. Once we have your information, you will be welcomed back into one of our exam rooms where Dr. Jordan will sit down with you to get a history on you and/or your child. She will want to discuss any symptoms you or your child have been experiencing. She will do a thorough exam to confirm a tongue and/or lip tie. From there, recommendations will be made for treatment and additional therapies as needed. Dr. Jordan will explain the procedure to you and answer any questions you may have. You will then have the option of completing treatment same day. We do not require a return visit.
You can begin to prepare your infant for his or her appointment by making tummy time a priority. Babies with soft tissue restrictions (tongue ties) or tension specifically benefit from intentional tummy time experiences both before and after a revision of a tongue or lip tie. Learn more about tummy time and incorporating a therapuetic program into your routine by visiting the TummyTime! Method website. In addition to more tummy time, beginning some oral stimulation exercises can be beneficial to your child. You can do this by massaging the gums, allowing your child to bite or chew on your clean finger and attempting the exercises shown in this video by Michelle Emanuel to help prepare baby and yourself for a relaxing healing period following tongue tie revision.
The procedure itself lasts approximately 2 minutes and is done with a dental laser. A local anesthetic may be recommended based on the patient’s age and cooperation level. Parents of infants will be encouraged to feed their baby as soon as treatment is complete. We have private spaces available for moms to feed and comfort their babies. Some moms have reported immediate relief of pain, extended nursing times and improved infant sleeping following a tongue-tie release.
What happens after treatment?
Parents are given post-operative instructions including stretches of the treatment sites in order to reduce risk of reattachment. Stretches are to be done 3 times per day for 3 weeks for the best outcomes in infants. Dr. Lawrence Kotlow created a great tutorial here https://m.youtube.com/watch?sns=fb&v=xk-hXwCk6Gc Active wound management (stretching) is vital to prevent reattachments. The Liper is a great device to aid in the stretches required. Find directions on use here.
Older children and adults will be instructed to practice myofunctional exercises after revision for two weeks to begin retraining the muscles of the tongue and face. Additional Myofunctional Therapy and other support is often required for best possible outcomes following the procedure. Depending on your child’s age and symptoms, your support group may include a Lactation Consultant, Craniosacral Therapist, Speech Therapist, Myofunctional Therapist, Chiropractor or Osteopathic Doctor.
Why do we do this?
Dr. Jordan has been personally affected by tethered oral tissues by having not one, but two, children with tongue-ties. You can read her personal testimony here.
Our office is committed to continue educating ourselves and our patients about this important topic while providing a safe and loving environment to all families affected by tongue and lip ties.