A frenum is a fold of skin joining 2 parts of the body. In the mouth they can be found under the tongue and inside the upper and lower lips. Everyone has them and in most people they don’t cause any problems. When they are overly tight or thick they can cause restrictions to normal movement/function and they are commonly known as ‘ties’.
Common reasons for tongue and lip tie release include:
- Breastfeeding difficulties
- Difficulties with chewing, swallowing and speech
- Orthodontic reasons
- Tie causing gum recession to nearby teeth
- Obstructive sleep apnoea (as a supplement to other forms of OSA treatment)
With any form of treatment, a thorough assessment and correct diagnosis is very important. Ties are not purely assessed by their appearance, but also the degree of function/restriction. The most important factor in deciding whether to treat is the problems you are having.
It is more important to focus on how things work rather than how things look.
Our dentists have had have had training specific to tie release in infants with a leading Australian expert in this area – Dr Marjan Jones (Enhance Dentistry, Brisbane).
How do ties affect breastfeeding?
Thankfully, there is now increased awareness of how ties can affect breastfeeding. To put it simply – a tongue tie reduces the ability of the tongue to move upwards towards the palate and create suction to draw out milk. A lip tie makes it difficult for the upper lip to flange properly, resulting in a shallow latch.
Some common signs of Infant tongue/lip tie include:
- Poor latch or inability to latch
- Fatigue during feeds
- Poor weight gain
- Increased gassiness, reflux or colic
- Maternal nipple pain/ damage
For appointments regarding breastfeeding difficulties we will need a referral from your lactation consultant, maternal health nurse or doctor.
Treatment – What’s involved?
A frenectomy is a surgical procedure where we remove / release the tissue that is causing the restriction in the lip or tongue. Sometimes we call this procedure a ‘release’ of a tongue or lip tie.
We prefer to use a laser rather than scissors for this procedure. With laser, there is less bleeding, improved visibility and more precision. Because of this, we have an easier time releasing the deeper fibres of the frenum (aka posterior tongue tie).
Our laser of choice is the Waterlase. The advantage of using a Waterlase over other dental lasers (e.g. diode) is that there is no heat generation (burning) and very low penetration depth (minimal damage to surrounding structures).
On average, a frenectomy will take just a few minutes. We don’t give anaesthetic to infants and toddlers but adults and older children can have local anaesthetic if they wish
A team approach
The surgery itself is just a small part of restoring function to the lips and tongue. Much like how rehab and exercises are needed after a knee operation, a team approach to tongue/lip tie release will help achieve the best possible results.
Where required, this team can involve lactation consultants, physical therapists (physiotherapists, osteopaths, chiropractor), maternal health nurses, speech pathologists, doctors and many more.
If you are a fellow health practitioner wanting to refer us, or want more information about what we do, feel free to contact us via email: firstname.lastname@example.org
For those who wish to read more, here are some useful links.
Dr Bobby Ghaheri
Tongue and Lip Tie Support Facebook Group