What Do Parents Need to Know About Lip and Tongue Ties?

For newborn babies, lip and tongue ties can cause difficulties in nursing. Left untreated, these conditions could lead to speech difficulties, a gap in between the front teeth and other dental issues.
Here’s what we should know about lip and tongue ties.

What is a frenulum?

A frenulum is a fold of soft tissue which helps attach your lip to your gums or your tongue to the floor of the mouth. It is useful in helping to secure your lips and your tongue and prevent abnormal movement. In some cases, the frenulum can be large or extended (hereditary causes) and so needs to be reduced.

What is a lip tie?

A lip tie is also known as low frenulum attachment. If it is unusually large, or has a lower than normal attachment, the frenulum can cause difficulty in feeding of new born babies as they will find it difficult to achieve the suction required. Later in life if the frenulum connects through to the gum tissue between the teeth and extend to the front part of the roof of your mouth, or palate (lower than usual) this contributes to a separation of the front teeth, causing what is known in dental terms as a diastema.
If the frenulum is not reduced, the separation may remain (or relapse if orthodontic treatment has been carried out) and hence frequently we need to surgically reduce it to allow for the teeth to come together either naturally or in conjunction with orthodontic treatment.

What does the procedure involve?

Frenectomy is a simple procedure when carried out by an experienced dentist. Reducing a low frenulum attachment is usually a painless procedure done under local anaesthetic. Modern dental techniques have allowed us to do this effectively using lasers to reduce postoperative discomfort and bleeding. The soft tissues of the mouth including the gums have an astonishing ability to heal rapidly and the patient usually feels no pain but a small ulcer may be present for a few days following the surgery which self resolves.

What about tongue tie?

The tongue is attached to the floor of the mouth by the “lingual frenulum”. If the attachment of the frenulum is extended beyond a certain point it can cause many difficulties either early on in a baby’s life or can manifest at a later stage in life.

Early complications include difficulty in feeding in neonates (especially breastfeeding as the child is unable to latch on effectively) and can lead to delayed speech as the tongue tie reduces the range of movement that is available for the tongue hence it becomes more difficult to pronounce certain sounds.

Later complications can be of a social nature such as difficulty in pronouncing certain words, or even cause malpositioning of some teeth.

What’s a tongue release procedure like?

Tongue tie is usually diagnosed at birth, and can be treated very effectively usually within the first 2 weeks of the baby’s life. The procedure involves a simple cutting of the tie area (which is usually very thin) to “release” the tongue. This is usually done under topical anaesthesia (a simple gel). A tongue release procedure can be very effective in easing nursing problems in newborn babies and can prevent future delayed speech complications.
The procedure is very simple with very little postoperative complications. Again, the patient usually feels no pain but a small ulcer may be present for a few days following the surgery which self-resolves.

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