Common Questions on Tongue Tie & Lip Tie
A tongue tie can be short or long, thin or thick fibrous-looking tissue. This tissue is called the lingual frenum or frenulum. The lingual frenum stretches from underneath the tongue to the floor of the mouth.
Dr. Bhaumik: Each one looks unique, and the position of the frenum underneath the tongue also varies! Some are positioned in the front (anterior), and some further back of the tongue (posterior). It is not the LOOK of the tissue that matters, but rather the FUNCTION and SYMPTOMS that the tethered tissue (frenum) is causing, is what really matters.
This is why it is so important for a properly trained healthcare provider (lactation consultant (board certified), trained pediatric dentist, speech-language pathologist, or myofunctional therapist) to do a proper assessment.
Dr. Bhaumik: No! According to current research, only 5% of the population is truly tongue-tied. Some healthcare providers and myself included believe that this statistic is NOT accurate and that more research needs to be performed to validate this statistic. We ALL have a lingual frenum but for some of us, the frenum is tighter. This “tightness” underneath the tongue for kids that are truly tongue-tied exceeds beyond the mouth and we must carefully assess the body as a whole.
When the lingual frenum is normal, it should be elastic and should not interfere with the movements/proper positioning of the tongue. Newborns/infants/children ideally should not have a problem with sucking, eating, clearing off food with their tongue, swallowing, and speech. When the lingual frenum is short, thick, tight, or broad it can result in various issues with function, feeding, speech, and airway.
Dr. Bhaumik: Correlated symptoms of a tongue tie can be as simple as difficulty sticking the tongue out OR as complex as trouble with breastfeeding (latching) as a newborn, eating and speech issues, digestion issues, and sleep/airway issues.
Other very specific symptoms correlated to being tongue-tied are head and neck tension, midline asymmetries/misalignment, chronic headaches, or lower jaw tension.
Dr. Bhaumik: I never push parents to get this procedure done and I never discuss this issue if it is not an issue. Motherly instinct about how breastfeeding is going home is often what starts this conversation or during our clinical exam when I am assessing the child’s airway, tongue posture, child’s gait, and signs of head/neck tension.
I believe if your newborn/child is truly tongue-tied then the benefits of this simple surgery are justified and will provide life-changing results. Unless parents are 100% motivated, committed, and understand HOW and WHY this surgery is beneficial, I don’t perform it. Also, I would like to express the importance of working with other healthcare providers (IBCLC, SLP, CST, OMT) invested in your child’s overall well-being. At our office we often times coordinate with other healthcare providers to figure out the best approach to providing lifelong results.
Dr. Bhaumik: Cutting the tongue tie with scissors has a high degree of unpredictability in regard to post-operative results and bleeding. Burning the tissue off with a diode “laser” (not a true laser) results in heating and burning the frenum tissue. A diode laser results in longer healing times when compared to a CO2 laser. Healing time is a very important factor for the breastfeeding mother/newborn and older children.
I made the decision for our practice to provide the best for our patients by investing in a CO2 laser because I believe this should be the gold standard for pediatric soft tissue surgeries, Ex: Tongue and lip tie surgeries.
We use a LightScalpel CO2 laser, which works by removing water molecules (ablation) from the frenum tissue. This makes our tongue tie release minimally invasive, allows us precision when performing this surgery, reduces healing time, and, most importantly, the best results.
It takes us approximately 10-15 min perform this surgery on infants. At our practice it takes us 25 minutes to prepare the treatment room and our breastfeeding room. Our breastfeeding room is afterwards reserved for parents and our patient so that the family is able to breastfeed in privacy after the procedure.