Tongue Tie or Lip Tie?

My name is John Montoya. In addition to being a general and cosmetic dentist for the last 17 years, I am a father of three and supporter of breastfeeding.

When my children were born it was difficult to see my wife and children experiencing struggle during the beginning stages of breastfeeding. Each child presented a unique set of challenges to overcome. I can appreciate how anxiety inducing it can be if there is a struggle to get nutrients to your growing baby. Breastfeeding in general is a process that requires patience and commitment on everyone’s part, and when a tongue or lip tie is present, an additional element of stress is introduced to the equation. When babies have difficulty latching onto the breast or a bottle they may fail to thrive and this is not only dangerous for baby, but extremely stressful for parents.

Thankfully, there are so many resources for getting support with any issue that may arise with feeding. New parents can compile a support team that may include a lactation consultant, doula, chiropractor, massage therapist, craniosacral therapist, and other health/wellness supporters in order to help them find a comfortable feeding position, head and body posture, and to help relax the baby’s muscles enough so that they can latch properly and get the nutrients they require. Sometimes, the issue is more than head or body position though, and a lip or tongue tie is actually restricting the movement of baby’s natural feeding reflexes. The help of these supporters is invaluable but sometimes their work cannot overcome an anatomical restriction that is creating the difficulty latching properly. These anatomical restrictions are often referred to as “lip ties” or “tongue ties.” It can be difficult for parents to evaluate whether a lip or tongue tie needs to be addressed in order to help with breastfeeding. Parents may be unaware that their dentist can help, however, the dentist is one of the best trained professionals to consult regarding a lip or tongue tie.

What is a frenum?

A “frenum” refers to the tissue either under the tongue that connects the tongue to the floor of the mouth or from the vestibule of the lips that attaches to the gum tissues of the dental arch. Thick and fibrous frenum tissue can restrict the movements of the tongue, lips, or both, which does not allow a baby to adapt to a functioning latch. A “tongue tie” is used to describe a frenum that is restricting the movement of the tongue. A “lip tie” similarly restricts the movement of the lips.

In instances where baby is having difficulty latching, your dentist can determine if your baby has a lip or tongue tie. This is not always easily determined by a visual exam only. Your dentist will examine baby visually, but also provide an intra-oral exam and speak with the mother about the difficulties she is having. If you do find out that your baby has a lip or tongue tie, then it is time to decide what to do about it. Your dentist will help you determine if your baby requires a minor surgical procedure called a frenectomy in order to release one or more restrictions so that baby can feed effectively.

What is a frenectomy?

A frenectomy is a procedure where the fibrous, tethered tissue is released in order to allow baby’s lips and tongue unrestricted movement. This will in turn help baby achieve a better latch to a bottle or breast. A frenectomy can be done as easily as possible by using a laser. Use of a laser allows for little to no bleeding, faster healing and a more comfortable post-operative surgical site. Once the procedure is complete, there will be some exercises for parents to do with their baby to aid in proper healing. Your dentist and a lactation consultant can help with these gentle healing stretches. It is important to have a lactation consultant that you feel comfortable working with before and after the procedure.

I have a tongue and lip tie clinic in Boulder, CO that utilizes the latest laser technology to accomplish the frenectomy procedure to release tongue and lip restrictions. When visiting the office, your baby will have a thorough assessment and diagnosis from myself. I will discuss my findings with you and make recommendations. If necessary, we can complete a laser frenectomy for your baby. After the procedure it is recommended to have a follow-up appointment with your lactation consultant and possibly your other support team members, depending on the situation.

The laser I use in my office is a Biolase Waterlase that removes soft tissue gently with water and laser energy. This laser does not emit heat, but rather, cools the tissue with water while it works. The laser is able to cauterize the tissue which minimizes bleeding, helps with increased speed of healing, decreased pain, and leads also to minimal scar tissue.

The laser is a wonderful tool to have in the office. Tongue and lip tie releases are not the only thing we use the laser for. We use the laser for a wide range of procedures including cavity removal, biopsies, periodontal therapy, cosmetic gingival re-contouring, peri-implantitis, bone re-contouring and more.

To learn more about our lip and tongue tie clinic and the other procedures we provide please see our website– www.boulderdentaldesigns.com or call the office at 303-443-1895.

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