Pediatric tongue ties are surprisingly common.
Because tongue ties aren’t always diagnosed, we don’t know how many babies are born with this condition. However, researchers estimate that between 4 and 11% of babies have a tongue tie.
A tongue tie can affect breastfeeding and bottle feeding. It may cause dental problems as the child grows.
In many circumstances, when the tongue tie is causing issues for a baby or young child, a pediatric dentist can perform a minor, outpatient procedure called a laser frenectomy to address those problems.
What Is a Tongue Tie?
A tongue tie, also called ankyloglossia, is a condition that restricts the tongue from having a full range of motion.
The lingual frenulum is a band of tissue that tethers the bottom of the tongue to the floor of the mouth. If this band is too thick, short, or tight, that restriction can cause a number of problems.
Signs and Symptoms baby may show may include one or all of the following:
- Difficulty with latching, especially while breastfeeding (mom may or may not complain of pain or discomfort)
- Colicky baby
- Spitting up
- Inadequate milk transfer
- Prolonged feeding times
- Slow weight gain
- Clicking
- Chomping/Gumming
- Leaking milk while breast or bottle feeding
- Open mouth posture
- High-vaulted palate
- Audible breathing
- Snoring
- Butt in the air position
- Mouth breathing
- Grinding
- Clenching
- Inability to stick out the tongue or move the tongue side-to-side, up, and back to the roof of the mouth
- Speech delays, especially the inability to pronounce the following sounds: d, l, n, r, t, z, and th
- Underbite
- Deep bite
- Swallowing problems
- Anxiety
- Lack of focus
- ADD/ADHD symptoms
- Sleep walking
- Night terrors
- Restless Sleep
- Bedwetting beyond potty training age
- Irritability
- Allergies
- Recurrent/frequent ear infections
- Sleep disordered breathing
- Underdeveloped jaws and face
- Obstructive sleep apnea
If the function of the tongue is not affected, a tongue tie won’t have any significant impact on the child. This means that there is no correction necessary.
However, when tongue ties are playing a major role in a baby’s ability to eat,sleep, breathe, grow, or speak, it is time to think about treatment options. Pediatric dentists are one of the most trusted resources for information about pediatric tongue ties.
What causes a tongue tie in a child?
In most babies, the lingual frenulum (which connects the tongue to the bottom of the mouth) separates before birth. This allows babies without a tongue tie to have their full range of motion.
When a child has a tongue tie, the frenulum has not detached from the bottom of the tongue. There is no clear answer as to why this happens, although there is evidence that suggests a genetic component.
Tongue ties are somewhat more common in boys than girls.
How a tongue tie affects breastfeeding
When an infant struggles to get a good latch, the problems can be very significant.
For example, a baby with a tongue tie may not be able to gain weight. Poor weight gain causes fussiness and discomfort for the baby.
A bad latch can also cause problems for the breastfeeding mother, who is likely to experience cracked and sore nipples or pain with latching.
Tongue ties may cause problems in bottle-fed babies, but it is usually less noticeable in this population. This is because a baby does not need to have as much tongue motion to feed from a bottle, compared to breastfeeding.
Laser Infant Frenectomy: A Treatment for Pediatric Tongue Tie
Laser infant frenectomy is a simple, outpatient procedure. We are able to perform this procedure right in the office.
The purpose of a laser frenectomy is to use a special laser device to separate the connective tissue of the frenulum.
Laser frenectomies can be performed under local anesthesia. However, in younger babies, all we usually need is topical anesthetic, as it takes just a few short seconds to complete the frenectomy.
How is a laser infant frenectomy different from other treatment options?
Laser infant frenectomy has many benefits when compared to traditional, surgical methods, which include using scalpels and electrosurgery techniques.
Benefits of using lasers to treat pediatric tongue tie issues include:
- Minimal bleeding (because the laser cauterizes the tissue as it is detached)
- Lower risk of infection (because the laser kills the bacteria)
- Precise and complete results
- Faster recovery time
- Minimal discomfort and pain
How to know if your baby needs a laser infant frenectomy
There are many people who can advise you on your child’s need for a laser infant frenectomy, including your dentist, pediatrician, lactation consultant, or a speech pathologist.
Importantly, not all tongue ties require treatment. Just because a baby has a tongue tie does not automatically mean that it needs to be corrected.
At Ashburn Children’s Dentistry, we routinely perform laser infant frenectomies when it is in the best interest of the child. Although frenectomies can be performed at any age, we find that they are most frequently needed in babies whose tongue ties are causing:
- Feeding problems, such as a weak or poor latch
- Failure to thrive
- Painful breastfeeding for the mom
- Excessive gassiness
- Decreased milk production
- Choking and sputtering while feeding
- Early speech problems
Tongue ties need to be addressed when they cause problems for the baby and its caregivers. The good news is that an infant laser frenectomy is a minimally invasive procedure that can immediately remedy most or all pediatric tongue tie issues.
What to Expect After Your Baby’s Laser Frenectomy
For the first few days after the procedure, you may use Children’s or Infant Tylenol, according to the dosing instructions. Your baby may be fussy or a little uncomfortable for a couple of days after the frenectomy.
You should see an improvement in your baby’s range of motion immediately. If there are additional concerns such as low muscle tone, you may still need to work with a lactation consultant or your pediatrician to address those additional underlying issues.
To prevent the frenum from reattaching during the healing process, we will provide you with some simple and easy exercises to do 3-4 times a day during the first week after the procedure.
When can a baby breastfeed after a frenectomy?
You can breastfeed and bottle feed immediately after the frenectomy. In fact, many babies find it comforting to nurse immediately after the procedure.
You will always be welcome to breastfeed in our office following the procedure.
Discussing Your Baby’s Pediatric Tongue Tie with Your Dentist
Pediatric dentists like Dr. Krystle Dean-Duru and Dr. Lynda Dean-Duru are happy to discuss your concerns and put your mind at ease regarding your child’s tongue tie.
We can help you determine if the tongue tie is playing a part in your child’s feeding and speaking difficulties and provide guidance about the best course of treatment.
If you choose to schedule a laser infant frenectomy, we will walk you through the process, each step of the way!
Make an an appointment with Ashburn Children’s Dentistry
You can schedule your appointment with Ashburn Children’s Dentistry to discuss your child’s tongue tie and the possibility of a laser infant frenectomy.
After a quick, painless examination and evaluation, your child’s dentist will be able to move forward to help your baby get rid of the tongue tie that is causing problems!
Contact us today to schedule an appointment for your child.