Tongue tied and lip tied
Did you know tongue tied can have serious negative affect on facial development and general health? We use Laser to treat tongue tied
Tongue tied and lip tied
 
Tongue-tie, or Ankyloglossia, is a congenital oral anomaly that may decrease mobility of the tongue tip  and is caused by an unusually short, thick lingual frenulum, a membrane connecting the underside of the tongue to the floor of the mouth
 
The most common reasons to treat them are as follows:
• For infants - Breast feeding difficulties
• For children - Speech difficulties and narrow jaws, or crooked teeth
• For adults - Head and neck pains and snoring
 
Infants
Lip and tongue tie can cause immense difficult with the fundamental functions of the tongue and lips including speech, swallowing, chewing and breathing.  For infants it poses restrictions on successful breastfeeding. 
For many mothers and infants, compensating through postural and positional modifications can allow for better breastfeeding. However, these compensations can eventuate into life-long ill habits which are not favorable for long-term functionality. 
 
Signs and Symptoms of Tongue tie and lip tie in infant
• Difficulty latching 
• Slipping off the nipple
• Lethargy  during feeding 
• Sleepiness during feeding 
• Irritability during feeding 
• Poor weight gain 
• Clicking noise during feeing 
• Trickling of milk whilst breastfeeding or bottle-feeding  
• Digestive complications (e.g. increase in flatulence, reflux, nausea, heaving and vomiting ) 
• Nipple pain/injury for mother 
• Increase risk in nipple/breast infections 
• Diminished milk supply from mothers 
 
All tongue restrictions start beneath the skin of the mouth (sub-mucosal) towards the middle or lower tip of the tongue. The length or appearance of the extension does not determine the severity or effect of the tongue/lip tie. The severity is determined by the impact on the function of the mouth as a whole and the symptoms experienced. 
The underlining fact is, if the mother or the child are experiencing several of the symptoms listed above then is it integral to explore the tongue and lips by a health practitioner that familiar with the condition. 
 

Children
Tongue ties occur in children whose tongue are attached to the floor of the mouth and as a result can’t move the tongue around. This can also prevent the tongue from contacting the anterior palate (roof of the mouth). This can then promote an infantile swallow and hamper the progression to an adult-like swallow
It often impedes speech.  

They are likely to breathe through their mouth. This leads to major facial growth problems including:

Open bite (where the front teeth do not touch with each other when the child closes the mouth). This happens because during swallowing the tongue sits between the teeth in the front part not allowing the jaws to come together.
Under develop and narrow upper jaw and thus causing crooked or crowded upper teeth due to lack of space for those the teeth
The lower jaw being trapped inside the upper jaw, this prevented it to grow properly result in an in big over bite. 

Mouth breathing is a breathing problem. 

 

Long term breathing problems are likely to lead to
 i. Snoring
ii. Sleep apnoea leading to tiredness and therefore ADHD
iii. ADHD
iv. Enlarge tonsil, which block the airway and in turn make the above problems worse
v. Multiple ear infections
vi. Bed wetting

 

Adults
Long term compensations for dysfunction can lead to many symptoms as below:.
-chronic head and neck pain from chronic subluxation of the head and neck
-severe sleep apnoea from severely underdeveloped jaws and airway
-chronic states of stress from chronic poor sleep and chronic pain
 
 
Treament: Laser Frenectomy
A frenectomy is the surgical elimination of the fold of mucosal skin under the tongue or the mucosal attachment of the lip (frenum).
Lasers are known to have advantaged over conventional scissors and scalpels. 
The advantages include: 
• More precise 
• Less damage to surrounding tissues 
• Bactericidal reducing risk of infection 
• Less discomfort and soreness during and after the procedure 
• Less swelling and inflammation post-treatment 
• Less bleeding 
• Better healing due to light energy encouraging cellular healing 
 
 At Best Western Dental Centre, we have nominated lasers… which remove tissue and cauterizes it, stopping bleeding immediately. The healing and recovery is faster due to the advantages listed above.  
 
 
Pain relief for treatment
We will apply topical anesthetic cream followed by a small dose of local anesthetic to the area of concern prior to laser treatment. This ensures that the patient does not feel a thing during the procedure.
 
The treatment
Once it is numb, it takes about 30 seconds to release the tongue/lip tie with laser. There is often no bleeding afterwards, no sutures and hardly any discomfort.
Children go to school the day after and adults can go back to work the same day.  Eating is normal.
Babies can suckle immediately after the procedure. 
It is advisable to have the tongue tie remove as early as possible. The reason being between the ages of 12 months and 5 years it is difficult to co-operate with children to ask them to stay still. Under 12 months of age, generally it is easy to hold the patient still for Dr Le to carry out the procedure. Older than 12 months, we preferably like to give sedation. For patients older than 5 years old, this procedure is done in chair under local anaesthetic if patient is cooperative enough to have the injection.
 
Post-treatment care
For children over the age of 4 weeks, parents may decide a pain-relief medication of their choice according to guidelines presented by their health practitioner approximately an hour before a feed. 
It is important to note that a small amount of bleeding is typical a few days following treatment and is not of concern.
 
Exercises to promote proper healing 
We recommended to do exercise for the area by applying repeated, gentle but firm pressure. These exercises are important to minimizing the reattachment of the frenum to its original position. 
The time it takes to see a noticeable change in functionality varies from patient to patient, from almost immediately to a few months following treatment. 
 
 
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