Tongue Tie And Lip Tie Release

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Ankyloglossia, or tongue-tie, is a condition of limited tongue mobility caused by a restrictive lingual frenulum (the band beneath the tongue). The definition of ankyloglossia is not standardized, and there is wide variation of opinion regarding its clinical significance and optimal management.

Tongue tie can sometime demonstrate the following

Impaired side-to-side movement of the tongue
Heart shaped or notched tongue with protrusion
Tongue is not lifting up to the upper dental alveolus

During the examination with your doctor, he will assess for any signs of clinically significant tongue tie.

Upper lip tie

There is controversy regarding the significance of this. Important to understand that all newborns will have frenulum band at the upper lip. But not all of them will cause any issues. Some experts suggest a tight upper lip frenulum can cause issues with latching during breast feeding. Division of the upper lip tie is only advocated in such cases, which will be assessed at the time of the consultation with your doctor.

Some of the potential issues with tongue tie

Breast feeding issues- issues with latching or significant nipple pain to mum during feeding
Toddler or young child- speech articulation problems- Important to note that is it will not prevent vocalization or delay the onset of speech.
Olde or adolescent kids with mechanical and social problems associated with difficulties with restricted tongue movements

MANAGEMENT

It is recommended to consult with a lactation specialist and/or a speech pathologist based on the issues the child is facing because of tongue tie.
Definitive treatment is surgery – the decision regarding this will be taken following he consult between the doctor and the parents after discussing the benefits and risks of the procedure.

Tongue tie release or frenulotomy or Frenotomy is simple release or clipping of the frenulum. Procedure is a quick release of the tongue tie without local anaesthesia in infants with breast feeding difficulties.

The procedure is performed under direct vision, carefully avoiding injury to nearby structures. The infant is restrained by swaddling by a nurse holding the child’s head. The area is illuminated with a headlight or an office microscope.

There can be some bleeding following the procedure but it’s rare to have significant bleeding unless the child has a bleeding disorder.

Infants needs to be kept hungry for the procedure and need to be fed immediately after the procedure.

Potential but rare complications of the procedure could be

hemorrhage,
airway obstruction,
injury to surrounding structures,
scarring, and
recurrence – mostly if the post operative instructions are not followed properly

You will be given instructions on post operative care following the procedure – mainly regarding massaging or stretching of the tongue and floor of the mouth after the procedure until complete healing takes place which is generally a week to 10 days.

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Ankyloglossia, or tongue-tie, is a condition of limited tongue mobility caused by a restrictive lingual frenulum (the band beneath the tongue).

During the examination with your doctor, he will assess for any signs of clinically significant tongue tie