Dr Samintharaj Kumar
Tongue Tie and Lip Tie Release
This page provides a broad range of information about tongue and lip ties and their treatment at Nuffield Dental Clinics. The information contained here forms a critical part of the pre-reading for parents bringing their infant or toddler to improve your understanding of the procedure and postoperative care. Please kindly read all of the information contained here prior to your appointment so that your valuable appointment time can be dedicated to any specific questions you have.
Some of the challenges new mothers face with breastfeeding can be related to tongue or lip tie. Both of which are conditions that can be easily treated.
Ankyloglossia or tongue tie is a congenital condition where the lingual (tongue) or labial (lip) frenum (sometimes called frenulum) is too tight, causing restrictions in movement that can cause significant difficulty with breastfeeding initially. Left untreated, there are other reported implications including speech, dental, swallowing and digestive issues.
Common symptoms of a restrictive tongue/lip include poor ability to latch or inability to stay latched, sliding off the nipple, falling asleep at the breast, regular clicking during a feed, poor weight gain, maternal nipple pain or damage, increased maternal nipple or breast infection, compromised maternal milk supply, dribbling milk at the breast/ bottle and even digestive issues such as increased gassiness or reflux due to additional air being swallowed and poor control of the milk during swallowing.
Adults frequently present in my clinic where they might not have had treatment before. Common problems that they might have include pronunciation difficulties and restriction of tongue movement.
Tongue or lip ties present in many different shapes and forms. Often health care providers only look for very prominent, classic tongue ties that often create a heart shaped tongue. However, tongue ties can be deceptively hidden in the base (back) area under the tongue and cannot be easily seen and diagnosed. Critical for proper identification are not only a visual examination but a thorough investigation of the functional challenges as well as a manual examination of the mouth.
When the diagnosis is made after full investigation and the surgery is done correctly (where there is thorough removal of the restrictive attachment) the potential complications a tongue or lip tie makes to challenges with feeding can be eliminated. Laser or conventional scalpel surgery allows a layer by layer, thorough removal of the attachment of lip and/or tongue tie.
Lasers or Scissors/ Scalpels can be both utilised as means to treat this condition. In laser terms the tissue is “ablated”. Light energy is used to incise tissue rather than cutting which occurs with scissors or scalpels. The use of lasers in surgery has a distinct advantage over other methods for a number of reasons: it reduces the collateral damage as it is more precise and removes skin layer by layer, it is bactericidal (kills bacteria as it ablates), reduces oedema, swelling and inflammation and therefore allows for better healing through the concept of photobiomodulation.
Dentists using lasers need to be properly trained in laser physics and laser safety. They are required to complete a suitable course on laser oral surgery. Both surgical methods of treating lip and tongue tie require a good knowledge of the purpose of the surgery as well as the necessary post-operative care.
Treating the breastfeeding infant is not merely a quick “snip”. It involves informed consent by the parents and a thorough clinical examination by an expert in the oral environment. In addition, parents will have to participate in the care by doing massage and stretching exercises which I will teach you.
During your consultation, I will evaluate your problems and inform you of various treatment options. If you wish to proceed, kindly let my team know and they will arrange a time and date for the procedure. Most surgical services at Nuffield Dental can be performed under Local Anaesthesia, General Anaesthesia or intravenous sedation. (as requested by nervous patients)
Lip Tie and Tongue Tie Surgery may be done under Local Anaesthetic, IV Sedation or General Anaesthesia.
In the video below, I demonstrate how I perform careful meticulous tongue tie dissection and release in an adult.
** In this instance, I am not using a laser for tongue tie release.