Feeding comfortably and efficiently is one of the most important aspects of a newborn’s life, and it should be a precious experience for all new parents. Lip and Tongue-Ties have complicated both breast and bottle feeding relationships, and they are not a new problem. However, in the past decade, there has been increased awareness of the benefits of breastfeeding, and this awareness has brought more attention to the problems associated with breastfeeding, such as Lip and Tongue-Ties.
A normal frenum is a band of connective tissue, bringing two soft tissue structures together. The lingual frenum is the connective tissue that attaches the base of the tongue to the floor of the mouth, and the labial frenum attaches the lip tissue to the gum tissue. In some cases, if that band connects too restrictively or is too tight, it may result in a condition known as a Tongue-Tie or a Lip-Tie. These conditions can jeopardize the beautiful nursing relationship between the breastfeeding parent and their newborn. Additionally, tethered oral tissues can impact bottle feeding as well as other types of feeding and we also see a variety of other long term consequences of untreated lip and/or tongue tie(s):
Many children struggle with transitioning from liquids to purees or table foods. When introducing solids, it is not uncommon to see some gagging on, pouching or cheeking of, and spitting out of food, but when these behaviors persist long after food is introduced, that is concerning. Some kids will swallow foods whole, gag on foods, and some will refuse foods they cannot manage, becoming picky eaters and having difficulty managing variable textures of table foods.
Cavities seen on the front part of the incisors or recession of the gums near the midline are often attributable to lip-ties. Cavities on the chewing surfaces of the molars are also often seen in patients that have a tongue-tie and never developed the reflex to use their tongue to clean sticky foods off their teeth after snacks or meals.
Many children develop air management and speech clarity or articulation problems due to the limited range of motion and elevation of all parts of the tongue required to produce various speech sounds like: /th d/n, st/sr/kh/gh, m/p/b.
Disordered Breathing and Sleep Apnea are often seen in children that cannot manage the proper posture and tone of the tongue muscle due to lip and/or tongue ties. Snoring, exhaustion, grinding of teeth, attention deficit disorders, behavioral issues are all now being connected back to sleep disordered breathing in the literature.
Many children will develop reflux or acid reflux symptoms from air intake that can lead to long term gastrointestinal issues as well as concerns for the health of back molars as the acid can damage the teeth and children with reflux will often grind those back molars.
Lip tie can cause a large gap between the front two teeth as well as crowding on either side of the tie for the front teeth. Tongue tie can also contribute to high arch palate which impacts the alignment of the upper teeth as well as how the upper and lower jaw bite together. Leaving ties unresolved can complicate these orthodontic symptoms, whereas treating them prior to teeth can prevent or alleviate some of these orthodontic issues.
How Are Tongue-Ties and Lip-Ties Treated Today?
A frenectomy procedure allows a baby to freely use their lip and tongue for an efficient, effective, and comfortable feeding experience. Thanks to the great advances in laser technology, most technologically-savvy and up-to-date healthcare providers are educated on the laser’s properties and why they are highly favorable in soft tissue procedures. Dr. Rishita’s experience in using Waterlaser allows her to provide desensitization, coagulation and cooling as it separates the tissue. The laser light beam is precisely controlled for the most thorough and safe procedure. Waterlaser eliminates the need for scalpel, sutures, or anesthetic in infant frenectomy cases. The newborns we treat can feed immediately after the procedure for comfort. Breastfeeding parents report a significant improvement in their comfort after the procedure, as well as an increase in baby’s efficiency and transfer. Bottle feeding parents also note an improvement with baby’s bottle skills. Regardless of feeding method, symptoms including gassiness, reflux, dribbling of milk, loss of seal on breast and bottle, are improved by allowing both the lip and tongue a full range of motion after the procedure.
Dr. Jaju and the Smile Wonders team have helped improve the quality of life for her patients ranging from infants to older children who are struggling with challenges associated with Lip and Tongue-Ties.
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