Frequently Asked Questions

Questions about treatment considerations

What Are the Symptoms of Lip Tie/Tongue Tie in newborns and babies?

There are a variety of symptoms associated with lip tie and tongue tie that may present at different milestones of life.

At birth, babies with lip tie and tongue tie may have difficulty with latching at the breast, sustaining a latch, and nursing efficiently. Nursing-parent often reports significant discomfort, nipple damage, and milk supply concerns due to inefficient drainage of the breast. Many babies struggle to maintain a seal with their lips and tongue on both the breast and bottle nipple and dribbling of milk, and pulling off to gasp or cough during feeds is fairly common. Air Induced Reflux leading to excessive fussiness, arching, low intake, frequent small feeds or copious amounts of spit up are noted by parents of babies with restrictive oral ties. Some babies may have difficulty with transitioning to solid table foods or purees as they cough and gag on textured foods.

Does My Baby Need a Frenectomy?

Whenever we are considering a surgical procedure for an infant, we take into account both the necessity and optimal timing of treatment in order to help our baby get the best possible post-procedure outcome. If tethered oral tissues (TOTs) are negatively impacting feeding, speech, sleep and/or oral development, Waterlaser treatment may be beneficial in conjunction with therapeutic interventions both before and after the Waterlaser procedure.

Can Tongue-tie or Lip-tie Resolve Itself?

Tongue-tie and lip-tie do not ‘resolve’ themselves. Sometimes, trauma to the tissues can occur, like a fall, which can change the appearance and impact of the tethered tissue on the surrounding oral structures, but as a philosophy, we do not think of physical trauma to the site as ‘resolution.’ In many cases, if the ties are not treated surgically, children are able to find ways of compensating around the ties in order to do “well enough” with eating/speaking, etc., but the compensations are usually developed in the absence of proper oral motor function, and laser lip and tongue tie revision are often needed in order to help establish proper oral motor function at some point during the course of development.

If my child has a lip-tie does that mean they will have a tongue-tie?

What are buccal ties?

Can you share some research articles about lip and tongue ties?

What additional evaluations/therapies may be recommended and/or required pre/post-procedure, and why?

Collaborative, team-oriented care is a cornerstone of our record-high rate of long-term successful outcomes.

Our doctors want to make sure that our families have an established support system and care with a feeding specialist like an IBCLC or feeding therapist to help prepare for the procedure. This ensures functional improvement with feeding after the procedure.

Based on clinical findings, doctors may also make referrals to bodywork providers such as infant massage, craniosacral therapy (CST), physical therapy, occupational therapy or chiropractic care for overall wellness both before and after the procedure. In many cases, referrals may be recommended while in others such supportive care may be required prior to providing the frenectomy procedure. The clinical team provides detailed and stepwise guidance for our parents so that we can get our babies treated quickly and effectively in the right sequence!

How can we find the best provider for my baby’s tongue tie frenectomy?

Not every frenectomy provider has the experience, skill, and knowledge to treat tethered oral tissues, but it can be crucial for both you and your child to find an experienced frenectomy provider to get the best post-procedure outcome. When searching, you can take some steps to find a good fit.

Is there a difference between the treatment approaches and outcomes for different types of laser?

Waterlase is one of the only dental lasers that is biocompatible, protective of all tissues, and a multi-purpose laser that can be used for treating hard tissues such as teeth and bony structures, as well as soft tissues like gums, lips, tongue, and more.

Questions about procedure day

What can I do to prepare for my baby’s frenectomy?

Dr. Rishita Jaju reviews the 5 steps to prepare for the most effective and smooth experience during your baby’s Tongue and Lip-tie Laser Frenectomy procedure.

Is the surgery painful? How is the baby's pain managed during the procedure? Do you give anesthetic during surgery?

Waterlaser virtually eliminates the need for scalpel, sutures, or anesthetic in infant frenectomy cases. The newborns we treat can feed immediately after the procedure for comfort.

How does laser surgery compare with use of blades in tongue/lip tie surgery?

Thanks to the great advances in laser technology, the most technologically-savvy and up-to-date healthcare providers are educated on the laser’s properties and know why they are highly favorable in soft tissue procedures. The laser’s ability to coagulate as it releases tissue allows better healing of the surgical site. Lasers virtually eliminate the need for scalpel or sutures, in most frenectomy cases.

Will there be pain after the surgery? What can I do to help with comfort-management after the procedure while at home?

We will give you written instructions on pain management with age/weight appropriate dosing of Infant Tylenol. We recommend using your usual methods of soothing your baby, including swaddling/shushing/snuggles, etc. but when your baby is not easily soothed or discomfort seems to be impacting the quality of feedings, use of Infant Tylenol is also recommended.

Can I be present in the room while my child is having the procedure?

Aftercare Questions

How soon after the procedure can I feed/nurse my baby?

We encourage you to feed your baby right after the procedure. We typically like to show you the surgical sites and demonstrate exercises prior to the feed so that your baby is soothed immediately afterwards by feeding.

What are recommended wound-care exercises & stretches?

What is the importance of wound stretches and is it really necessary?

Are there any restrictions on activity or travel after surgery?

Is a follow-up visit necessary?

How common is reattachment?

The incidence of reattachment in our office is extremely low! Less than 1 percent.

This is possible mainly due to 2 important factors:

Our doctors are highly skilled providers in the mid-atlantic area and maintain a highest level of training in the use of Waterlaser. This ensures safe and thorough/complete release of the restrictive tissue.
We focus on supporting the parents after the procedure by providing detailed site management exercises, staying in close contact with them (and their providers) via text/phone/email. The aftercare protocol is customized to the needs of each baby and family at the follow up visits that are a part of our service.

Is it normal to notice a frenulum again in my baby’s mouth after frenectomy?

After infant frenectomy, it is very common for a healthy new frenum to form. The goal is for the new frenum to maximize functional results of the procedure and have proper development of the mouth and face. The new frenum is less prominent as well as soft and supple to allow for a full range of motion for the tongue and lip.