“Tongue-Tie Morphogenesis, Impact, Assessment and Treatment. Education based on well-performed research seems to be the solution… Although it isn’t the parents’ duty to provide this education, they may be the only ones in a position to do so. If the parents are fortunate, the physician will listen and respond by expanding his or her repertoire.” Allison Hazelbaker
At birth, your baby will be checked for common disorders and birth defects but one simple assessment is often missed. An oral assessment of the infant can be done to check for a midline defect that may affect breastfeeding, speech, and oral health. Checking under the tongue and upper lip for ties early can save a breastfeeding relationship. Why is it important to correct a tongue and lip tie? Dr. Larry Kotlow explains,
“The tongue is a remarkable muscle possibly misnamed, and is really part of a larger organ system of the head and neck. It is the only muscle in our body that has one end that moves freely, unattached to any other body structures and at its other end attached to eight other muscles.
During the embryologic development, this muscle is initially attached to the floor of the mouth. This attachment usually partially disappears and in most cases reduces naturally from the tip toward the base of the tongue. When this piece of tissue fails to disappear or reduce its attachment, it may restrict the ability of the tongue to function and have adequate mobility.
Problems which can be associated with ankyloglossia or a tongue-tie may include difficulties from birth to problems that may exist a lifetime. A tongue remaining abnormally attached may be responsible for allowing many concerns to develop” (KIDDSTEETH.COM).
It is important to note that revisions most likely will not be a quick fix that solves all of your problems and symptoms immediately. Your baby is so used to their tongue or lip restriction and using their tongues inefficiently. Their tongue needs to be strengthened and trained to be used efficiently not only for breastfeeding but for bottle feeding, speech, and oral health. After revision, it is very important to follow up with a professional who is familiar with post revision exercises like an IBCLC. It can take several weeks before you see significant improvement with the latch but many mothers report that the nipple pain subsides or significantly decreases within the first few days post revision. Cranio Sacral Therapy (CST) is also recommended before and after revision. It is important to find a Lactation Consultant who is experienced with tongue and lip ties who will refer you to the appropriate professionals.
Q: What are the symptoms of tongue ties and upper lip ties?
A: Symptoms vary from infant to infant and from mother to mother. Symptoms include pain during breastfeeding, nipple trauma, failure to thrive, slow weight gain, reflux, recurrent plugged ducts and/or mastitis, failure to maintain latch, clicking noises while nursing, and an uncoordinated suck, swallow, and breathe pattern.
Q: Do all tongue ties and lip ties need to be revised?
A: No, not all tongue and lip ties need revised. Appearance alone will not determine whether the ties will need revised and not all ties have symptoms. You should be evaluated by a professional who has experience with tongue and lip ties and can perform an oral evaluation to check the function of the infant’s tongue along with evaluating you for any symptoms you may be experiencing.
Q: Where can I find more information?
A: There are several resources available. KIDDSTEETH.com is a great starting point. If you would like research articles please contact me. I have several peer reviewed scientific articles and can email them for you to review. There are also some support groups on Facebook, National TT and ULT Support Group and Local TT and ULT Support Group.
Q: If I choose to not revise my baby’s tongue tie or upper lip tie, will they have problems later in life?
A: It is possible. Here are some potential problems,
Potential problems for infants
- Inability to sustain a latch with increased risk of prior listed tongue-tie problems
- Orthodontic problems: large gaps between from teeth, relapse after orthodontic care
- Painful latch once upper front teeth erupt
- Dental decay on upper from teeth when still nursing
- Speech problems
- Esthetic problems
- If cut due to injury, may bleed extensively (KIDDSTEETH.COM)
Potential problems as an adult
- Periodontal disease
- Esthetic problems with smile lines
- Poor oral hygiene (KIDDSTEETH.COM)
Q: Why is laser revision preferred?
A: There are several advantages to a laser revision.
- No need to place infant under sedation or in the operating room
- Bactericidal: virtually no chance of infection
- Reduced post-surgical swelling, pain, discomfort
- Significantly reduces risk of any bleeding
- • Procedure takes less than 2 to 3 minutes in the dental office
- • Infant is away from mother for less than 10 minutes
- • More precise surgery (KIDDSTEETH.COM)