Infant Frenectomies

Everyone has tissue that looks like a band or a cord that is attached from the floor of the mouth to the underside of the tongue. This is most often called a “frenum” but may also be referred to as a “frenulum” or “frenula”. If the frenum restricts the proper movement of the tongue then it is considered “tied” and may need to be released to improve function and movement. Just because you can see the frenum does not mean that it is restrictive or “tied”. If you are concerned that your baby may have a tongue tie, you should be seen by a provider trained to evaluate their tongue function. Board certified lactation consultants (IBCLCs) are a great place to start. Not all dentists, pediatricians, or even ENTs are trained to properly evaluate for restricted tongue function.

Similar to the tongue, the upper and lower lip also have a frenum that runs from the lip to the gum tissue. It has a similar appearance to the frenum under the tongue but sometimes it can be very thick, wide, or overly restrictive. Over 80% of babies have an upper lip frenum that attaches low on the alveolar ridge (the bony ridge that will eventually be full of teeth). Just like with the tongue, it is very important that a provider evaluates the function and not base a diagnosis solely on the appearance. Often the upper lip frenum will move upward as the child grows so a release is only recommended if the lip is impacting function (breastfeeding, bottle feeding, or proper cleaning of teeth if present).

Before any surgical intervention it is important to have a functional assessment and diagnosis.  Dr. Annie works closely with other providers in our community to ensure that a baby is properly prepared if a tongue/lip tie release is needed.  A diagnosis cannot be made simply by looking at the tongue or seeing if the baby can stick his/her tongue out.  In fact, for nursing (and growth and development) it is more important to assess whether the tongue can properly lift.  Dr. Annie encourages parents to work with an IBCLC as well as a body-work professional (like a pediatric physical therapist or chiropractor) prior to being seen in our office for an assessment.  This is because improper feeding habits, as well as body tension elsewhere in the body, can make it seem like the tongue is the problem when it is not the main issue.  By working with these providers prior to release assessment we can avoid unneccesary surgical intervention. 

After a thorough functional assessment, Dr. Annie will help you determine whether your baby may benefit from a tongue/lip release.  She carefully considers your and your baby's unique situation, needs, and goals to help you decide if and when you would like to move forward with releases.  

She will swaddle your baby and apply a topical anesthetic to help keep your baby comfortable during the procedure.  Dr. Annie uses a state-of-the art LightScalpel CO2 laser which is ideal for procedure accuracy, speed, patient comfort, and post-operative healing.  The procedure itself takes less than 5 minutes and you are welcome to feed your baby right after the procedure.  

Dr. Annie prefers that you coordinate with your IBCLC to be seen 1-3 days after the procedure so they can monitor wound stretching and be a source of support during the post-procedure period.  You will also be scheduled with Dr. Annie for a one week post-op appointment for her to evaluate healing and discuss any progress or concerns you may have.