Frequently Asked Questions
I’ve seen a pediatrician, lactation consultant and another dentist. Each of them told me something different. Why does everyone have a different answer?
Tongue and lip ties are a controversial topic. Minimal emphasis is placed on tongue and lip ties in medical and dental school since the 1950’s when infant formula was widely accepted. For this reason, most providers do not know how to properly evaluate and diagnose tethered oral tissues. There is also a misconception that we “outgrow” our ties, which is incorrect. If a provider wants to be informed about tongue and lip ties they must seek substantial extra education. Even when the extra education is pursued we are left without an internationally standardized way to diagnose the ties, so there is not a common language between providers. With your permission, I communicate anatomical and functional findings back to your support team (pediatrician, lactation consultant, midwife, doula, chiropractor, craniosacral therapist, etc.) so we can all learn and work together to achieve your personal goals.
Do tongue/lip ties impact life beyond breast or bottle feeding?
Absolutely! Catching these restrictions early allows you to prevent many potential issues. Tongue and lip ties are correlated to deficiencies in; speech, growth, development, feeding (picky eaters, taking a long time to eat), sleep, and breathing. It is also common to struggle with acid reflux, neck/shoulder tension, migraine headaches, tension headaches, TMJ discomfort, clenching and grinding, forward head posture, open mouth breathing, snoring obstructive sleep apnea and more.
Why do you recommend working with lactation consultants and bodyworkers?
Pursuing a frenectomy should be somewhat of a last resort. Being diligent to rule out other contributing factors to feeding challenges prevents unnecessary (even minimally invasive) treatment. A lactation consultant will help improve latch and positioning, evaluate milk supply and transfer. Bodyworkers will unwind tension surrounding birth and gestational positioning and help with cranial nerve integration and spinal alignment. It would be negligent for me to perform treatment without first addressing these non-invasive options. Lactation and body work also promote a smooth and easy healing period. Working with these providers creates a whole team working toward your goals and sets you up for success!
What does an infant frenectomy procedure look like?
Your baby is placed in a swaddle, protective glasses are worn, and topical numbing gel is placed on the areas we will be treating. A before photo is taken. Cotton gauze is used to hold the lip or tongue and then a CO2 laser is used to release the ties gently and effectively. The frenectomy generally takes 5-10 seconds of laser time per tie. An after photo is taken and then your baby is given back to you. You’re welcome to be in the treatment room, or not…whichever you prefer. Your baby will be able to feed right after the frenectomy.
Will this hurt my baby?
Some amount of discomfort is expected following a frenectomy. This is typically quite manageable. I recommend being prepared to use something to treat discomfort for one week. The first 3 days are typically the most challenging. Pain control may be homeopathic or traditional. Every family is different and there are great pain control options for every situation.
When will I notice improvement?
Expect one better feed each day. By the end of the first week, you should have mostly improved feeds. Many families notice improvement in the first 24 hours, which is wonderful…but we aim for gradual, sustainable improvement.
How long does it take to recover?
External healing is complete in about 6 weeks. Lips and cheeks heal faster than tongues. A new frenulum will form in a better location, guided by proper exercises at home. This allows improved function and range of motion. Exercises are completed 4-6 times per day for 6 weeks.
Will my insurance cover this?
Every insurance is different. You can request reimbursement from medical or dental insurance. I am considered out-of-network, so you may want to be sure your insurance doesn’t prevent you from seeing an out-of-network provider. I will provide you with the medical and dental codes so you can pre-authorize with your insurance if you desire. I provide a detailed invoice and am happy to write a narrative if your insurance requests this. Many of the families I work with are successfully reimbursed (at least partially) from their insurance.
Do you treat older children and adults?
Yes! It is never too late to experience relief from the symptoms associated with tethered oral tissues. When treating children I do not restrain or sedate. I want your child to be actively involved in his or her treatment, which includes giving them autonomy over their body. As we age, our bodies compensate for the lack of tongue function. For this reason we must establish adequate tongue space and tongue strength before proceeding with treatment.