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Frequently Asked Questions
What are tongue and lip-ties?
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Tongue and lip ties are collectively known as “tethered oral tissues” or TOTs. They occur when the bands of tissue that connect the tongue or the lips to the mouth become overdeveloped to the point that proper mouth movement is restricted.
Minor tongue and lip ties may not cause any feeding problems or contribute to speech impediments. However, more restricted tongue and lip ties, including posterior tongue ties that are not as commonly diagnosed, can make it hard for your child to breastfeed or use a bottle properly, resulting in poor feeding and inadequate nutrition. Dr. Amy and Jill take a conservative approach to treating infants with tongue and lip ties and focus on improving your baby’s function prior to considering a release.
What are infant tongue and lip tie symptoms?
Many babies with tongue and lip ties may be able to latch to the breast and feed normally. The following lists are signs and symptoms that mothers and babies may experience if these ties are impacting breastfeeding. However, it is important to note that many of these signs can also be linked to other breastfeeding problems and are not solely related to ties.
Mothers may experience:
- Flattened nipples after breastfeeding
- Nipple pain or damage
- Decreased milk production
- Poor breast drainage leading to mastitis
- Prolonged feedings
Babies may exhibit:
- Noisy suckling or clicking
- Slow weight gain
- Poor latch
- Popping on and off the breast
- Gas or reflux symptoms
- Leaking milk out of the side of the mouth due to ineffective seal
- Curling in or lips during feeding
- Lip blisters
- Arched palate
- White milk residue on tongue
- Choking/coughing/exhaustion during feedings
How do I know if my child needs a frenectomy?
Feeding problems are the most common signs of tongue and lip ties. Your child’s lips and tongue need to be able to move properly to latch onto the nipple and stimulate it for proper feeding. If they seem to be having trouble making a proper seal, milk dribbles out from their mouth while feeding, or they frequently stop and start feeding, they may be having latching issues due to tongue or lip ties.
Some lip and tongue ties are easily visible with the upper lip having a prominent frenulum that makes it difficult to pull the upper lip up, or the tongue frenulum being attached closer to the tip of the tongue and giving the tongue a “heart-shaped” appearance. Other times, a tongue tie is not as obvious and may present as a posterior tongue tie, restricting your child from lifting the posterior portion of their tongue, and causing functional issues. Dr. Amy will be able to diagnose the level of your child’s tie and determine if a release is necessary. Rest assured, Dr. Amy is a conservative provider and will only recommend a release if she feels it is absolutely necessary.
Will my baby be in pain after their frenectomy?
Babies are generally fussier a few days following the procedure, as they heal and adjust to the range of motion from their newly released tongue and/or lip. We will give you some options for pain management in your post-operative instructions.
Are frenectomies covered by dental insurance?
Insurance coverage for frenectomies can vary. Because of this, you will pay the fee upfront, and we will courtesy bill out to your dental insurance company on your behalf. Your dental insurance will then reimburse you depending on your individual plan. If your child is not on your dental insurance, we can provide a superbill to you to submit to your medical insurance for reimbursement. If you have any questions about your dental insurance plan or our pricing, don't hesitate to give us a call to speak with one of our friendly, knowledgable team members!
What is recovery and aftercare like for frenectomies?
Dr. Amy, and her team will teach you proper stretches to perform for your baby to prevent re-attachment following the release. To view our stretching protocol, click on the “Parent Resources” page to watch our helpful stretching videos. Your care at Vibrant Beginnings includes follow-ups with Dr. Amy to check the healing sites, as well as a follow-up with our in-house occupational therapist Jill to provide customized exercises for your baby to help strengthen their tongue and achieve long-term functional results. Because the tongue is composed of muscles, the pre-and-post-operative exercises given by our occupational therapist to train and strengthen the tongue are key to your baby's success.
How soon will I see results?
While many mothers experience an immediate improvement in their baby’s ability to nurse, other babies may take time to relearn how to utilize their tongue and might require the help of other professionals. The tongue is made up of several muscles and when restricted by a tie, these muscles develop compensations to function. After the release, your baby’s tongue has no muscle memory of how to function effectively so your baby will need time to learn this new skill. You may even notice a little regression in the first day or two as your child learns how to use their unrestricted tongue.
Our in-house occupational therapist has specialized training in pre-and-post-frenectomy therapy to get your baby back on track. We have also carefully developed a local network of excellent providers in our area to assist your baby post-revision, should they need additional care.
