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Tongue, Lip and Buccal Ties (Frenectomies)
A frenectomy is a simple surgical procedure that removes the tethered oral tissue or frenal attachments in the mouth. The frenum is a connective tissue attachment that attaches two oral structures – the tongue to the floor of the mouth, the inside of the upper lip or cheeks (buccal) to the gums. Sometimes these attachments can be too tight and restrict the movement and function of the tongue, upper lip and cheeks. This can commonly cause problems breastfeeding or bottle feeding in infants. In older children and adults this can contribute to speech, breathing and digestive issues as well as heavily influencing facial development (narrow jaws and crowded teeth), contributing to dental decay and can cause a gap between the front teeth.
A frenectomy can be performed on people of all ages but is most commonly performed on infants. A frenectomy is sometimes needed before or during orthodontic treatment.
Traditionally, frenectomies were typically performed with a scalpel or scissors. At Magical Smiles, we use an advanced surgical laser to release the tethered oral tissue attachments. This means that there is less pain and incredible precision which enable release of both the anterior and posterior component of a tongue tie as well as no need for sutures.
Here is what you can expect, if you need a frenectomy at our Melbourne clinic.
We suggest a dose of age and weight specific pain relief if appropriate (*see below) and avoid feeding for a minimum of one hour in infants before the tongue tie surgery. It’s recommended to also seek supplementary treatment from a body-worker (chiropractor, osteopath or physiotherapist who is familiar with the treatment of tongue/oral ties and craniosacral therapy) both prior and post treatment. You can refer to our listing of local body-work practitioners who we trust and have experience.
Prior to any treatment performed you will have a consultation with the treating practitioner. During this we will discuss at length the benefits to treatment, the procedural details along with a thorough examination and diagnoses of your child. We will also discuss if any topical or local anesthetic will be used during the procedure as when treating infants usually the risks outweigh the benefits.
During the procedure
We request that parents stay out of the room during the procedure. The release itself is very quick and usually your little one is away from you for a short time, usually only 5-10 minutes with most of this time being made up of safety preparation. All people in the room, including the patient, will be wearing laser-specific safety goggles. Babies can cry during the procedure but please be assured we have a dedicated staff member present to care for your child whilst they are away from you and during the procedure.
After the procedure
We strongly recommend stretching the affected area. This will be covered and demonstrated in depth during the consultation. The aim of these stretches is to stop reattachment of the area and also to promote healing the tissues in a more “elastic” way.
Some parents find it challenging to do the stretches on infants. If so, an easy way to get access to their mouth and visualize the wound is to place your child’s head in your lap with the feet facing away from you as it was done during the consultation. Before you start, ensure that your hands are clean and your fingernails are short. Gloves aren’t required.
These stretches should be done 4 times, every 4 hours, for the first week. After the initial week and review appointment further instructions will be given as to the frequency required. The stretches should be done for 4 weeks post operatively. Be firm and thorough for the best results. Don’t be disheartened by your child crying during these stretches, instead try making it into a game or an engaging activity that your child can look forward to.
- For Tongue Ties:
Use your finger to sweep up from the floor of the mouth to the tip of the tongue, right over the wounded area. Additionally, position one finger either side of the wound under the tongue. Lift the tongue towards the roof of the mouth with the aim or stretching open the widest part of the diamond shaped wound. Do these 4 times, and repeat 6 times a day.
- Lip and Buccal Ties:
Use one hand to lift the lip out and up, so that there is a stretch. Run a finger of the other hand over the wound. Repeat this 4 times, and do it 6 times a day.
These stretches help reduce the chance of reattachment.
You will notice that the wound starts to appear white, yellow or grey. There is no need for alarm as this is the body’s natural response to heal and is essentially a ‘wet bandage’. Continue doing the stretches over the wound. It is ok to see a small amount of blood around the wound when you are doing the stretches.
Any recovery from this procedure is a rollercoaster, especially for infants. It is natural for your baby to feel irritable for a few days. Initially feeding might also take longer, especially to establish a latch onto a breast. Remember that the muscles are freer than they ever have been so new muscle habits need to be formed as the baby relearns how things work and explores with new movements. It is important to work with your lactation consultant and body worker to help overcome any muscle tensions and feeding obstacles. To help alleviate discomfort babies can have ice chips or even shards of thin frozen breast milk, along with continued pain relief (if appropriate).
*Please note that infants under 1 month should not be given any pain relief unless specifically instructed by your GP. Infants under 3 months should not use ibuprofen (Neurofen). If you have any queries please consult a medical practitioner prior to administering anything.
We understand that as a parent, you’d only want the best for your child. And we are here to offer just that. The team at Magical Smiles goes all out to make any dental treatment as comfortable as possible. Our team of experienced dentists have undergone extensive laser training and also dedicated training in infant ties. Reach out to us at (03) 8358 2565 to book a consultation for treatment of tongue ties in Melbourne.