During infancy, the function of the tongue is essential in feeding from the perspective of getting proper nutrition but also for the development of facial anatomy. It’s very important that parents understand the importance of seeking an in-person initial oral examination by a professional trained in oral restrictions for your baby if you are experiencing any symptoms or feeding challenges. This examination can help detect a tongue-tie or other oral functional issues that may be impacting your baby. The first step is to work on oral function and body tension with skilled providers. If additional support is needed beyond therapy, a procedure to release tethered oral tissues may be indicated.
While we do not perform frenectomies for preventive reasons, left untreated, a tongue tie can lead to oral health challenges in adulthood, including difficulties with speech and sleep, as well as increased risk of gum disease, tooth decay and TMJ issues.

Consequences of Untreated Tongue Ties:

Impact on milk supply

Impact on sleep

Painful feeding

Mastitis, clogged ducts

Difficulty introducing solid food

Inefficient feeding

Poor weight gain

How do we treat infants with tethered oral tissues?

Infant Frenectomy

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Oral Frena are the fibrous attachments of the lips and tongue to the jaws, and they are structures we all have. Everyone’s oral frena are different based on many factors including genetics, epigenetics, and development. If the oral tissues are restrictive, it can negatively impact feeding early in life. Healthy tongue function is vital to infant feeding, sleeping, and growth, so identifying challenges early on can help get babies off to a good start. By collaborating with a team to help with healthy oral function and body movement, we can help improve infant feeding with a frenectomy when appropriate. This procedure is performed to relieve tension in restrictive oral tissues with a state-of-the-art CO2 laser for increased precision and improved healing. The procedure itself is brief, and infants are encouraged to feed immediately afterwards.

The pressure from the tongue during swallowing forms the shape of the jaws, and the jaw shape and position dictates how the face and airway will develop. So while infant feeding is important for nutrition, it is also crucial for development, which is why we are so passionate about our work with infants.

Performing a frenectomy is only one aspect of treating tethered oral tissues- we also need to teach the tongue how to move in a new way and release tension in the body. While some may notice an immediate change, usually improvement happens slowly over time when combined with the appropriate therapy.

Tips for Your Infant Frenectomy Visit:

We will have comfortable chairs available, but please bring any pillows or accessories you may need to aid in nursing.

You will have a private room to nurse.

Please have an alternate feeding plan available for the initial healing period. While many babies latch and feed right away, it is possible baby may not want to nurse immediately

Freezing milk in flat 1 oz increments to make breastmilk ice chips can help with wound care/You will be given a small syringe to take home. Having milk stored (either frozen orrefrigerated) to fill the syringe and apply to the site can also help with wound care.

Ideally baby should come “ready for a snack”. Not starving, and not having just eaten a big meal.

Have infant Tylenol (or your analgesic of choice) ready at home.

Infant Frenectomy FAQs

What is a tongue tie?
A tongue tie, or ankyloglossia, is a condition when the frenum under the baby’s tongue is restricted in its ability to move.
Why does it occur?
A combination of genetic and environmental factors contribute to the occurrence of tongue ties.
Should I see an ENT or dentist?

The tongue is a unique structure that falls in the scope of practice of both Ear Nose and Throat doctors as well as dentists. Both are licensed to treat tethered oral tissues, but more important is their post-graduate training. Tethered oral tissue diagnosis and treatment is not taught in medical or dental school, so providers must seek additional training to be knowledgeable in this area.

Those performing the procedure are knowledgeable about the anatomy. How babies feed and use their tongue involves specialties like Speech Pathologists, Lactation Consultants, and Occupational Therapists. Both are important in achieving best results.

What do you use for the procedure?
We utilize state of the art CO2 light scalpel laser technology.
How long is the procedure?
The procedure lasts a few seconds, and your baby will be with our team for a few brief minutes in total.
What is the ideal time to have a release?
This varies by patient, as feeding concerns may not surface until later in infancy. Ideally, we see patients during the newborn phase, less than 3 months old. However, we treat babies up to 1 year.

Infant post-frenectomy care