Posted by Dr. Julie Boudreault On 7-06-2021
Tongue-tie, or “Ankyloglossia” occurs when a child’s tongue is fused to the floor of the mouth because the “frenulum” is either abnormally short or attached too close to the tip of the tongue. The frenulum is the piece of skin that attaches the tongue to the bottom of the mouth.
When the attachment is too tight, it causes issues for your child, including making it difficult to feed. When this happens surgery for tongue tie is recommended. The “frenectomy” is performed at Milltown Dental by our dentist, using laser surgery. The procedure allows your baby to move their tongue for easier feeding and normal development. Here’s how to care for your child’s mouth following tongue tie surgery.
What is a Frenectomy?
At Milltown Dental, we use simple laser surgery for tongue tie to quickly separate the frenulum from the tongue. The laser allows for a cleaner cut to separate the tissue making it safer and more comfortable for your baby. You can hold your baby during the procedure so they remain calm and comfortable. We recommend laser surgery because it offers many benefits including:
- Very rare bleeding as the laser cauterizes during the surgery
- No infection
- No needle required
- No sutures
- None or very minimal post-op pain as the laser seals the nerve endings
- No recovery time required
- Immediate successful feeding
What to Expect Following Surgery
Following surgery for tongue tie your baby will experience some discomfort for a day or two. However, they will be able to feed right away. In fact, if you breastfeed, the skin to skin contact acts as a natural form of pain relief. If your child seems very fussy and uncomfortable, you can give them a pain killer for babies such as acetaminophen following the instructions for dosage.
Expect to see yellowish or white skin at the surgery site. This can take a few weeks to return to a normal colour. It might be a little scary as it often appears there is pus at the wound site. However, the discolouration is perfectly normal.
After about two weeks, you’ll slowly see the wound start to narrow as the healing proceeds. If you do feel the wound looks particularly red and irritated, and you are worried there is an infection, don’t hesitate to call our office if you see any of the following:
- Uncontrolled bleeding
- Your baby won’t feed
- Your baby has a fever
We will see your baby right away to look for signs of infection or complications. In most cases your baby will not experience these issues and will heal more and more each day.
Tongue and Lip Stretching Exercises
The best way to help your child heal following surgery for tongue tie is to perform some routine stretching exercises. If you check under your baby’s tongue you will see the scar from the surgery. This is your target to help you ensure you perform the tongue exercises properly.
Always be certain to thoroughly wash and rinse your hands before you begin. Here are the stretching exercises to perform for the lip and tongue:
- Upper Lip: Place your clean finger under your child’s upper lip placing it at the very top, and move your finger gently from side to side for a few seconds.
- Tongue: Next, insert both index fingers into the mouth gently under the tongue and lift the tongue towards the roof of their mouth. Then follow these stretches:
1. Lift the tongue as high as it will go very gently and hold it for a second or two and then let it fall back onto your finger. This is important as it keeps the tongue from reattaching to the floor of the mouth. The ideal position for your fingers during this exercise is to keep the two fingertips touching for full support and a better lift. You don’t want to be lifting from the sides, as you need to be under the tongue to prevent the fusion.
2. Next, use one finger to prop up the tongue and then place your other finger in the center of the scar site. Turn this finger sideways to help lift the tongue higher. This requires a very gentle touch as you are working right at the site of the wound. You want to apply just enough force to gently separate the horizontal fold across the wound, but you also don’t want to cause pain or interfere with the healing at the site.
3. Finally, gently massage both sides of the wound area to keep the muscles loose on the floor of your baby’s mouth. This will ensure proper movement as the wound heals. Since you aren’t touching the wound itself during this stretch you can use a bit more pressure. Gentleness will keep your baby more comfortable during the exercise.
Sucking exercises help the baby learn to suck properly with their new tongue, while also making sure they don’t become scared or nervous that if something enters their mouth it automatically means they will experience pain. Do the following exercises for 30 to 45 seconds each starting the third day following their frenectomy:
- Gently and slowly use your finger to rub your baby’s lower gumline side to side. Your baby should start following the movement with their tongue which will help them learn how to properly move their tongue laterally.
- Use your finger to entice your child to suck, and slowly pull your finger out so your baby will instinctively try to suck your finger back into their mouth. This step can be done with a pacifier as well. The exercise helps strengthen the tongue. However, if your baby becomes frustrated, stop the exercises and move on to the next step.
- Place your finger in your baby’s mouth and as they suck apply gentle pressure to the top of their mouth. Then press down on their tongue so your baby pauses the sucking. Then put your finger back to the top of the mouth to encourage the sucking again. Repeat this a few times. Again, if they seem frustrated move onto the next step.
- Place an index finger inside your baby’s cheek and then place your thumb on the outside of the check and massage from side to side to reduce tension.
By following these post surgery for tongue tie tips your baby will experience the full benefit of the procedure. For more information call Milltown Dental at (905) 878-8528 or CONTACT US HERE.