Posted by Dr. Julie Boudreault On 11-10-2023
Tongue tie is a condition where the frenulum (the piece of skin that runs along the floor of the mouth) restricts the movement of the tongue. In these cases, the frenulum is usually too short or in the wrong place. It can cause breastfeeding problems in babies and speech difficulties in older children.
Consequently, your Milton dentist will recommend a simple surgery to correct your child's tongue tie. There are several types of tongue tie surgery, which we cover in this post. We also go over how to prepare for your surgery, what recovery looks like, and what to expect in the long term.
Types of Tongue Tie Surgery
A frenotomy is a simple surgical procedure that involves snipping or cutting the frenulum with a sterile scalpel or pair of scissors. It can be done quickly with or without anesthesia since discomfort is minimal. Bleeding is also rare during the procedure.
In most cases, the baby can breastfeed immediately after the procedure and should be fully healed within a few days.
Tongue Tie Laser Surgery
Instead of a scalpel or scissors, we use a laser to sever the frenulum. These procedures are quick, lasting less than 15 minutes. Since the laser cauterises during surgery, bleeding and infection are rare. There is also minimal discomfort; most newborns can nurse immediately afterwards with little post-op pain.
Tongue Tie Electrocautery
Electrocautery surgery uses electricity to heat and cut the frenulum. As with laser surgery, this can help to reduce bleeding and speed up the healing process.
Sometimes, the entire lingual frenulum requires removal. During a frenectomy, a scalpel removes the frenulum under general or local anesthetic.
Frenuloplasty surgery is used to treat more complicated cases of tongue tie. For example, the lingual frenulum may be thick and located at the back of the tongue. Conversely, a prior tongue tie procedure may have failed.
During a frenuloplasty, the frenulum is cut and properly reattached with sutures. It is done under general anesthesia with surgical tools. Since the procedure is more extensive, there is a greater risk of scarring. Consequently, patients should perform tongue exercises that reduce the potential for scarring and enhance tongue movement.
Preparing for Tongue Tie Surgery in Milton
Your tongue tie surgery is scheduled in Milton. Now what? Dr. Julie and the team at Milltown Dental will provide instructions detailing how to provide for your child's tongue tie surgery.
Here are a few things you should know.
Eating and Drinking
Infants may breastfeed up until four hours before arrival and consume formula until six hours before. By scheduling their tongue tie surgery in the early morning, you can minimize the potential stress caused by food and drink restrictions.
It can be helpful for children to take Tylenol 30 to 60 minutes before their procedure. Some other medications, such as NSAIDS, may need to be avoided altogether before the tongue tie surgery. Your child’s doctor or dentist will let you know what (if any) medications they should temporarily stop taking. Also, inform them of any prescription or over-the-counter drugs your child is consuming.
What to Bring
Bringing something to comfort your child after the procedure is a good idea. For example, bring their favourite stuffed animal or blanket to the clinic. Since most infants can nurse soon after the surgery, we suggest also bringing a bottle. Feeding will soothe them, as well as encourage tongue mobility.
Recovery After Tongue Tie Surgery
Your child will likely feel groggy if they undergo general anesthesia. They will be discharged once they are fully awake and alert. With local anesthetic, on the other hand, it’s important to be cautious with eating or drinking until the numbness is gone. That’s why it’s better to opt for soft foods and avoid hot drinks instead.
A small amount of bleeding and discomfort is also normal after tongue tie surgery. Tylenol is best for pain management, although children older than six months can take ibuprofen instead.
In most cases, you won't have to worry about cleaning the wound left behind from your child’s tongue tie surgery. There is little chance of infection, and it should heal fine. However, older children and adults may still want to rinse their mouths with salt water a few times daily. This can be done the day after the procedure.
If your child received stitches after their frenectomy or frenuloplasty, these will either dissolve on their own or require removal a week after surgery.
Tongue exercises are essential to your child's recovery after tongue tie surgery. They will strengthen the tongue muscle and improve mobility and coordination. Additionally, exercises help prevent scar tissue from forming or the frenulum tissue from regrowing and reattaching.
It’s recommended to do these tongue stretching exercises several times daily for four to six weeks after your procedure. It may feel uncomfortable at first, but it is definitely worth it. Since your infant cannot do these exercises independently, you'll have to help them. Manually manipulate their tongues a few times daily to stretch the muscles.
Long Term Care
Although the healing and recovery time varies depending on the type of procedure, your child should notice some immediate results. For example, many infants can nurse far more quickly when the frenulum is snipped. (However, some babies will need longer to adjust!)
Older children should find that their speech articulation improves within one to three weeks. Nonetheless, they will likely need to continue speech therapy as they adjust to a more mobile tongue.
In some cases, a second tongue tie surgery is a requirement. Sometimes, the frenulum reattaches or scar tissue forms, once again restricting the tongue's movement.
Visit Milltown Dental for Tongue Tie Surgery in Milton
At Milltown Dental in Milton, Dr. Julie and her team offer tongue-tie surgery for infants and children. Your baby can easily breastfeed after a simple, quick, and painless laser frenectomy. Severing the frenulum also improves speech difficulties in older children and ensures healthy palatal development.
For more information on tongue tie surgery or to book a consultation, contact Milltown Dental in Milton, Ontario.