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What to do about tongue tie

Are you facing a tongue tie diagnosis and wondering what to do about it?

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If you suspect that you or your child could have tongue tie (ankyloglossia), it can be a lot to take in. The decisions you make (or don’t make) about an oral restriction could have repercussions for life. 

If you are a parent facing the issue of baby tongue tie, you know that the choices you make early on will make a big difference in your child’s development over the years. Oral tethers can affect vital functions such as breathing, sleeping, and eating.

Addressing an oral restriction is more complex than a simple “snip”. Having a collaborative circle of healthcare professionals from multiple fields can help before, during, and after a release procedure.


Wondering how to deal with an oral restriction?

These three steps will help you address your own or your child’s tongue tie, lip tie, or buccal tie and chart your path towards better health:

  1. LEARN and empower yourself about oral restrictions.
  2. TRUST the circle to guide you and find the answers and care you're looking for.
  3. THRIVE and grow your unique circle of healthcare providers who can help.


 

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Step 1: Learn & empower yourself

Find research and access education to guide your decisions

Although there is still a lot of research to be done around oral restrictions and their effect on health, more information is available than ever before.

  • Empower yourself with evidence-based reporting and case studies.
  • Use critical thinking to analyze information and sources.
  • Talk to parents and patients who can tell you first-hand about their experience dealing with oral restrictions.
  • Follow your instincts if something isn’t right with your health or the health of your child.
  • Continue to ask questions and keep investigating until you find the answers and support you need.


There are many common misconceptions about tongue tie. You might read confusing or conflicting information from various sources, or even come across healthcare professionals who are dismissive of the role of oral restrictions and your health.

Why is this? Part of the reason for the lack of awareness about tongue tie among medical professionals is that so little time in medical school is devoted to oral health. Even in dental school, oral restrictions are minimally addressed, depriving healthcare professionals of important knowledge that could help them spot the symptoms early-on, and prevent health issues later in life.

Thankfully, this is changing as more clinically validated information is made available to the medical community and the public at large.


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Step 2: Trust your healthcare providers

Surround yourself with a circle of people who understand

Clinical providers who treat oral restrictions are beginning to connect the dots between the tiny tether under the tongue and overall health throughout life. More research is needed to understand the link between oral restrictions and health problems such as sleep apnea, asthma, and even possible connections with ADD, ADHD, and mental health.

That is why the first step is to surround yourself with a supportive and knowledgeable community who can help you navigate your choices.

By bringing together healthcare professionals across a variety of fields, the health:latch circle helps parents and patients to assemble a personalized team to accompany and guide their journey towards better health.

Timing counts

The ideal time to diagnose and treat tongue tie is between 6-14 days after a baby’s birth. This is why it is so important for parents, lactation consultants, midwives, pediatricians, and other healthcare providers to be aware of and on the lookout for oral restrictions in babies.


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Step 3: Thrive with your circle

Feel the support of a community with your health at heart

Because it is an emerging field, there is still much education to be done to help healthcare professionals identify an oral tether issue. Unfortunately, some healthcare professionals who are not alert to oral restrictions may fail to notice the symptoms. Make sure that your healthcare provider can identify when a patient is compensating for their condition, even if they don’t present the classic symptoms of a tongue tie.

To this day, some healthcare professionals may avoid treating an oral tie saying that it will “stretch” or that your child will “grow out of it”. This goes against the advice of many oral restriction experts who believe that ignoring a tongue, lip, or cheek tie can cause short and long-term health problems.

The long-term effects on overall health and development make it important to get an examination with a specialist who can either diagnose an oral restriction or advise you to continue to monitor symptoms. The health:latch circle will allow you to assemble your team of healthcare professionals who can assess and diagnose whether or not your child has an oral restriction.

It's important to talk to a professional who is alert to the subtle, yet important symptoms and oral restriction. A registered nurse or lactation consultant who knows about tongue tie can listen to what you are going through and make a referral to a healthcare professional such as a pediatric dentist who can make a diagnosis and provide the release procedure.

Just as there are risks associated with any medical procedure, there are also risks of doing nothing. The health:latch circle can help you access clinically validated information, ask questions to healthcare professionals, and listen to various perspectives so you can make an informed decision.

 

Get solutions & support

If your child is diagnosed with tongue tie, the main treatment is a surgical procedure to release the membrane to allow normal movement. The type of healthcare professional who can perform the release is known as a proceduralist and can be a dentist, doctor (including a pediatrician), naturopath, or nurse practitioner.

Once you’ve decided that you or your child needs a release procedure, keep the following important aspects in mind:

  • Timing - the sooner the better
  • Type of procedure - frenectomy or frenotomy
  • Tools and technology - laser or scissors
  • Proceduralist - experience & technique
  • Follow-up care - therapy and treatment


If you or your child has an oral restriction, you want to have a well-timed release procedure with a skilled proceduralist. Do your “homework” to make sure that your proceduralist is known for having excellent technique and uses the highest quality tools and technology. It is very important to select a healthcare provider who has both experience and up-to-date medical training in the release procedure.

 

Types of tongue tie surgery

The procedure to release an oral tie usually takes a few minutes to complete. There are two main types of procedures for releasing an oral restriction. Before the invention and use of medical lasers, scissors, scalpel, or clippers were the main tools used. Now, modern technology allows for improved technique, less pain, faster healing and better outcomes.


As you explore your options, it's important that you know the difference between a frenectomy and a frenotomy.

 

Frenectomy

Frenotomy

Uses laser technology to eliminate tissue restricting the tongue or lip Uses scissors or scalpel to “clip” or “snip” restricting tissue
Precise removal of restricting tissue Separation of restricting tissue
Better visualization of all main and accessory fibers restricting the tongue Limited visibility of the restriction
More consistent results Less consistent results

 


 

Wondering which procedure is right for you?

The advantage of seeing a proceduralist who specializes in oral tie release procedure means that they have invested in the technology and perfected the technique. Many tongue tie specialists consider the CO2 cold laser “gold standard” for infant frenectomy because it provides better visualization (especially for posterior tongue tie, which is harder to see), gives consistent results, minimal pain, and faster healing for the baby.

 

What are the risks?

If a release procedure is not done properly or fully the first time it could cause scar tissue to build up, or fail to fully resolve the physical problem. The patient might need another procedure in the future to correct this. This is why it's best to “get it right the first time” with a proceduralist who specializes in treating oral restriction.

You want to make sure that the health professional that sees your child is very familiar with oral restrictions and uses a full-health approach, not just a “quick snip” fix that is unlikely to deliver the long-term results and support you need.

A whole-patient approach can take into consideration factors that can help with healing and recovery. For example, a dietician can adjust a nursing mother’s diet to give the baby the best oral environment for healing.

 

Questions to ask your proceduralist:

  • How often (how many procedures per month) and for how many years have you done this procedure?
  • Do you take photos before and after? Can I have the photos?
  • Can you describe my after procedure exercise and demonstrate them on the patient after the procedure?
  • What type of tools and technology do you use?
  • Where and when did you train in this technique?
  • Which healthcare providers do you work with or recommend with for ongoing therapy?


Follow-Up Care

One of the biggest mistakes that a parent can make is to assume that an oral tether release is a “miracle procedure” that will instantly solve your baby’s breastfeeding issues or your child’s airway issues.

We wish it were so. While in many cases the “before and after” effects of an oral tie release procedure are dramatic, for many it is actually just the beginning of a journey towards integral health.

The longer a baby or child has compensated for their oral restriction, the more therapy will probably be needed to resolve functional and structural problems. It is vital to have a long-term plan with a qualified team of healthcare professionals for lasting improvement and wellbeing.


Functional and structural support

Oral restrictions can impact and modify both structures and functions in the body. Healthcare professionals who can support you or your child can be broken down into two basic categories: Functionalists and Structuralists.

As the names imply, Functionalists can help improve and rehabilitate the function of the mouth, while structuralists focus on adjusting or repairing the physical structure of the body. For example, a functionalist such as a speech pathologist can help a child with a lisp, while a structuralist such as an orthodontist can help correct jaw alignment with braces.

Functionalists and Structuralists can help you prepare for the release procedure. They can also provide therapy and support afterwards.

For example:
  • Occupational therapy can help patients recover important mouth and jaw mobility for daily activities.
  • Holistic approaches such as myofascial therapy (also known as myofascial release) and craniosacral therapy, have been reported to ease tension and tightness caused by oral tether issues.
  • A naturopathic physician can help a patient tap into their body’s self-healing abilities and usually take a whole-health approach to recovery.

Functionalists can include:
  • lactation consultant (IBCLC)
  • craniosacral therapist (CST)
  • occupational therapist
  • speech language pathologist (SLP)
  • doula
  • midwife
  • myofunctional therapist
  • physical therapist
  • registered nurse (RN)
  • dietician
  • dental hygienist
  • posturologist
  • massage therapist
  • nutritionist

Structuralists can include:
  • chiropractor
  • ENT (ear, nose, and throat doctor/or Otorhinolaryngologist)
  • general dentist
  • general surgeon
  • naturopathic doctor
  • oral surgeon
  • orthodontist
  • physical medicine specialist

 

Getting started

Are you ready to create your circle of support? health:latch was created to make this easy and simple.

The health:latch circle is a radically kind and defiantly joyful online community of parents, patients, and professionals across healthcare fields who know the issues of airway health, oral dysfunction & oral restrictions inside and out, and hold your best interests at heart.

Becoming a member of the health:latch circle is FREE for parents will allow you to access information, connect with professional care and get answers from specialists.


Learn more about creating your unique circle of care here.

want to keep learning?

Click here to return to the LEARN page and explore more resources about oral restrictions.

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