Tongue-Tie: Complications and Remedies
Tongue-tie or ankyloglossia is a condition that can be caused by a malformed frenum. The frenum is a band of tissue that connects two soft tissues in the mouth such as the cheek, gums, or lips. There are two types of frenum in the mouth, the labial frenum and the lingual frenum. The labial frenum connects the gum above the two upper or lower front teeth to the underside of the lip and the lingual frenum connects the underside of the tongue to the floor of the mouth. A frenectomy is the removal of the frenum and a frenotomy is the incision and relocation of the frenal attachment. In the case of the lingual frenum it is often tight, short or thick causing tongue tie. In the case of the labial frenum is often too large and extends past the gum line and interferes with the front teeth or can lead to receding gums.
Lingual Frenectomy/frenotomy
A lingual frenectomy is often advised to remedy cases of tongue-tie. In these cases the lingual frenum is unusually short, thick or tight which can cause the development of a speech impediment in developing children. This condition can be corrected by a simple procedure to release the tongue.
Tongue-Tie in Children
In older children tongue-tie has been linked to speech difficulties like trouble making sounds like, “t”, “d”, “z”, “s”, “th”, “r” and “l”. It can also lead to limitations in oral hygiene because of limited dexterity of the tongue as well as problems with other oral activities like playing a musical instrument or licking a popsicle.
Tongue-Tie in Babies
Tongue-tie can affect a baby or child’s oral development or the way they eat, speak and swallow. Symptoms can include problems in lifting the tongue to the roof of the mouth and moving the tongue from side to side, and trouble sticking out the tongue past the front teeth. These symptoms can lead to problems breastfeeding in babies, because it requires a baby to keep their tongue over the lower gum while sucking. If a baby cannot move the tongue or keep it in place, the baby will often instead chew on the nipple leading to significant pain to the mother and causing trouble for the baby in getting breast milk.
Tongue-Tie Surgery
A simple procedure can help to remedy the possible complications of tongue-tie. An incision is made in the lingual frenum to “release” the tongue and allow a more broad range of motion. The traditional method using a scalpel carries with it routine risks of surgery like bleeding and post-operative patient compliance.
When appropriate the preferred surgical technique in the office of Dr. Vincent Vella DDS is to use a state of the art CO2 laser to perform the frenotomy. The advantages of using a CO2 laser to perform the surgery include the shorter duration of the surgery, the simplicity of the procedure, the absence of postoperative infection, less pain, less swelling and the presence of little or no scarring.
Labial Frenectomy Surgery
The labial frenum is the piece of tissue that connects the gum line, above the top front teeth and below the bottom front teeth, to the lips. At times the labial frenum can grow past the gumline and interfere with the alignment of the upper or lower front teeth. In this case a labial frenectomy, the surgical removal of the portion of the frenum that extends past the gumline, may be needed to allow for the teeth to grow in straight and even.
Benefits of CO2 Lasers For A Labial Frenotomy
The LightScalpel dental CO2 laser system used by Dr. Vella and his team offers the same benefits when performing a frenectomy/frenotomy on the gums as it does when it is used on the underside of the tongue. It is faster, less prone to postoperative infection and offers diminished pain, swelling, and scarring.
Diagnosis and Treatment
Dr. Vincent Vella recommends that the need for a surgical correction for tongue-tie or ankyloglossia be established by medical and occupational therapists, speech pathologists, trained professionals specialized in lactation consulting, and other medical doctors and professionals. An assessment for a labial frenectomy/frenotomy can be performed by Dr. Vella and his team.
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