Dental Soultions of South Florida
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Dental Solutions of South Florida

Tongue Ties


What is a tongue tie?
There is a band of tissue that connects the tongue with the floor of the mouth called a frenum. It is normal – everyone has one. However, if a frenum is too tight, it keeps the tongue from moving normally. In this case, it is called a tongue tie. The condition is present at birth. Releasing a too-tight frenum is called a frenectomy (also called frenulectomy, frenotomy, frenulotomy and frenoplasty). Not all tongue ties look the same. Some attach at the tip of the tongue, others in the middle, and others attach way at the base of the tongue. Symptoms depend on many factors and in infants can include painful breastfeeding, poor latch, colic, reflux, excessive fussiness or excessive sleeping, tongue thrust, poor weight gain, clicking and milk dribble while nursing and not wanting to be put down on their backs. Tongue ties are diagnosed based not just on appearance, but on a combination of appearance and symptoms. Some may look harmless but are very problematic for babies and their mothers.

If not treated in infancy, children with tongue ties can suffer from delayed speech and speech impairment, dental cavities, teeth crowding with mouth breathing, snoring and sleep apnea. They are frequently slow and picky eaters because swallowing is not easy.

In adults, symptoms can include poor posture with forward head position, shoulder, upper back, neck and TMJ pain, migraine headaches, and sleep apnea including snoring and grinding your teeth in your sleep.



What is an upper-lip tie?

When the frenum that attaches the upper lip to the gums is too tight, it keeps a baby from being able to flange or curl the lip upwards and outwards to form a seal around the breast. An ineffective seal leads to swallowing excess air. It can cause retention of breast milk or formula under the lip which will lead to decay of the teeth when they erupt. When the teeth erupt, it can keep the two front teeth from moving completely together leaving a space. Upper-lip ties commonly occur in infants that also have a tongue tie, so we usually release both the tongue and upper lip at the same time.

What is an Buccal tie?

This is the most uncommon condition that can affect infant breastfeeding. Buccal ties are abnormal mucosal tethers that extend from the cheeks to the gingiva. This situation is in contrast to the upper lip ties which are mucosal tethers extending from the midline upper lip to the gingiva and tongues ties which extend from the midline tongue to the gingiva and floor of of mouth.

The vast majority of buccal ties are small without any medical significance and can be safely ignored, however, buccal ties can be quite severe and impede good latch with breastfeeding in very rare situations. In addition, if severe, they can cause discomfort in smiling as the cheek lifts and pulls away from the gingiva.

Fortunately, buccal tie releases can be performed in a manner similar to the way tongue tie and upper lip tie releases are performed. As is the case with upper lip ties, stretching exercises are required to prevent reattachment.

Tongue Tie Consultation

Dr. Leslie Haller is a leading expert in laser tongue tie surgery and therapy.

Call (305) 447-9199 today for your Tongue Tie Consultation.

  • Run in families
  • Occur in boys more than girls by 3:1
  • Occur in 5-10% of the population (probably 20%)
  • Tongue ties come in anterior and posterior
  • If you find an upper lip tie, there will be a tongue tie – but not necessarily the reverse
  • Tongue and upper-lip ties interfere with breastfeeding
  • Pediatricians do not always know about them
  • The inability to swallow properly leads to reflux and choking
  • The inability to flange the upper lip to create a seal around the breast causes swallowing excess air (colic)
  • They bite and chew the breast rather than sucking which causes nursing blisters on their lips and pain for the mother.
  • These infants are always hungry, can’t get enough to eat, spit up what they do manage to eat, have painful gas and are labeled “fussy”.
  • They frequently have poor weight gain
  • Pediatricians do not learn about them. When tongue ties are recognized, they frequently prefer to “wait and see” rather than treat.
  • Left untreated, both infants and parents suffer.
  • Later, these children can have, among other things, speech problems, dental problems, life-long reflux, headaches and sleep apnea.
  • Child unable to talk; children can be bullied and suffers through years of ineffective speech therapy.

Post Frenectomy Exercises

Here is an excellent video for helping you do post frenectomy exercises with your baby. It is done by Dr. Rajeev Agarwal who is a pediatrician who uses the same CO2 laser that Dr. Haller uses.

This is a great video for getting children to do their post op exercises. It is from another practice using a different laser, but the exercises are correct.

Tongue Tie Consultation

Dr. Leslie Haller is a leading expert in laser tongue tie surgery and therapy.

Call (305) 447-9199 today for your Tongue Tie Consultation.