Tongue Tie Laser Frenectomy
What is a Tongue Tie?
A tongue-tie, medically known as ankyloglossia, is a condition present at birth where a short, tight band of tissue (the lingual frenulum) tethers the bottom of the tongue to the floor of the mouth. This can restrict the tongue’s range of motion and affect various functions, including: breastfeeding, speech development, oral hygiene and other developmental difficulties with eating/swallowing. Tongue Ties can affect us at any age with different symptoms present. An untreated tongue tie can inhibit proper oral and facial development, tongue posture and overall breathing mechanics. Tongue ties are compos
Why does it matter?
Tongue posture and airway development go hand in hand…
The tongue is necessary in shaping the palate and jaw during early development. We want the tongue to be resting against the roof of the mouth. When a tongue tie is present, the restriction prevents the tongue from achieving this position, leading to a high, narrow palate reducing the space for nasal breathing. Poor jaw structure development can lead to a crowded oral cavity and airway.
Mouth Breathing and Sleep Apnea…
A tongue-tie (ankyloglossia) can contribute to airway problems in various ways, particularly when it affects oral and facial development, tongue posture, and overall breathing mechanics. Here’s how the two are connected:
Obstructive Sleep Apnea (OSA): This condition involves repeated episodes where breathing stops during sleep due to upper airway obstruction. A tongue-tie can contribute to this by reducing tongue mobility, causing airway collapse during sleep.
Snoring: the inability to properly position the tongue may lead to vibrations in the throat during sleep, causing snoring.
Impact on Jaw and Facial Development
Underdeveloped jaws: With restricted tongue movement, the lower jaw may not grow forward properly, leading to a retruded mandible (backward-positioned lower jaw), which further reduces the size of the airway.
Malocclusion (bite issues): Misalignment of the teeth and jaws can also narrow the airway and worsen breathing problems.
Oral Function and Breathing Efficiency
Dysfunctional swallowing: A tongue-tie can cause an abnormal swallowing pattern, where the tongue does not properly seal the airway. This may lead to tongue thrusting, which can further distort the palate and affect the airway.
Speech-related airway impact: In severe cases, improper tongue function can cause compensatory movements that affect the throat and airway, straining muscles involved in breathing.
Tonsil and Adenoid Hypertrophy
Children with tongue-tie are more likely to become chronic mouth breathers. This can lead to enlarged tonsils and adenoids, which can further obstruct the airway and contribute to conditions like sleep-disordered breathing.
Sleep and Behavioral Concerns
In children, restricted airway from tongue-tie can lead to poor-quality sleep. This is often associated with: fatigue during the day, behavioral issues (such as ADHD-like symptoms), difficulty with attention and learning in school
What are the symptoms to be aware of in infants?
Some of the symptoms include difficulty nursing, likely painful for mom, poor weight gain, a need to nurse all of the time, blisters on lip, colic/reflux/spitting up/fussiness. Additional symptoms can be present which is why a thorough evaluation is necessary.
What are the symptoms to be aware of in children/adults?
Symptoms often include: challenges with speech, swallowing issues (gagging/choking/vomiting), mouth breathing (day or night), tonsils enlargement or chronic sore throat, recurrent infections in upper respiratory system, restrictions of jaw growth and development, maligned teeth/narrow arch/ high palate, bed wetting, thumb sucking or prolonged pacifier use, snoring, obstructive sleep apnea, restless sleep with frequent awakenings, excessive daytime tiredness, teeth grinding, behavioral problems/inability to focus and more.
When should something be done?
Early intervention is key. Intervention is most beneficial when performed at a young age to prevent a range of developmental issues. When surgical intervention is completed during the infant stage, it helps to prevent the child and adult symptoms mentioned above.
Intervention includes myofunctional therapy (aka physical therapy) for the tongue, both before and after release. For infants, we recommend bodywork such as craniosacral therapy, chiropractic care, myofascial therapy or massage. Children through adults need myofunctional or physical therapy of the tongue before and after the release.
How do we treat it?
All diagnosis' are made after a thorough exam and consultation. If a tongue tie (and lip tie) release is recommended, treatment options may include a simple surgical procedure called a frenotomy or frenuloplasty, which involves releasing the frenulum to release the tongue. In addition to the procedure, myofunctional therapy is crucial to the success of the release.
Here at BioDentistyMI we use a state of the art laser, Light Scapel CO₂ laser, specific for this procedure. The CO₂ laser is considered an excellent tool for tongue-tie releases (frenectomy) for several key reasons:
1. Precision: The CO₂ laser offers precise releases, allowing the doctor to target only the restricted lingual frenulum without damaging surrounding tissues. This precision minimizes the risk of complications and promotes a more effective release of the tongue-tie.
2. Minimal Bleeding- The laser cauterizes blood vessels as it cuts, leading to significantly less bleeding compared to traditional methods using scissors or a scalpel. This is especially beneficial for infants, as they have smaller, more delicate tissues.
3. Reduced Pain- Because the CO₂ laser seals nerve endings and blood vessels as it works, there is often less post-operative pain compared to conventional surgical methods. This can result in a more comfortable experience for the patient, particularly for babies and young children.
4. Faster Healing- Laser procedures typically lead to quicker healing times. The laser’s ability to promote coagulation and minimize tissue trauma helps reduce swelling and inflammation, which speeds up the recovery process.
5. Lower Risk of Infection- The CO₂ laser sterilizes the area as it works, reducing the risk of post-operative infection. This is an important advantage in procedures performed in the mouth, where bacteria are abundant.
6. No Need for Sutures- In many cases, the CO₂ laser doesn't require sutures because the laser closes small blood vessels and tissues as it cuts. This means fewer follow-up procedures and less discomfort during healing.
Overall, the CO₂ laser offers a safe, effective, and relatively pain-free method for tongue-tie release, with advantages in terms of precision, reduced complications, and faster recovery.