Pediatric Frenectomies
in Fairview

Tongue and lip ties are collectively known as “tethered oral tissues” or TOTs. They occur when the bands of tissue that connect the tongue or the lips to the mouth become overdeveloped to the point that proper mouth movement is restricted.

They are uncommon in infants and toddlers, and sometimes do not need treatment. Minor tongue and lip ties may not cause any feeding problems, or contribute to speech impediments.

However, serious tongue and lip ties can make it hard for your child to breastfeed or use a bottle properly, resulting in poor feeding and inadequate nutrition. If you think that your child is having trouble feeding because of tongue or lip ties, you should get help from a pediatric dentist right away.

Feeding problems are the most common signs of tongue and lip ties. Your child’s lips and tongue need to be able to move properly to latch onto the nipple and stimulate it for proper feeding. If they seem to be having trouble making a proper seal, milk dribbles out from their mouth while feeding, or they frequently stop and start feeding, they may be having latching issues due to tongue or lip ties.

You can also look for visual signs of tongue and lip ties. For the lips, you can fold back your child’s upper lip and look at the frenulum. If it is difficult to lift the lip or it seems like your baby is unable to move their upper lip on their own, they may have a lip tie.

Signs of tongue ties include an inability for your child to stick their tongue out past their front teeth, or problems moving the tongue from side to side. Tongue ties can also be identified visually. A common sign of tongue ties is a “heart-shaped” tongue. When your child sticks their tongue out, the restriction caused by the tongue tie may cause it to look “notched” or heart-shaped, instead of appearing as a smooth “U” shape.

However, some tongue ties, known as posterior tongue ties, are "hidden" and may appear normal to the untrained eye. In these cases, symptoms may not appear until later in life, but trained professionals like the team at Songbird Pediatric Dentistry can evaluate and diagnose these cases.

With our CO2 laser, there is minimal discomfort during a frenectomy. For infants, we offer both a specially formulated topical anesthetic as well as natural options. For older patients, we typically provide a small amount of local anesthetic to the area to help minimize any discomfort.

We're happy to assist you in maximizing your child's health benefits. It's important to note that coverage for congenital anomalies is unpredictable and varies widely among different insurance providers. To overcome this challenge, we created Tiny Ties of Middle Tennessee. This entity operates independently of insurance agreements to ensure complete transparency with our patients and their families regarding procedure costs. As a courtesy, we do offer medical superbills that you can submit to your insurance provider for reimbursement

Recovery and aftercare after a laser frenectomy is generally minimal and straightforward. We will recommend a series of exercises and stretches based on the procedure performed. These exercises and stretches are important to prevent reattachment and maintain range of motion. We will also provide detailed guidelines for your reference, so you can help your little one heal with confidence.

Frenectomies are usually identified in infants and young children before they grow older, so the treatment is primarily done on younger children. However, it’s not exclusively provided to infants and young children. Older kids, teenagers, or even adults who have tongue or lip ties may be able to benefit from treatment with a frenectomy if they have significant tongue or lip ties.

We're proud to be transparent about pricing for this life-changing procedure. The initial consultation is a one-time fee of $97, which can then be applied towards the cost of the frenectomy itself. A lip tie release or tongue tie release is $400, or $800 for both if necessary. If we find any buccal ties (tethered oral tissues from the cheek to the gum line), we will release them free of charge. You will also receive a complimentary evaluation one-week post-operation.

Tongue-tie occurs when the lingual frenulum, the small band of tissue connecting the tongue to the floor of the mouth, does not fully separate during a baby’s development in the womb. While the exact cause is unknown, genetic factors are suspected to play a role. Studies have shown that tongue-tie can run in families and tends to be more common in boys than girls.

After a tongue-tie release, follow your provider’s aftercare instructions to ensure proper healing. For infants, they may resume breastfeeding or bottle-feeding almost immediately. Older children should avoid hard or crunchy foods for a few days, and gentle exercises may be recommended to encourage tongue mobility. Pain can usually be managed with over-the-counter pain relief, and regular follow-up appointments help ensure that the area heals correctly.

In some cases, a tongue-tie left untreated may lead to issues in adulthood. Restricted tongue movement can impact speech and even lead to dental health problems, such as gum recession, due to inadequate oral hygiene. Additionally, some adults with untreated tongue-ties experience jaw pain or sleep apnea symptoms due to improper tongue posture. If you or someone you know suspects a tongue-tie that was not addressed in childhood, consulting with a dentist or specialist can provide insights and treatment options.

There’s no one-size-fits-all answer for treating a tongue-tie, as the best age for intervention depends on the severity of the condition and the child’s symptoms. If a tongue-tie is identified early and is interfering with breastfeeding, some doctors may recommend a frenectomy shortly after birth. For children with mild symptoms, it may be beneficial to wait and monitor their development, as some children adapt well without treatment. However, if a child is older and experiencing issues with speech, eating, or oral hygiene, it may be advisable to seek treatment at that point. Consulting with a specialist, such as Dr. Breanna Barnes at Songbird Pediatric Dentistry, can help determine the best approach based on the child’s unique needs.

In certain cases, a mild tongue-tie may stretch or loosen on its own over time, especially by ages two or three. However, severe cases, where the tongue is tightly bound to the floor of the mouth, are unlikely to improve without medical intervention. For children experiencing challenges related to their tongue-tie, it’s essential to monitor the condition and consult with a healthcare provider if symptoms arise.

The procedure to correct a tongue-tie, called a frenectomy, is typically quick and causes minimal discomfort. For newborns, the procedure often requires no anesthesia or just a local anesthetic, and discomfort is minimal and brief. Older children usually receive a local anesthetic, and in some cases, general anesthesia may be recommended. Most children experience only mild soreness for a few days post-procedure, and over-the-counter pain relievers are usually sufficient to manage any discomfort. It’s helpful to discuss any concerns about the procedure with your provider, like Dr. Barnes at Songbird Pediatric Dentistry, to ensure you’re fully informed.

A tongue-tie is usually diagnosed through a physical examination, often by a pediatrician, lactation consultant, or pediatric dentist. The healthcare provider will assess the tongue’s range of motion, the thickness of the lingual frenulum, and any difficulties related to feeding or speech. In some cases, a more detailed assessment is necessary, particularly if the child is experiencing speech or feeding difficulties. Parents concerned about a potential tongue-tie should bring it up with their child’s healthcare provider for evaluation.

While some mild cases of tongue-tie may not cause any significant issues, severe cases can lead to complications if untreated. Potential risks include difficulty with breastfeeding in infants, leading to inadequate weight gain and nutritional concerns. In older children, an untreated tongue-tie can affect speech, making it difficult to pronounce certain sounds. It can also impact oral hygiene, as restricted movement may prevent the child from effectively cleaning their teeth, increasing the risk of cavities and gum issues. Additionally, some children experience difficulty with chewing and swallowing, which can affect their overall eating habits.

Laser frenectomy has become a popular method for releasing tongue-ties as it’s generally quicker, reduces bleeding, and may allow for faster healing compared to traditional snipping methods. The laser cauterizes the area as it cuts, minimizing bleeding and reducing the risk of infection. Many patients find the laser option to be less painful and prefer the convenience of a shorter healing time. However, the best option depends on the child’s specific needs and the provider’s recommendation.

Yes, a tongue-tie can impact speech development in some children, particularly if it is severe. Restriction in tongue movement can make it difficult for children to pronounce certain sounds, especially those requiring elevation or movement of the tongue, like “t,” “d,” “z,” and “l.” While not every child with a tongue-tie will have speech issues, those who do may benefit from a frenectomy or speech therapy to improve articulation and clarity.

Recovery after a frenectomy is generally quick, particularly for infants, who may return to feeding within a few minutes post-procedure. Older children may experience mild soreness for a few days, which can be managed with over-the-counter pain relievers. Gentle tongue exercises may be recommended to promote healing and help the tongue regain full range of motion. Within a week, most children are back to their regular activities without any restrictions.