Let’s Talk About Tongue Ties with Dr. Adena Borodkin of Golden Valley Kids Pediatric Dentistry in Minneapolis, MN

Mar 13, 2019
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Having a tongue tie is not just an inconvenience, it can have an impact on newborn health, toddler speech development, and can lead to tooth decay and gum disease in older children and adults. Luckily, it’s simple to fix and easy to diagnose. Additionally, not every diagnosed tongue tie has to be treated! We hope you find this information helpful and encourage you to contact our office if you have any questions.

A frenum (also known as a frenulum) is a band of tissue that connects various parts of the mouth. They are commonly found under the tongue, behind the lips and sometimes behind the cheeks. Some people are born with a frenum that is too short or too thick, which can prevent the tongue from moving as freely as it should. Depending on the age of your child and their tongue’s restriction, this can lead to problems with infant feeding (breastfeeding or bottle feeding), speech development, eating solid foods, and more. Issues with frenums are commonly called tongue or lip ties. Fortunately, these issues can be corrected through a simple surgical procedure called a frenectomy.

A frenectomy is a procedure to repair the frenum by eliminating its restriction. The goal is to remove excess tissue from the frenum to allow a greater range of motion in the tongue or lip. This can be performed with scissors or a laser and can generally be completed in minutes.
The age at which a frenectomy can be completed depends on the symptoms that the patient develops. There are no age or size limitations that would prevent a patient from having the procedure done. For newborns and infants, the procedure can be completed as soon as they are discharged from the hospital, and sometimes in the hospital.

A lip tie occurs when the tissue that connects the lip to the upper gums is too thick, too tight, or attached too low. Lip tie symptoms are mostly related to the frenum behind the upper lip. Sometimes the frenum behind the lower lip may create symptoms in older patients. A lip tie can cause latching difficulties in newborns and infants which can result in pain or discomfort for the mother when nursing. It can sometimes cause symptoms such as reflux or gassiness in your newborn.

The lingual (tongue) frenum is the small fold of tissue connecting the bottom of the tongue to the floor of the mouth. When the frenum is too short, it is known as a tongue tie. This prevents the tongue from moving as much as it should. The medical term for a tongue tie is ankyloglossia.

A tongue that appears notched, or heart shaped when stuck out is a sign of a tongue tie. Other symptoms are difficulty sticking the tongue out past the lower front teeth, difficulty lifting the tongue to the upper teeth, and difficulty moving the tongue from side to side. Tongue ties in newborns and infants can cause difficulty with breastfeeding. Toddlers with a tongue tie may have problems with eating and speech development. Brushing their teeth and swallowing can also be challenging with a tongue tie. There is virtually no evidence in the literature to establish a definite causal relationship between ankyloglossia and speech disorders. Therefore, it can be assumed that ankyloglossia is unlikely to cause speech problems in most cases.
Most experienced speech-language pathologists would conclude that frenectomy is rarely indicated for speech reasons unless it is very severe, or the patient has other oral-motor problems. It may, however, be warranted for problems with early feeding, bolus manipulation, dentition, or aesthetics. A danger in performing frenectomy for speech related concerns, is the disappointment that can result when parents are led to believe that this will correct speech problems that are actually due to other causes.

Dr. Borodkin in enrolled in a hands-on course in May, 2019 to learn the applications of laser procedures in children. She has a diode (soft tissue) laser in the office and hopes to perfect her frenectomy skills and begin offering the procedure this summer. Using a laser for surgical procedures allows for a more comfortable experience for the patient while also providing cauterization of the surgical site to limit bleeding.

Checking for tongue and lip ties is another great reason to be sure your child visits our office by their first birthday. We can check to make sure all components of their mouth have the range of motion needed for eating, drinking, speaking, and brushing. Remember, NOT EVERY TONGUE TIE REQUIRES TREATMENT, some are just a variation of normal.

As always, please reach out with any questions or concerns 763-222-1299 or gvkidsdental@gmail.com

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