A frenum is a small membrane that attaches your tongue to the floor of your mouth, and your lip to the top of your mouth. In some cases, these frenums can be thick, or attached more anteriorly than they should be, and become restrictive.
More commonly known as a tongue-tie, a restricted tongue can contribute to difficulties with breast- or bottle-feeding as an infant, preventing a proper latch, or seal, around the nipple. As a consequence, feeds can be incomplete, frustrating, prolonged, and/or painful. As your child grows, a restricted tongue may lead to other adverse conditions such as speech difficulties, sleep apnea, and food aversions. It is important to have your child evaluated by a properly trained specialist to ensure this condition is addressed if present.
A frenotomy is a quick procedure that cuts the restricted frenum, thereby releasing the tongue/lip from its tethered state. Dr. Gouri uses a laser for this procedure, eliminating the need for a scalpel or sutures, and in many cases, local anesthetic. Your child will be able to eat immediately after the procedure, as the laser causes minimal to no bleeding!
Why is my child still having difficulties even though we had their tongue clipped?
I was told my baby doesn't have a tongue-tie, but is having a lot of difficulty feeding. Why?
Many people only notice tongue-ties when they are tethered very anteriorly, tying the very tip of the tongue to the floor of the mouth. All anterior tongue-ties also have a posterior tie. Untrained providers may “clip” just the anterior portion, leaving the posterior tie untouched, resulting in an incomplete release of the tongue. Many providers often do not know to examine for a posterior tongue-ties, which can only be detected by elevating the center of the tongue to the roof of the mouth, and not just by having the patient extend their tongue.
Dr. Anita Gouri attended numerous courses on infant and pediatric lip- and tongue-tie diagnosis and treatment by renowned experts including Dr. Bobby Ghaheri, Dr. Martin Kaplan, and Dr. Robert Convissar. She is a member of the Academy of Laser Dentistry and received her extensive pediatric-specific laser training form the World Clinical Laser Institute and the Biolase corporation. Dr Gouri trained to use the Waterlase iPlus laser to perform frenotomies because it deposits virtually no heat in the tissues, resulting in minimal scarring and very little bleeding, if at all. This Erbium:YSGG laser therefore leads to less post-operative discomfort and faster healing.