What does a tongue tie look like?

A tongue tie can be short or long, thin or thick fibrous looking tissue. This tissue is actually called the lingual frenum or frenulum. The lingual frenum stretches from underneath the tongue to the floor of the mouth.

Dr. Bhaumik: Each one looks unique and the position of the frenum underneath the tongue also varies! Some are positioned in the front (anterior) and some further back of the tongue (posterior). It is not the LOOK of the tissue that matters, but rather the FUNCTION and SYMPTOMS that the tethered tissue (frenum) is causing is what really matters.

This is why it is so important for a properly trained healthcare provider (lactation consultant (board certified), trained pediatric dentist, speech language pathologist or a myofunctional therapist) to do a proper assessment.

Are all kids tongue tied?

Dr. Bhaumik: No! According to current research only 5% of the population are truly tongue tied. Some healthcare providers and myself included believe that this statistic is NOT accurate and more research needs to performed to validate this statistic. We ALL have a lingual frenum but for some of us the frenum is tighter. This “tightness” underneath the tongue for kids that are truly tongue tied exceeds beyond the mouth and we must carefully assess the body as a whole.

When the lingual frenum is normal, it should be elastic and should not interfere with the movements/proper positioning of the tongue. Newborns/infants/children ideally should not have a problem with sucking, eating, clearing off food with their tongue, swallowing and speech. When the lingual frenum is short, thick, tight or broad it can result in various issues with function, feeding, speech and airway.

What are the symptoms of a Tongue Tie?

Dr. Bhaumik: Correlated symptoms of a tongue tie can be as simple as difficulty sticking the tongue out OR as complex as: trouble with breastfeeding (latching) as a newborn, eating and speech issues, digestion issues and sleep/airway issues.

Other very specific symptoms correlated to being tongue tied are head and neck tension, midline asymmetries/misalignment, chronic headaches or lower jaw tension.

Is Treatment for Tongue Tie Necessary?

Dr. Bhaumik: I never push parents to get this procedure done and I never discuss this issue if it is not an issue. Motherly instinct about how breastfeeding is going at home is often what starts this conversation or during our clinical exam when I am assessing the child’s airway, tongue posture, child’s gait and signs of head/neck tension.

I personally believe if your newborn/child is truly tongue tied then the benefits of this simple surgery is justified and will provide life changing results. Unless parents are 100% motivated, committed and understand HOW and WHY this surgery is beneficial, I don’t perform it. Also, I would like to express the importance of working with other healthcare providers (IBCLC, SLP, CST, OMT) invested in your child’s overall well being. At our office we often times coordinate with other health care providers to figure out the best approach to providing life long results.

What is special about your laser you use for tongue tie surgeries?

Dr. Bhaumik: Cutting the tongue tie with scissors has a high degree of unpredictability in regards to post operative results and bleeding. Burning the tissue off with a diode “laser” (it is not a true laser) results in heating and burning the frenum tissue off. A diode laser results in longer healing times when compared to a CO2 laser. Healing time is a very important factor for the breastfeeding mother/newborn and for older children.

I made the decision for our practice to provide the best for our patients by investing in a CO2 laser because I believe this should be the gold standard for pediatric soft tissue surgeries Ex: Tongue and lip tie surgeries.

We use a LightScalpel CO2 laser, which works via removing water molecules (ablation) from the frenum tissue. This makes our tongue tie release minimally invasive, allows us precision when performing this surgery, reduced healing time and most importantly the best results.

How long does this surgery take?

It takes us approximately 10-15 min perform this surgery on infants. At our practice it takes us 25 minutes to prepare the treatment room and our breastfeeding room. Our breastfeeding room is afterwards reserved for parents and our patient so that the family is able to breastfeed in privacy after the procedure.