When Pediatric Dental Frenotomy for Infant Tongue Tie May Be Recommended

An infant frenectomy is a minimally invasive pediatric dental treatment that removes one or more frena from the mouth. A frenum is a membrane of connective tissue that joins the mouth cavity's surfaces. The lingual frenum (which links the tongue to the bottom of the mouth), the buccal frenum (which connects the gums to the insides of the cheeks), and the labial or maxillary frenum (holding the lips to the gums) are the three major frena.

When should a frenectomy be performed on a child?

The lingual frenum can be extended or short in newborns, limiting tongue movement and making breastfeeding or bottle feeding more difficult. Tongue-tie is another term for this ailment. If the aberration is not rectified before the child reaches adulthood, they may have trouble speaking at a level comparable to their peers.

During routine checkups, the condition may go unnoticed. It is possible that it will not be noticed until the child is old enough to go to school. In children, elongated frena might hinder the tongue from extending normally. Sucking may become challenging and painful for the child in severe instances. Within the first few weeks following birth, an infant frenectomy can be performed with minimal pain.

When a dental problem arises, such as an enlarged maxillary labial frenum, the main concern is the possibility of orthodontic problems. An extended labial frenum can hamper the normal growth and spacing of the two front upper teeth. Many parents are concerned about a gap's appearance, anticipating it will necessitate the use of braces. However, it is best to wait until the adult teeth begin to erupt before beginning orthodontic therapy from a pediatric dental specialist.

The gap created by the prolonged labial frenum can sometimes resolve naturally as adult teeth emerge. If the gap persists, even after the use of braces, the incorrect spacing can be corrected with a labial frenectomy. 

Tongue-tie is usually detected during a pediatric dentist's routine physical examination of the baby. A screening instrument may be used to score many features of the tongue's appearance and its capacity to move.

Treatment procedure

Tongue-tie has many different treatments. Some doctors suggest addressing it quickly, while others prefer to wait and see what happens. Tongue-tie may be relieved if the lingual frenulum loosens over time. In some circumstances, it can also persist without resulting in complications.

If tongue-tie causes issues in children, adults, or babies, surgical treatment may be required. A frenotomy or frenuloplasty are two surgical procedures.

Frenotomy

In the pediatric dentist’s office, a frenotomy can be performed with or without an anesthetic. The lingual frenum is examined by the doctor, who then snips it free with sterile scissors. Since there are few nerve endings and blood vessels in the lingual frenum, the surgery is rapid and causes little discomfort.

It is likely that any bleeding will be limited to a few drops of blood. A newborn can start breastfeeding right after the operation. A frenotomy might cause bleeding, infection, or injury to the tongue or salivary glands; however, these are uncommon complications. Scarring or reattachment of the frenum to the base of the tongue are additional possible outcomes.

What to expect after the procedure

Since breast milk has therapeutic characteristics and the mere act of nursing soothes and reassures an infant, immediate breastfeeding is recommended. Quite often, parents will see a difference right away. Since just a modest dose of anesthesia is required to finish the surgery, latching may be difficult at first. About 30 to 45 minutes following the operation, the numbness will subside. In the beginning, latching may be challenging, so try not to panic. To maximize the likelihood of success, it is advisable to work with a lactation consultant.

In most cases, no pain medication is necessary. However, Tylenol or Ibuprofen may be used (if the child is six months old or older) to alleviate discomfort. The wound will have a sticky white or yellow appearance a few days following the process. This appearance is normal and indicates healing. The healing process may manifest itself in the form of an increase in sleep and a decrease in breastfeeding in the days after a revision. Some infants may nurse more often and for shorter periods than others. In certain cases, the mother may observe a terrific latch immediately after a revision but subsequently notice a decrease in latch quality as discomfort and new oral musculature begin to take hold.

Final note

Book an appointment with the pediatric dentist if you want to learn more about pediatric dental frenectomy or frenotomy and whether your child might need one.

Request an appointment here: https://www.hvkidsmiles.com or call Hudson Valley Pediatric Dentistry at (845) 363-4177 for an appointment in our Middletown office.

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