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The frenum is a small fold of tissue found in three places in the mouth: under the tongue (lingual frenum) and descending from the center of the upper and lower lip (labial frenum). In some cases, these frena can impair the normal function of the mouth and require removal, also called a frenectomy.

Lingual frenectomy: The lingual frenum connects the tongue to the floor of the mouth. If the lingual frenum extends too far toward the tip of the tongue, tongue mobility is limited, causing difficulties with speech, eating and swallowing. This is common in young children and is treatable via lingual frenectomy.

During this procedure, the doctor will utilize a non-invasive CO2 laser to separate the tissue. Once that tissue has healed, normal function will return to the child’s tongue. This usually takes only a couple of days; in the meantime, the child will be able to use the tongue normally, albeit with some discomfort. Infants who have a frenectomy generally recuperate more quickly and with less discomfort.

Labial frenectomyThe labial frenum, the bit of tissue that joins the upper and lower lips to the front gums, can sometimes cause gaps between your child’s front teeth and misalignment throughout the mouth.

When to refer a Newborn to a Pediatric Dentist for a Lip and Tongue Tie Evaluation:

Are they having trouble gaining weight?

Is mom having difficulty breastfeeding? Breastfeeding should not be painful. Let us help!

Around 3-4 months it’s less of mom’s let down and more of the baby’s pull; therefore, if a baby is unable to develop an efficient latch, the mother will begin to lose her supply and begin supplementing or give up on breastfeeding.

Signs that they are working too hard when feeding:

Nursing blisters, white milk deposit on tongue, chomping/gumming when feeding, quivering, taking a few sucks then stopping, falling asleep on the breast, gassiness, hiccups and/or spit up.

If a baby has tongue restriction, they’re unable to open as wide as they can. With proper tongue movement, they’re able to open wider allowing them to have a deeper latch. The deeper the latch, the happier the baby will be. The tip of the nipple should be where the soft palate meets the hard palate; this allows for the back part of the tongue to go up, press against the breast and allow for an adequate milk transfer.  If they’re unable to open wide, they end up with a shallow latch; this means they’re using more of their jaw and not their tongue causing chomping, gumming, quivering and falling asleep on the breast.  The role of the lips is to form a proper seal.  However, when shallow, they’re having to use their lips; this causes them to intake air causing gassiness, hiccups and/or spit up.

At Shenandoah Smiles Pediatric Dentistry, Dr. Melissa Gibson and a Certified Lactation Counselor will do an oral evaluation, counseling, and, if indicated, a carbon dioxide/DEKA laser frenectomy can be performed."

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