A lip tie occurs when the labial frenulum, the thin band of tissue connecting the upper lip to the gum, is unusually short or tight. This condition restricts the natural movement of the upper lip and can cause various functional challenges. Fortunately, it is a correctable condition with effective methods to improve oral function.
Recognizing the Need for Correction
A lip tie can lead to several issues, particularly in infants. In babies, indicators include breastfeeding difficulties like struggling to latch, clicking sounds during feeding, or falling asleep from nursing fatigue. These challenges can result in poor milk transfer, leading to slow weight gain, reflux, or excessive gas. Mothers may also experience pain during or after breastfeeding, engorged breasts, or blocked milk ducts.
As children grow, an uncorrected lip tie can cause other issues. Older children might experience speech issues with sounds like ‘b,’ ‘p,’ or ‘m’. Dental problems can also arise, including gaps between the front teeth, gum recession due to tension, or increased tooth decay from difficulty cleaning the upper front teeth effectively. Children may also struggle with eating certain foods, leading to picky eating habits or difficulty managing food in the mouth. Diagnosis of a lip tie is made by a healthcare professional, such as a pediatrician, pediatric dentist, or lactation consultant, through a physical examination and assessment of symptoms.
Approaches to Lip Tie Correction
Lip tie correction primarily involves a frenectomy, a procedure that releases the restrictive frenulum. Two common methods are traditional surgical release and laser frenectomy. The choice of method depends on the specific case and the practitioner’s expertise.
Traditional frenectomy uses surgical scissors or a scalpel to snip the frenum. This method is quick and effective, especially when the frenulum is thin and easily accessible. The procedure involves applying a topical anesthetic to numb the area, with the child held securely. While straightforward, this approach may result in a raw wound area, which can increase the chance of reattachment.
Laser frenectomy utilizes a soft tissue laser to release the frenum, offering several advantages. The laser vaporizes tissue, resulting in minimal bleeding because it cauterizes blood vessels as it cuts. This precision allows for a more controlled release, leading to less discomfort, reduced swelling, and a lower infection risk due to the laser’s sterilizing effect. Minimal trauma and cauterization contribute to quicker healing times. Pediatric dentists, oral surgeons, and Ear, Nose, and Throat (ENT) specialists perform these procedures.
Post-Procedure Care and Healing
Following lip tie correction, some discomfort is expected, and infants may be fussy. Pain can be managed with over-the-counter medications like acetaminophen or ibuprofen, as recommended by a healthcare provider based on the child’s age and weight. Providing extra skin-to-skin contact, warm baths, or increased feeding sessions can also help soothe the child.
An important aspect of post-procedure care is performing specific wound management exercises, often called stretches, to prevent the frenulum from reattaching. These gentle stretches are performed multiple times a day for several weeks, as instructed by the practitioner, ensuring the released tissue remains open and heals with increased mobility. Consistency in these exercises is important for optimal results.
Feeding might initially present a challenge as the child adjusts to newfound lip mobility, but improvements occur quickly. Continuing breastfeeding or bottle feeding immediately after the procedure is encouraged, as feeding helps with healing and allows the baby to learn new oral motor patterns. The surgical site’s healing time ranges from one to two weeks, with full tissue healing around six weeks. Follow-up appointments are important to monitor healing and ensure the procedure addressed initial concerns. Collaboration with a lactation consultant or speech therapist may also be recommended to support the child in adapting to improved oral function.