Lip and Tongue Ties

Boston’s Lip and Tongue Tie

Recently Boston had his lip tie and tongue tie released with a laser. It is something that as an oral health professional I should know a lot about, but unfortunately, most of us have had very little training in it.

Boston’s lip tie

When Boston was a baby I had a huge amount of trouble breastfeeding him. He was (and still is) a pretty determined eater so managed to compensate for a poor latch, but it was extremely painful for me to the point where I was shaking during feeds. I was told at the hospital that his latch was fine and he was gaining weight well so I assumed this was just how breastfeeding was. Needless to say we only lasted 5 weeks. Once the ‘newborn fog’ lifted though, I thought “hey, maybe he has a lip tie”. Sure enough, the frenum (the tissue attaching the top lip) attached right down onto the palate in what is known as a grade 4 lip tie. I later learned that he also had a grade 2 tongue tie.

Baby Boston

Since we had finished breastfeeding I didn’t worry too much about it and thought we’d think about it again when he was a bit older. I knew he was a mouth breather, and knew the dental implications, but thought we’d manage for a few years. Then one day I noticed that he held his hand up to his mouth when he was eating. As I watched him, I realised this was to stop the food from falling out. Feeling like a terrible mother by now, I decided we had better do something about it sooner than I hoped. Luckily, I’m in the right industry and one of my work colleagues who has been doing extra training in the orofacial myology area, pointed us in the right direction (Thank you Carly!).

Boston ended up with chest infections a lot. I didn’t realise mouth breathing could play a role.

We ended up going to a dental practice in Brisbane called Enhance Dentistry where Dr Marjan Jones released both ties with a water laser. Ties can be released with scissors, a scalpel, a diode laser or a water laser. Lasers essentially vaporise the tissue meaning less bleeding, as well as having an analgesic and antibacterial effect. The Waterlase used at Enhance is also very quick, about 30 seconds per tie. Dr Jones and her team were brilliant. They know exactly what they’re doing, and everything from the initial phone call, to the consult, to the surgery and aftercare ran smoothly. They know having to do minor surgery on babies or young children isn’t all that nice, and they’ve thought of everything to make parents feel at ease. They even pay for your parking!

One thing that did surprise me was that to get the best outcome, they recommended Boston see a chiropractor before and after the appointment. In the staunchly, straight-as-a-die, dental world that I am used to, asking a patient to go somewhere slightly left field like a chiropractor is crazy (don’t worry, I have since drastically revised my views of chiropractic). We saw Dr Salesh Dheda just across the road at Chiropratix who did a wonderful job. The reason for this is because the mouth, and especially the tongue, is so connected to everything else in the body. This is important in contributing to successful breastfeeding for the young babies that they treat especially, but for Boston it was a good start in the long road to retraining his muscles to function properly (keep food in his mouth). Carly will be working with Boston to get his mouth and airway functioning correctly again.

In the month after the ties were released we had to stretch out the wound every 4 hours. The mouth is great at healing itself, so this stops the tie reattaching. As you can imagine, catching a large 2 year old to stretch out his mouth every 4 hours was by far the worst part of the whole ordeal, but with a lot of bribery we get it done.

Post surgery treats went for about a week!

As I mentioned earlier, I was just lucky that I was in the right industry to get Boston’s ties released easily. As I speak to more mothers about this, I realise it can be a hard road just to get their babies ties diagnosed. Many health professionals are not very well educated about it, or don’t believe it to be an issue. As more research is being published, we now know that if left, ties can contribute to problems with breastfeeding, facial development, airway, sleeping, speech, orthodontics, general dental, gut health and immunity due to forced mouth breathing.

If you think your baby has a tongue or lip tie my tips are:

  • Find out who is diagnosing ties in your area. I saw one lactation consultant who didn’t even look in Bostons mouth.
  • Get a referral to a dentist or doctor who is experienced in releasing ties. Using a water cooled laser is an advantage, but a scissors release by someone who knows what they’re doing is much better than a cowboy waving a laser around. Incomplete releases with no after care instructions are an issue.
  • Make sure your chosen dentist or doctor has a multidisciplinary approach ie. lactation consultant, osteopath, chiropractor.
  • Do your stretches or exercises. The mouth is such a great healer that the wound really needs to be managed to stop the tie from healing right back to where it started.

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