Lip and Tongue Tie Cairns
Modern medicine is an amazing thing, and it’s now possible to treat lip and tongue ties with a laser at all ages
Future Dental is pleased to be able to offer this treatment, however, it is a lot easier in fairly newborn babies up to 6 months or so and kids over 6 years of age.
How can lip or tongue ties (Ankyloglossia) be treated?
Your doctor, midwife or lactation consultant may diagnose an anterior or posterior tongue tie or upper lip tie. The best-qualified person to diagnose these problems is an IBCLC (International Board Certified Lactation Consultant) or a dentist with broad training and experience in these problems. Dr Gibbins has been treating these problems by laser since 2003 in all age groups.
We invite you to consult with your IBCLC and even have them attend your visit for the procedure or diagnosis with us.
There are times when Dr Gibbins advises no release of these lip or tongue ties are required. Listening just to your Facebook friends may not inform you correctly if baby actually has a problem that is due to a tongue or lip tie and we quite frequently see babies where Mum may think babies’ feeding problems are related to a lip or tongue tie but actually the problem may be of a different cause. That is why we advise you to speak to your paediatrician, IBCLC, Dr Gibbins or your midwife before asking for a release of a tie. Only an expert can tell if a normal anatomical frenulum is a problem or not and the Assessment Tool for Lingual Frenulum Function (ATLFF) is the basis for diagnosis.
Some GP doctors, Paediatricians, midwives and Lactation consultants may use scissors and some surgeons use a scalpel.
Future Dental exclusively uses the Waterlase Laser
Future Dental is the only practice in North Queensland including Townsville offering the use of the Waterlase Laser for these procedures. Other lasers work very differently and cut by quite intense heat causing soft tissue charring.
The particular Laser (2780nM wavelength) is the most efficient tool to surgically treat lip, cheek and tongue ties. It’s advantages are:-
- Minimum pain for baby
- Seals blood vessels so almost never any bleeding
- Seals nerve endings so pain afterwards for baby does not usually return for 3-4 hours
- Seals lymphatic vessels so no swelling afterwards
- Sterilises the surgical site as it goes.
This laser is by far the gentlest and safest technique with virtually no pain, bleeding or post-operative swelling, no stitches required and most rapid healing. Baby can feed immediately after. The laser also sterilises the surgical site as it works so post-op infection is rare.
Our Waterlase MDX is the gentlest of all laser wavelengths to use and causes no tissue charring like a CO2 laser and is virtually painless for baby. It is also the safest for eyes with a very short Nominal Ocular Hazard Distance compared to other laser wavelengths where use of specific wavelength filtering protective glasses for all in the room is mandatory. It is the cleanest cutting laser and in almost all cases baby does not react at all to the actual laser release procedure but just complains about Mum or Dad swaddling them up in a blanket to hold little arms clear. While we have several Diode Lasers also which can do the same thing, the Rolls Royce of lasers for these procedures is the Waterlase. We use this one exclusively for lip and tongue ties.
Newborn infants to one year of age
There is a short window of time in which an infant can be treated through the use of our Waterlase MDX laser. Up to 1 year of age, most Anaesthetists will not perform a general anaesthetic (GA) and will ask to wait until the child is at least a year old. It is mostly in the first few months of life where feeding problems for both baby and Mum occur and in this age-group, a GA is just not an option.
After 12 months it will be easier for a GA and we will refer you to the best-qualified dentist.
As such, if you’re experiencing these symptoms with your newborn, we’d encourage to seek our help as quickly as possible!
1 to 6 years old
After 12 months of age and up to age 6, it’s much easier for the procedure to be done using a laser again, but under a general anaesthetic. We will refer you to the best qualified in Cairns for this procedure under GA.
6 years plus
From the age of 6, it is again possible for us to treat this condition with the laser in our office under a local anaesthetic.
Adults at times will also require a release of tongue or lip ties for problems with gum problems, tooth crowding or Obstructive Sleep Apnoea.
What to expect for Mums and Dads.
We are very aware that these procedures are very psychologically difficult for Mums and Dads and it may render you to tears watching your tiny bub going through a procedure where no form of anaesthetic is safe or suitable.
We advise that you should not feed the baby for at least 90 minutes before the appointment.
Please bring a generous sized clean baby blanket to swaddle the baby.
You may choose to leave the room and have our trained staff to handle baby during the procedures after we have examined baby but it is fine if you prefer for either Mum or Dad to hold the baby.
We will ask you to sit knee to knee with the doctor with baby’s feet in your lap and baby’s head in doctor’s lap and we will show you how to hold and support the baby.
Baby will cry during the procedure and it will mainly be because they are being held in one position and do not like that feeling.
We do not pretend that baby will feel nothing but it is our usual observation that the actual laser time use amounts only to probably a minute or two during the procedure with the baby moving around constantly where we only get a split second at a time to accurately deliver the laser beam to trim the restricted tissues.
It can still take up to an hour but usually shorter depending on how active baby is. We are very protective of the salivary ducts and veins under the tongue so just have to be patient waiting to get those few moments when we activate the laser.
Sometimes in that actual tissue trimming time, babies actually stop crying when they notice a few drops of the distilled water from the laser in their mouths and then swallow and sometimes they definitely feel something sharp momentarily.
Fortunately, babies do not remember these things after and the moment we finish they go to Mum in a closed room and immediately feed properly and often well for the first time.
What is a frenectomy procedure?
Frenectomy is a procedure in which little tissue extensions under the lips and tongue are carefully removed. These tissue excesses can cause a tongue-tie, also known as ankyloglossia, which can affect speech development in young children. The condition can also affect new born babies, causing them to be unable to attach to the breast to start feeding in the first few days of life. At Future Dental, we often use laser dentistry to perform frenectomies.
When can a frenectomy be performed?
It is important to know that there is only a very short time window between birth and two weeks of age when the frenectomy procedure can be done. After this, the only way in which the procedure can be performed is with a general anaesthetic or by a paediatrician or general practitioner using surgical scissors. An anaesthetist will not perform a general anaesthetic on an infant under 12 months of age without very good reason. From around the age of a year to seven years old, a general anaesthetic is required for a frenectomy. After that, it can be done routinely under local anaesthetic in our surgery.
If you think you or baby has a Tongue or Lip Tie, please ask us to assess it.