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Tongue Ties - What you should know

Hi there everyone! This is Dr. Wang from Molar Bear Family Dental! We hope everyone had a fantastic new year! One of my new years resolution is to be more active on our website and social media, as well as to provide more education and teaching about various whole body health/dental topics.

We hope to make this a monthly thing!

January's topic is about tongue ties, specifically regarding infants and why it is important to have them evaluated

Have you noticed that your baby has been having trouble latching while feeding? How about difficulty with breastfeeding? Have you wondered if your baby is having tongue tie or lip tie?
While it may be seeming simple in appearance, the evaluation and treatment of tongue is a very complex and controversial area in Medicine and Dentistry.
With the info below, we hope to make you more knowledgeable about what tongue tie truly is, how to evaluate for SYMPTOMATIC tongue tie, and the proper treatment of tongue tie.

What is a tongue tie?

A tongue tie is the formation of a thin membrane under the baby’s tongue, known as the lingual frenulum. 

In some instances, this membrane can restrict the movement of the tongue to where they are unable to move their tongues freely.

What is a lip tie?

An abnormal membrane that forms and attaches on the upper lip/upper gums. Babies with lip ties often have difficulty feeding as they can’t form a proper seal on the breast. As a result, they will often take in excess air when attempting to breastfeed, making them fussy and gassy.

Tongue Tie Lip Tie

What are the signs and symptoms of tongue tie?

While in some instances, babies with tongue ties are able to latch onto the breast and breastfeed without difficulty, some may have some issues with feeding.  The signs of symptoms to look out for if your infant is possibly having issues with tongue tie/lip tie/cheek ties are below:

How are tongue ties diagnosed?

While it is fairly easy to visualize the oral structure restriction as we become aware of it’s presence, in actuality, tongue and lip ties are considered “tied” if their movement/function is restricted! Therefore, on top of visualizing the physical anatomical membrane, the movement and function of the tongue is assessed as well to evaluate to see if there is any restriction in its movement. Only when the movement and function are decreased, is it truly consider a tongue tie!

What are the treatments for tongue tie?

Tongue tie / lip tie revisions, known as frenectomies, are performed to remove or release the tissue under the tongue. This allows better tongue mobility, and for babies, can help with their ability to breastfeed. In some cases, frenectomies can also aid the prevention of other condition such as speech difficulties, breathing issues, digestive issues and others!

Why do we need to wait for some tongue ties to be released?

While releasing tongue ties are important and can significantly help with improving a tongue’s mobility, that is actually only part of the equation in regards to breastfeeding.

On top of having proper tongue mobility, it is necessary for the baby to have proper neurological development including the sucking reflex, as this will trigger a baby to suck when an object enters their mouth. Otherwise, even with a proper tongue function, the baby will still not be able to breastfeed.

In those sort of instances, if the primitive sucking reflex is not there, it is important to help “train” and “build” that reflex, with the assistance of bodyworkers, such as chiropractors, osteopathic physicians, or other providers that can help to develop that reflex, as it is vital to a baby’s ability to breastfeed.

What is Molar Bear's approach?

As mentioned above, our evaluation and treatment not only exam the attachment by anatomy, but also by function to look at the tongue's movement ability. We evaluate the neurological function of the baby to ensure they are able to suck and have that specific sucking reflex. If that reflex is missing, then performing a frenectomy may not be beneficial as the baby will still not be able to suck and latch even when the tie is release.

In those cases, we work closely with “bodyworkers” whom we refer to, who include chiropractors, osteopathic physicians or cranio-sacral therapists. This is very important in the “pre-treatment” phase as this helps to develop the proper reflex to allow the baby to suck and latch.

After a frenectomy is performed, we will also refer to the bodyworker for additional treatment, as the tongue will usually require additional assistance to help regain its lost mobility and function. In this way, this will allow the baby to regain its full potential to lead to the best health possible!

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