Should Tongue-Tie Be Removed?

Many parents wonder about removing their child's tongue-tie when they notice problems with breastfeeding, speech, or other oral activities. The lingual frenulum is normal anatomy and everyone has variations in the way it presents. 

Tongue-tie (ankyloglossia) is the condition where the lingual frenulum is short, thick, or taut, limiting movement. This can affect how a child develops orally and their overall quality of life, prompting parents to consider surgical intervention.

Understanding Tongue-Tie

Tongue-tie is fairly common, affecting roughly 4-11% of newborns. It can lead to several issues:

• Breastfeeding struggles because babies can't latch properly
• Speech problems due to limited tongue movement
• Dental concerns including teeth position and difficulties with oral hygiene

These symptoms vary widely from child to child, which matters when thinking about treatment options.

Benefits of Tongue-Tie Removal

Removing tongue-tie through a procedure called frenectomy can help significantly, particularly for babies and young children who have trouble feeding or speaking clearly. This straightforward procedure is often done in a pediatric dental office and offers several benefits:

• Better breastfeeding, which improves nutrition and bonding
• Improved speech development, possibly reducing the need for speech therapy later
• Easier oral hygiene as the tongue can move more freely

These improvements can make a real difference in a child's health and development.

Risks to Consider

While generally safe, tongue-tie removal does have some risks:

• Bleeding or infection where the procedure was done
• Scar tissue that might affect how the tongue moves
• In rare cases, damage to salivary glands or nerves

It's worth discussing these risks with a qualified pediatric dentist to understand what makes sense for your child.

When Is the Best Time for Treatment?

The timing of tongue-tie treatment depends on the severity of symptoms and your child's age. For infants with feeding difficulties, early intervention often provides the best results. Many lactation consultants recommend addressing significant tongue-tie issues within the first few weeks of life if breastfeeding is challenging.

For older children whose tongue-tie is primarily affecting speech, treatment may be recommended between ages 2-4, when speech development is crucial. However, treatment can be beneficial at any age if symptoms are impacting quality of life.

What to Expect During the Procedure

If you decide to proceed with a frenectomy, knowing what to expect can ease your concerns. The procedure typically takes only a few minutes and can be performed using a variety of tools including scalpel, scissors, electrocautery, or a laser.

For infants, the procedure is often quick with minimal bleeding. Many babies can breastfeed immediately afterward. 

Older children might receive a local anesthetic to ensure comfort during the procedure.

Recovery is usually straightforward, with most children returning to normal activities within 1-2 weeks. Your dentist will provide specific aftercare instructions, which may include gentle stretching exercises to prevent reattachment of the tissue.

How to Recognize If Your Child Needs Treatment

Sometimes the signs of problematic tongue-tie aren't obvious. Here are some indicators that your child might benefit from treatment:

For infants:

• Clicking sounds during feeding
• Poor weight gain
• Difficulty staying latched
• Gassiness or reflux from swallowing air while feeding
• Maternal discomfort during breastfeeding

For older children:

• Difficulty pronouncing certain sounds (particularly "l," "r," "t," "d," "n," "th," "s," and "z")
• Frustration when trying to communicate
• Problems eating certain foods or licking ice cream
• Difficulty playing wind instruments
• Self-consciousness about speech or eating in public

If you notice these signs, consulting with a pediatric dentist or speech-language pathologist can help determine if tongue-tie is the underlying cause.

Other Options

If you're not sure about surgery, you might consider:

• Speech therapy
• Therapies by other qualified professionals

These approaches might help with feeding and speech without surgery. Keep in mind they don't work for everyone, and you'll need to watch your child's progress to make sure they're developing well.

The best decision comes from talking with healthcare professionals who understand your child's specific situation.

Reach Out to Campfire Smiles Pediatric Dentistry in Colorado Springs

If you're considering tongue-tie removal for your child, Dr. Dan Hoang and the team at Campfire Smiles Pediatric Dentistry in Colorado Springs can guide you through your options and provide expert care. Call them at (719) 490-8881 to schedule an appointment and discuss what's best for your child's oral health.

A Note from Dr. Dan

Surgical intervention, especially of your infant baby, is the last thing we want to do. Only if significant symptoms present and treatment will solve problems for your child, will we recommend treatment. Otherwise, we will fully review all your options and go over all the things to consider. Please do not hesitate to reach out with any questions or concerns about your baby. At the very least, I would like to offer some peace of mind if you have even a mild concern.