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Tongue and Lip tie Assessment

Function is always more important than appearance!

For newborns, your postpartum care team may refer you if they believe your little one is experiencing feeding impairments due to a restrictive lip or tongue tie. Our doctors will perform a thorough examination and determine if a release is clinically indicated. Using our Solea CO2 laser, we can release these tissues and provide you with important exercises to encourage optimal results as healing occurs. We may also connect you with additional practitioners to ensure a supportive and well-rounded care team is in place for you and your little one, with or without a release!
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We welcome you to visit our clinic for a consultation to assess your child’s unique situation.

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FAQs

  • A frenum is the connective soft tissue that is present inside the upper lip or underneath the tongue. Tethered oral tissues (TOTs) is the term used when a frenum is too tight and doesn’t allow proper movement. You may also hear the term “tie” such as a lip tie or tongue tie. TOTs can make it hard for a child to breastfeed and eat, impair proper facial development, and negatively affect how they breathe, sleep, and even how they talk.
  • Symptoms of a restricted tongue and/or lip during infancy may include painful breastfeeding, fatigue during feeding, leakage, frequent de-latching, inefficient breast drainage, poor weight gain, and so on.
  • When tongue is tied towards the floor of the mouth, the hard palate development may be more narrow. This can interfere with development in the nasal space. Your tongue is meant to contact the palate when swallowing to create the proper seal. A high upper palate and a low tongue can make the suckling and swallowing more challenging for a baby.
  • Restricted tongue can cause speech difficulty to various degrees (but not always). We don’t suggest release just to prevent speech issues unless the tie is severe. Food manipulations in the mouth can also be affected and some children may be seen as picky eaters. Extension (sticking out) and elevation (lifting) of the tongue can be limited. High upper palate due to low tongue resting position can sometimes indirectly cause mouth breathing and other issues. 
  • Our team believes frenectomy is indicated only when there is functional restriction, symptoms, or other areas of concerns. We never base our recommendations on appearance. When indicated, we also connect your family to a team of professional body workers to ensure the most conservative approach and that all factors are addressed to maximise results. Because our decision is always functional based, we welcome you to visit our clinic for a consultation to assess your child’s unique situation.
  • Our team believes a frenum is called a “tie” when there is functional restriction. Therefore, a presence of a line or thin tissue under the tongue does not always necessarily mean it is a “tie”.
  • Tight upper lip tie for toddler and older children is more of an esthetic concern that can be evaluated by a dentist. It may or may not require a release based on your esthetic goals. Oftentimes but not always, a larger gap may be seen between the upper front teeth. In the meantime, please remember small gaps between baby teeth are normal. We are happy to provide consultation if you have questions in this area. Keep in mind brushing for the upper front area may become more challenging for little ones with tight lips. We are happy to demonstrate techniques to help maintain good oral hygiene if this is your child!
  • In addition to history intake and functional assessment, we thoroughly review the findings and expectations for the release. Sometimes we may suggest working with other professionals prior to making a surgical decision. Regardless if a release is recommended at the consultation, we practise the stretches and exercises together and make sure the family receives feedback to feel confident in the post-operative care. An instruction video will also be made available for review of the exercises and techniques. We believe pre and post release preparations will benefit the outcomes. 

Frenectomy

Tethered oral tissues (TOTs, or tongue and lip ties) are conditions that restrict the range of motion of the tongue or upper lip. A frenectomy is a procedure to address tethered oral tissues.

There are different tools that are available for frenectomy, including scissors and many different kinds of lasers. All tools can perform successful releases. At Kiddo Smile Pediatric Dentistry, we perform our frenectomy with Solea laser (can this be linked to the Solea page? Or have a “Read More” at the end of this section that links to the Solea Laser page). It is a CO2 laser and approved by the FDA to use on soft and hard tissue. We select this laser for its efficiency in the procedure and therefore limiting the bleeding and promoting healing.

Parents are welcome to observe the procedure as a silent observer at Kiddo Smile Pediatric Dentistry. Everyone will be provided with laser protective eyewear. Infant will be placed in a swaddle toprevent hand movements during the procedure. Our assistant will make sure the eyewear on your child is secure as well as gently holding your child during the release. A tongue director may be used to isolate and visualise the area. After the release, we encourage caregivers to practise the stretches and exercises again with our team. And feeding immediately after is encouraged.

That is perfectly okay! Coming in for a consultation does not mean that a Frenectomy will occur. This is a big decision to make and we encourage each family to consider their choice. There are important exercises that must be maintained following a release in order to support optimal healing, and we may suggest spending a few days practising these prior to your decision. We encourage working with body workers to continue improving your child’s oral function while a decision is being made. Body workers can include lactation consultant, infant feeding physiotherapist, pediatric chiropractor, oral myofunctional therapist, craniosacral therapist, speech-language pathologist, registered massage therapist (RMT), and so on. We will always respect your family’s decision.

Kiddo Smile, a Vancouver-based Pediatric dental clinic, specialises in prioritising your children in their dental journeys. A fun space and motivational team to provide the best experience to keep those little smiles shining big! Among our areas of expertise are prevention, dental laser treatment, cosmetic fillings, sedation dentistry, tongue and lip tie evaluations, special needs program, and more.

Phone:

(604) 332 - 1100

Email:

info@kiddosmile.ca

Address:

3050 West 41st Ave, Vancouver, V6N 3C9

Monday

9:00 am  - 4:30 pm

Tuesday

9:00 am  - 4:30 pm

Wednesday 

9:00 am  - 4:30 pm

Thursday

9:00 am  - 4:30 pm (*)

Friday

9:00 am  - 4:30 pm

Saturday

One Saturday per month by appointment

Sunday

Closed

* 1 Thursday per month our clinic will be closed to accommodate the 1 open Saturday.

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