Tongue Ties

The Ultimate Guide to Tongue Tied Babies and Treatment Options 

If you suspect your baby has tongue-tie (ankyloglossia), this guide is full of health information that will help identify the tongue tie and find a potential solution -so your baby can get the nourishment needed to grow and flourish!

What is a Tongue Tie (Ankyloglossia)?

All babies have a piece of connective tissue on the underside of the tongue called a lingual frenulum that connects the tongue to the floor of their mouth. In fact, children and adults also have a frenulum. For most babies this tissue is flexible enough to allow for proper movement without any difficulty. In some infants, however, the frenulum is too tight and restricts the range of motion of the tongue, which is why we refer to these babies as “tongue tied”. The medical word for a tongue-tie is Ankyloglossia, which is actually latin for “fused tongue”. 

In tongue tied babies, this little piece of tissue (the lingual frenulum) tethers their tongue much closer to base of their mouth. As you can imagine, when this tissue is attached closer to the tip of the tongue,  it’s makes it difficult for that tongue to move up and down as well as in and out of the mouth, which makes it difficult to latch onto your breast or a bottle.

A tongue tie at the tip of the tongue will dramatically reduce the range of motion and functionality of a babies tongue for breastfeeding and can sometimes create a heart shape in the tip of the tongue. The good news is that it’s possible to identify and correct a tongue-tie so your baby (and you!) can return to healthy living.

My Story With a Tongue Tied Baby

My passion for helping Moms and babies stems from a long and confusing journey as a new mother. For many babies, a tongue tie is quickly recognized by a medical professional after birth. I wasn’t so lucky. Lily, my oldest of 3 girls, struggled to feed for months. It seemed like she fed around the clock and was always irritable. She would make a clicking sound during feeding and was extra squirmy which left us both tired and frustrated.

I went to well baby clinics for weighted feeds, asked multiple lactation consultants and got second opinions from pediatricians…  Still no answers.  I had all but given up on breastfeeding at 6-months as the pain of cracked and bleeding nipples were too much to bare.

When I noticed a blister had formed on her lip, I decided to ask around at dental school. Here I was, completely surrounded by medical professionals (that specialize in the human mouth, no less), and yet nobody, including myself, could see the problem was my baby’s tongue-tie.

As Moms, we do everything we can to prepare for labor and childbirth. We know the benefits of breastfeeding and expect we’ll be able to feed our newborn baby some howThough it can be natural for babies to lose up to 10 percent of their birth weight, it’s scary when we can’t transfer enough milk in a feeding to help them gain the weight back.. Like, it’s our one job. Everything in our nature needs to provide for this babe but every ounce lost puts the weight of the world on our shoulders.

Breastfeeding can be incredibly rewarding or frustrating -some days it both! Here’s a quote that gave me some peace:

“Although the ability to breastfeed is natural, it’s not natural like breathing, it’s natural like walking, which needs to be learned and learning is much easier with support.” -Unknown 

Now, as a Dentist and a mother who gave birth to 3 tongue tied babies, I love helping other Mom’s and babies struggling with tongue and lip ties. This page includes everything I wish I had known years ago as the new mother of a tongue-tied baby. ❤️

Dr. Brielle Renz

Dentist, All Smiles Dental

How Do I Know If My Baby Has A Tongue Tie?

Symptoms of a tongue tie may be recognized in the baby, the mother, or both baby and mother. Many tongue-ties are first recognized when the baby cries or when a mom notices that feeding the child has become difficult. Tongue ties are recognized by mothers, nurses, lactation consultants, doulas, and doctors; though they can go unnoticed until problems crop up.

 

Mom’s Symptoms Baby’s Symptoms
Nipple pain Difficult or shallow latch
Nipple cracks & bleeding Clicking sound during feeding
Lipstick shaped nipple Biting and gumming at the nipple
Clogged ducts & mastitis Poor weight gain
Vasospasms Head up, gasping for air while feeding
Low milk supply Milk coming out of corners of mouth
White strip at the tip of the nipple Heart-shaped tongue
Long & frustrating nursing sessions Colic and/or reflux
Stress & fatigue Trouble sleeping 

 

Does a Tongue Tie Need To be Treated?

Before it can be determined if your baby should be treated, it’s important to have an evaluation from a qualified medical professional, IBCLC, Dentist, Pediatrician, Ear Nose and Throat (ENT) Doctor, etc. The factors they will use to evaluate the tongue tie include:

  • Tongue function and range of motion
  • Symptoms experienced by both Mom and baby
  • Appearance of the tongue

Video: Examination Technique for Tongue-Tie and lip Tie

Many Tongue Ties Go Unnoticed by the Untrained Eye 

Some tongue ties are located mucosal layer which makes them harder to detect which is why it’s important to see a trained professional for a consult. When left untreated, tongue ties can affect:

  • Orofacial development
  • Speech and behavioral patterns
  • High and narrow palate development
  • Crowding of the teeth
  • Airway obstruction leading to sleep apnea and snoring

Later in life, a tongue tie may affect how your child eats, breathes, sleeps, swallows and speaks -as was the case in the viral video:

How Should We Treat a Tongue Tie (Scalpel, Scissors, or Laser)? 

The procedure to treat a baby’s ties may be referred to as a frenectomy, frenulectomy, or frenulotomy depending on the nature of the tie. There are 2 common ways to treat a tongue tied baby:

  1. Scissors/scalpel method 
  2. Laser method

Both methods are quick ways to cut the restrictive tissues -which sounds painful but is generally well tolerated by the baby. At All Smiles Dental, Dr. Brielle Renz uses the laser method because it it precise, kills bacteria, and instantly cauterized (seals) most blood vessels to minimize bleeding. 

There are risks to every procedure and a frenotomy is no different. That said, people have been performing frenotomies for centuries. Midwives in the 18th century used to look for ties and cut them with sharpened fingernails.

One consideration is the pain of the procedure. There are very few nerves in the frenulum so it’s rare for doctors to administer general anesthesia. From the doctors point of view, the risk of anesthesia outweigh any pain the baby might feel.

It is a relatively quick procedure and many babies are able to breastfeed right after the procedure. Breastfeeding right after helps calm both baby and mama and helps initiate the healing process.

 

We met Dr. Renz almost 4 years ago when my daughter was just 2 days old. We needed help, breastfeeding was excruciating (you know, bloody, cracked nipples). Our amazing Doula suspected our sweet baby had a tongue tie and got us an appointment with Dr. Renz the same day! Sure enough, Dr. Renz confirmed the tongue tie but also discovered an upper lip tie as well. The procedure was so quick and painless. She talked us through everything before hand and let us see and feel the water laser before beginning the procedure. Dr. Renz swaddled our sweet girl and my husband held her throughout the procedure, which only took about 5 minutes! We nursed in the office before we left and the change was amazing! So much easier already! No more pain! Needless to say, we switched dentists immediately and the whole family has been seeing Dr. Renz ever since!

Lauren Buol

RN BSN , CHI St. Alexius Health

Mom’s Benefits May Include:

  • Improved comfort during breastfeeding 
  • Reduced soreness and infection in the breast
  • Reduced cracking of the nipples
  • Improved bond and breastfeeding experience
  • Improved sleep without fussiness and cluster feeding

Baby’s Benefits May Include:

  • Improved latch and milk transfer during breastfeeding 
  • Improved ability to swallow
  • Reduced risk of speech impediments including lisp
  • Enhanced expression and communication skills
  • Improved airway, jaw development, and ability to chew and articulate as they grow
  • Reduced risk of orthodontic issues, oral hygiene issues, and sleep apnea as they grow

Results will vary and the benefits aren’t always realized immediatly after surgery. Often times a tongue tied babies has learned to compensate for their tethered oral tissue and will have to “relearn” to feed without the tie.

Similarily, a child who is already speaking, may need to work with a speech therapist to help your child master the new functionality of their untethered tongue. The good news is that this newfound mobility will make speaking and annunciating much easier.

Tongue Tie Release Surgery (Frenectomy) in Bismarck, ND 

If you believe that you or your child are dealing with problems related to a tongue tie, be sure to seek advice from a healthcare provider and a second (or third) opinion as tongue ties are a commonly missed and are a very treatable condition.

Dr. Brielle Renz offers tongue tie release surgery (frenectomy) at All Smiles Dental in Bismarck, ND. She is a member of the International Affiliation of Tongue-Tie Professionals (IATP). In 2013 Dr. Brielle Renz earned an Associate Fellowship in Laser Dentistry through the World Clinical Laser Institute (WCLI). Dr. Brielle Renz has used laser technology to help thousands of moms and babies with tongue tie release surgery over the years. If you’re interested in a tongue-tie evaluation, please give us a call. 

Went to all smiles to revise my sons tongue tie. Staff was very helpful and extremely informative about the process. Dr. Renz was so sweet to our one month old which was comforting to not only him, but It also put me at ease to know that he was greatly taken care of! After the procedure the front desk personal was so kind and engaging. All over a fantastic experience. Will be signing up the rest of the family for dental care and spreading the word for our friends! Cannot thank you enough!
owen G.
owen G.
01:20 17 Jul 20
Amazing experience. Everyone is so friendly. The atmosphere is relaxing and beautiful. My son had a tongue and lip tie revised. Couldn't recommend this more! I could tell the latch was better right away! This mama is so happy her little boy can eat properly now - not that he wasn't a chunk already! I feel good, too, which is a good thing! Thank you, Dr. Renz!
Kayla H.
Kayla H.
21:24 01 Jul 20
We have taken our youngest two for lip and tongue revisions. Dr. Renz is very knowledgeable and explains everything so you understand, she presents all the options so you can decide what is the best option for your family. Love their mommy and baby room and the pro support she and her staff display towards breastfeeding. I have recommended her to my friends and family.
Cherstin P.
Cherstin P.
00:31 28 Aug 19
Love Dr. Renz and her staff at All Smiles Dental!! My infant son had a terrible lip and tongue tie and nursing was such a struggle. After Dr. Renz released his ties, things got so much better for us! He finally nurses really well and we owe it all to Dr. Renz! She went above and beyond in answering any and all of my many questions. She is the absolute best and I trust her completely!♥️
Lauren K.
Lauren K.
23:50 27 Jul 19
It has been a little over one week since Dr. Renz released my son’s tongue and lip tie. From the exceptionally friendly front office staff to the hygienist and Dr. Renz’s kind and thorough education, this was a 10/10 experience. Our world has improved so much since the procedure, which was quick and easy. Thank you, All Smiles Dental staff!
Marley Z.
Marley Z.
23:07 25 Nov 18
I am so grateful for Dr. Renz and her expertise with tongue and lip ties. From her evaluation, explanation, treatment/revision, and follow-up care instructions, she was thorough, professional, and compassionate. I’d recommend her to anyone!
Sarah M.
Sarah M.
22:26 30 Apr 18
Dr Renz is so nice and so knowledgeable at tongue and lip ties! She made it so convenient to have the consultation and perform the procedure minutes later. We were told we’d be there about 1.5 hours and we were in and out in 45 minutes. I highly recommend Dr Renz!
Brittany G.
Brittany G.
11:24 02 Feb 18
Dr. Renz was wonderful with our daughter who had both lip and severe tongue tie. She was extremely helpful from start to finish and was so incredibly caring. Not only was she wonderful during the appointment, but helped answer all my questions via email afterwards as well. We traveled several hours to see her and we would do it again in a heart beat.
Maggie 'Hamm' N.
Maggie 'Hamm' N.
15:22 23 Jan 18
Dr. Renz is exceptional in what she does. She thoroughly explained everything about the procedure in great detail before ever doing anything. It helped ease our anxiety since our daughter was only 4 days old. I highly recommend her for assessing and fixing a tongue and/or lip tie. On top of that, she’s extremely kind and professional!! Nothing but the best!
Beth A.
Beth A.
12:55 21 Jan 18
Dr. Renz is a lifesaver!!! My 4 week old had tongue and lip ties and we went to her for the revision. She explained everything so well and took her time to answer all of our questions. There was zero pressure to have it done if we changed our minds. The procedure was very quick and she took her time explaining the after care when it was over, after allowing me to nurse him as long as I needed to. A week or so later, I had feared it was reattaching so she happily checked it out to ensure it was... healing properly. I wouldn't have been able to breastfeed without her help, and we are still nursing strong at 11 months! She is so nice and I couldn't recommend her enough!read more
Kianna K.
Kianna K.
14:20 18 Jan 18
We love Dr Renz. It has been over a year ago and I was having nursing issues with my little one and a CLC told me to get her checked out by Dr Renz to check for lip and tongue tie. My little one was 5 weeks old at the time and Dr Renz was very knowledgeable and explained everything very thoroughly. She was so caring and took the time to listen and answer all our questions. Immediately after she released the lip and tongue tie she told me to nurse my baby, it was 100x better and I had no pain... with nursing her. I am forever grateful that someone told me about her and I went in and had it done otherwise I don't think I'd still be nursing. My baby turns 1 on Saturday and we still going strong. I would highly recommend seeing her for an evaluation if you are having struggles with nursing!read more
Janene P.
Janene P.
15:34 17 Jan 18
Dr. Renz is truly one of a kind! She is professional, caring and knowledgable not only in Dentistry as a whole but she has taken the time to increase her knowledge base concerning tongue and lip ties and how they can affect oral development, speech and how they may cause feeding issue concerning both breastfed and bottle fed infants. There is no one else in our area that I will refer people to concerning this! She is truly the best!
Becky K.
Becky K.
14:03 17 Jan 18
She saved the nursing relationship with my daughter, and virtually eliminated my base of skull pain by identifying and revising our tongue ties. I will be forever grateful! She’s amazing!
Tessa R.
Tessa R.
03:57 17 Jan 18

Post-Op Stretches for After Ties are Released

 

Ties want to stay tied. Post-op stretches help prevent the reattachment of the revised areas and play a key role in successful healing after the surgical procedure.

Stretching Posture

Correct stretching posture is with the infants head in your lap facing the same direction as your head. Stretches last about 3-5 seconds on each arch. Gentle and consistent pressure is key. Stretch for at least 4-6x/day for 3 weeks.

Upper Lip Tie Stretch

Grasp the upper lip with two hands, gently lift the upper lip until it reaches the infants nose. Hold the stretch for 3-5 seconds.

Tongue Tie Stretch

With baby’s head in your lap and feet facing away from your body, place your fingers on either side of the tongue release. Aim for the top of the “diamond” under the tongue and gently pull the tip of the tongue towards the back of the mouth with your index fingers. Hold for 3-5 seconds. Video: Post Surgery Stretching for Breastfeeding Infants

Tongue Tie Release Aftercare Instructions

Beyond stretching, these aftercare recommendations can improve the outcome of a tongue tie release. 

Post Surgery Appearance

The released areas will show changes in appearance over the first 48 hours after the release. A creamy white film will develop over the released areas. This is a normal part
of the healing process in the mouth.

Pain Management

The most discomfort occurs in the first few days after the
tethered oral tissues are released. Manage pain using:

1. Homeopathic: Skin-to-skin, warm baths, and feeding on demand.
2. Medication: A pediatrician recommend dose of acetaminophen can be given if necessary. Consult a pediatrician for dosage.

Massage

Gentle facial massage is a relaxation technique that can be used before and after stretches. Perform as needed.

Follow Up Appointments

For best results breastfeeding after surgery, it’s important
to follow up with a knowledgable lactation consultant to
begin the retraining process.

Emergencies

If you believe your child has a serious or life threatening complication following the procedure, seek emergency medical attention immediately. Do not call the office for emergencies when an emergency room physician is required.

Aftercare Tips from Moms

1. Frozen breast milk chips for comfort.

2. Pediatric chiropractor as a follow up.

3. Use an open-back pacifier filled with breast milk for stretches.

4. Resources:

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All Smiles Dental

714 South 2nd Street

Bismarck ND 58504