Children and Adult Tongue Ties & Lip Ties
Children and adults can have tongue ties and lip ties that affect function or anatomy. Regarding function, tongue ties can affect speech, swallow and eating. Regarding anatomy, tongue ties or lip ties can affect recession or contribute to space between teeth. Symptoms are listed below.
Older children and adults with tongue ties or lip ties symptoms may include:
- difficulty with speech
- difficulty or limitations with eating, or difficulty licking an ice cream cone
- narrow dental arches, crowded teeth due to limited dental growth
- high arched palate (roof of mouth)
- myofunctional impairments such as poor swallow patterns, open mouth breathing, snoring
- gum tissue recession
- space between teeth (diastema)
Some older children and adults who have compensated for years may not realize they have had a lip tie or tongue tie. If there are functional or developmental concerns, your dentist might suggest a frenectomy or frenuloplasty procedure. This may help to restore function and improve range of motion or improve anatomy. Examples of lip ties and tongue ties in children and adults are shown in the photos below.
How are tongue ties and lip ties treated in older children and adults?
After a complete exam and consultation, Dr. Kristen Berning can discuss which procedure is best indicated on a case-by-case basis. Sometimes a LightScalpel CO2 laser is recommended, sometimes a scissors technique is recommended, or a combination approach. The procedure is well tolerated by children and adults. Topical anesthesia and local anesthetic are both used to numb the tissue. A frenectomy or frenuloplasty is performed to release the tight frenum attachment. Recovery is a few days, soreness may persist 1-2 weeks, and healing is complete after a few weeks.
What is a frenectomy/ frenotomy?
A frenectomy or frenotomy is a procedure used to correct a frenum that is too tight, causing limited function. A scissors or a LightScalpel CO2 laser is used to release the restrictive tissue attachment. The procedure can be done by a medical professional such as a dentist or physician who has specialized training in the technique.
What is a frenuloplasty?
A frenuloplasty is a procedure that corrects a tongue-tie in which sutures are used after the release to realign the tissue borders for healing. Dr. Kristen Berning has completed a functional frenuloplasty course with Dr. Soroush Zaghi of The Breathe Institute, and Dr. Berning is a TBI Ambassodor. Dr. Zaghi is an ENT physician who has published research on the benefits of functional frenuloplasty for improved function, breathing, and wellness.
What are the risks and complications?
A smooth recovery is expected, however, there are always associated risks that cannot be eliminated and may occur in a minority of cases. A consent form will be provided to parents and patients and can be discussed with Dr. Berning before the procedure.
What is aftercare?
To help assure the best possible healing result, Dr. Kristen Berning will provide specific aftercare instructions. Aftercare helps to guide tissue healing and also tongue retraining to improve function. For an older child or adult, it is recommended to continue care with a myofunctional therapist or speech language pathologist (SLP) who is familiar with tongue ties and frenectomies. Many times bodywork or other therapy (occupational therapy, physical therapy, chiropractic, cranial sacral therapy, massage) is recommended to address other functional compensations.
Where did Dr. Kristen Berning get her training for tongue ties and lip ties?
Dr. Berning has attended a variety of tongue tie courses from medical professionals who are considered leaders in tongue tie research and education. She has completed courses given by Dr. Larry Kotlow (pediatric dentist), Dr. Bobby Ghaheri (ENT physician), Dr. Soroush Zaghi (ENT physician), and Dr. Richard Baxter (pediatric dentist). For completing Dr. Baxter's comprehensive course, she earned the designation of a "Tongue-Tied Academy" Graduate. She has also received training from Dr. Fred Margolis (pediatric dentist) and Dr. Alison Hazelbaker, PhD, IBCLC through observation and hands-on workshops, respectively. She also has attended the TOTS Training Course with Autumn Henning, MS, CCC-SLP, COM, IBCLC.