Articles

Tongue Tie

Having recently seen a few babies with tongue tie or Ankyloglossia I asked Dr Laurie Kobler if I could use his article to inform parents of this sometimes debilitating condition.   These days many doctors either neglect to inform parents or believe it is unnecessary to treat a baby with ankyloglossia this can lead to several problems including poor attachment causing damage to the nipple and even poor feeding.  

Take a look inside your baby’s mouth.  If you notice a shortened frenum which you feel may be contributing to your baby’s poor attachment I suggest you seek medical advice.  If you are in NSW give Dr Kobler a call. 

Neo-natal Ankyloglossia Release

By Dr Laurie Kobler B.D.S. 

Ankyloglossia – A condition in which the sublingual frenum is shortened, tight or otherwise restrictive, resulting in reduced mobility of the tongue.

Consequences

1. Infant.  Interference with feeding, most especially causing maternal breast/nipple pain, significant air intake and extended feeding time.  This can express itself in poor weight gain.
2. Toddler.  Commonly causes difficulty with speech, as well as ongoing eating issues associated with the condition.  Often unable to phoeneticise correctly and rapid speech can be difficult to understand.
3. Unseen effects on personality development and self-esteem associated with poor communication skills are possible.
4. Inability to circumlocute is messy.  Occasionally excessive saliva flow is also evident.
5. Older child/adult.  Poor oral hygiene.  Reduced tongue mobility impacting intimacy issues

Treatment options

1. Non-treatment with associated symptoms as described
2. Conventional surgery often performed at 6 months age under G.A. using scalpel, scissors & sutures.  Breast feeding opportunity has passed with associated nutritional compromise.  This is significantly more invasive, costly and painful with longer healing time & often increased costs.
3. Laser correction can be performed as young as possible, is quick, minimal pain and rapid healing, allowing breast feeding to continue or re-commence if possible.  Minimally invasive and less cost as well as less time commitment to procedure.  No requirement for hospitalisation or overnight stay.

Procedure

1. Pre-operative photographic record
2. Topical anaesthetic application
3. (Local anaesthetic is rarely needed)
4. Tension frenum (DeLorenz Retractor)
5. Release ankyloglossia
6. post-operative photographic record

Take a look inside your baby’s mouth.  If you notice a shortened frenum which you feel may be contributing to your baby’s poor attachment I suggest you seek medical advice.  If you are in NSW give Dr Kobler a call at Intergrity Dental Clinic 02 96514488