Tongue Tie/ Lip Tie FAQ’S

Tongue and lip ties can have implications for breathing and airway function. Here are some ways in which tongue and lip ties can impact breathing and the airway:

• Mouth breathing: In cases where tongue ties restrict proper tongue movement, individuals may compensate by breathing through their mouth instead of their nose. Think of the tongue as the on/off switch for nasal breathing. When the tongue is up on the roof of the mouth, you can easily breathe through your nose; when the tongue lowered from the roof the mouth, nasal breathing becomes very difficult. Mouth breathing can have negative effects on oral health, facial development, and the airway. It can contribute to dry mouth, increased risk of dental issues, and potential changes in facial structure.

• Sleep-disordered breathing: Tongue ties may be associated with sleep-disordered breathing, including conditions like obstructive sleep apnea (OSA), Upper Airway Resistance Syndrome or snoring. When the tongue is restricted in movement, it can impede the proper positioning of the tongue during sleep, potentially leading to airway blockages or disruptions in breathing during sleep.

• Oral restrictions and airway compromise: Lip ties, which occur when the upper lip is attached tightly to the gum line, can affect the stability of the upper lip and impact oral muscle function. In some cases, severe lip ties can contribute to an open bite or other malocclusions that may compromise the airway.

• Tonsil and adenoid issues: In certain cases, tongue ties can be associated with enlarged tonsils and adenoids, which can further affect breathing and airway function. The restriction in tongue can lead to mouth breathing which can cause inflammation in the tonsils and adenoids.

It's worth noting that not all tongue and lip ties lead to significant breathing or airway problems. The severity of the tie, individual anatomy, and other factors can influence the extent of the impact. A consultation is necessary to assess the specific situation and determine if intervention is necessary.

Tongue ties form early on in the first trimester and is very prominent. The frenum should become less prominent or “resorb” as the baby grows while it is still in the womb. When it does not resorb completely, the frenum restricts the tongue or lip movement and is called a lip or tongue tie.

The following symptoms are indications that Untied looks for to indicate the need for surgery. They include:

• Speech and swallowing issues

• Tightness around the base of the skull and upper neck, shoulders, or hyoid

• Tenderness in the floor of the mouth

• Neck pain

• Headaches

• Tension

• Clenching

• Grinding

• Sleep bruxism

• Reflux

• Heartburn

• Digestion issues

• Sleep and breathing issues

These are indications of surgery necessity, but each case is different and may require alternative treatment indicative of Doctor Gardner’s opinion.

Tongue and Lip Ties can effect sleep, breathing and development. A tongue that is pulled tightly to the floor of the mouth can partially block the airway while laying down. The ideal resting position for a tongue is up on the roof of the mouth. Sleep disordered breathing can lead to poor sleep, wakeful sleep patterns fatigue and mouth breathing. Restricted Tongue mobility often is associated with narrowing of the maxillary arch and elongation of the soft palate. This can effect and restrict nasal passages causing breathing issues and limited space for future teeth.

Tongue and Lip Ties can affect nursing. The restriction of the tongue does not allow for a deep latch and alters the movement of the tongue necessary for baby to create a proper “vacuum” to remove milk efficiently while nursing.

A frenuloplasty is a straightforward outpatient procedure that can be completed in office without the need for general anesthesia. If a release is recommended, the treatment takes less than an hour. Dr. Gardner will apply an effective topical anesthetic gel on the frenular tissue underneath the tongue prior to treatment, followed by an injection of lidocaine, allowing for zero to minimal discomfort during the procedure. The anesthetic wears off approximately 30-45 minutes after the procedure is completed. For the first several days (occasionally up to 5 days) following surgery, pain is to be expected. This can usually be controlled with over-the-counter medication such as Tylenol or Ibuprofen.

We encourage you to eat a full meal prior to your procedure. We also encourage getting a good night's sleep the night before. Please refrain from consuming caffeine prior to the procedure.

It is normal to experience some swelling and inflammation in the first 3-5 days after surgery. We recommend using Tylenol and Ibuprofen as needed for pain. During the first few days, you may find it helpful to have soft, cool foods. You may find it challenging to consume hot or spicy foods, or foods that require a lot of chewing. Please refer to the post- operative instructions for more details.

No, antibiotics are not administered. We recommend rinsing with salt water and/or alcohol-free mouthwash several times a day to keep the wound clean and reduce the risk of infection.

Complications of surgery are rare, but may include numbness, bleeding, pain, failure of procedure, infection, injury to adjacent structures, and scarring. It is crucial to follow the post-operative instructions to prevent scarring or re-attachment of the frenum. Pre- and post-operative myofunctional therapy is essential for optimal recovery after frenuloplasty.

We use absorbable sutures that will usually fall off or dissolve on their own within 3-5 days and sometimes anywhere from 1-10 days after surgery. As the sutures fall out, white tissue will fill the open wounds. This is normal and not an infection, rather, it is granulation healing tissue that will heal and disappear in approximately two weeks. You can use a soft toothbrush to remove any oral debris if necessary. Please refer to the attached post-operative instructions for more details regarding wound management.