Adult Lip and Tongue Ties

     

What is lip tie?

Lip tie is a band of thick tissue that connects the underside of the lip to the gums and restricts the normal movements of the lip.

What is tongue tie?

Tongue tie is a band of thick tissue that connects the bottom of the tongue’s tip to the floor of the mouth and restricts the normal movement of the tongue.

What are some of the problems may be caused by tongue and/lip ties?

1.      Airway obstruction

·       In his book, “Tongue Tie,” pediatric dentist, Richard Baxter, D.D.S., discusses that the tongue is held down by a tongue-tie, the tongue often falls backward during sleep and blocks the airway.

·       When the airway is blocked, the body tries to open up the airway by protruding the lower jaw and grinding teeth.  It is a body’s defense mechanism of arousing the person to breathe when the airway is obstructed. (88, 89)

88.  Kostrzewa-Janicka J, Jurkowski P, Zycinska K, Przybylowska D, Mierzwinska-Nastalska E. Sleep-Related Breathing Disorders and Buxism. Adv Exp Med Biol 2015; 873:9-14.

89.  Jokubauskas L, Baltrusaityte  A.  Relationship between obstructive sleep apnoea syndrome and sleep bruxism:  a systematic review. J  Oral Rahabil 2017; 44(2): 144-53

2.      Chewing

·       Tongue tied restricts movement and function of the tongue.

·       Tongue cannot move food from side to side for sufficient chewing, swallowing and complete digestion.

3.      Swallowing

·       The tongue assists in swallowing 1200-2000 times per day.  Tongue tied restricts swallowing which prevents saliva/food to be swallowed normally and may lead to digestive problems.

4.      Cleaning of the Mouth

·       Tongue tied restricts the tongue from lifting and sweeping the food stuck between the cheeks and teeth.  Tongue is restricted and unable to clean the back teeth and the palate.

·       Lip tied can trap food between the lip and the teeth and make it difficult to brush.

5.      Facial development

·       Tongue tied keeps the tongue in a low position, so the palate does not receive its natural resting pressure from the tongue to form a broad and flat palate. Mal-alignment and mal-occlusion of the teeth may occur and affect the facial development of the person

6.      Obstructive Sleep Apnea (OSA)

·       Dr. Baxter’s article, Tongue-Ties and Sleep Issues, published from Dental Sleep Practice in winter 2018 discusses the following:

“A tongue that is held down by a tie is unable to rest in the palate.  The only place left for the tongue to go is backward, which closes off part of the airway.”  Snoring from upper airway resistance can be a warning sign of obstructive sleep apnea (OSA) or sleep disordered breathing.

7.      Speech

·       Movement of the tongue is important for pronunciation of words and linking the words into sentences.

·       Tongue tied restricts the tongue to move freely and reach the palate to sound out letters, words, and phrases

8.      Problems with posture, neck and back pain

Tongue tied may cause the head to tilt low and forward. The poor posture affects the sternocleidomastoid muscle, trapezius muscle and surround muscles and may cause the following problems:

·       Neck and back pain

·       Headaches and migraines

·       Shoulder pain

Note: dental problems caused by lip and tongue ties are discussed in the 2-24-2019 blog

What is frenectomy?

To remove the thick band of tissues that connects to the lip or tongue.

·       Labial frenectomy (aka frenectomy of lip)

·       Lingual frenectomy (aka frenectomy of tongue)

Indications of adult frenectomy

When the lip and/tongue tied is overlooked in an infant, future health problems can occur as an adult.  Lip and/tongue tied may be the cause of one or more of the problems discussed in this blog.  Consult with your dentist or general surgeon (ENT specialist) for evaluation and diagnosis.

How is frenectomy surgical procedure performed?

·       Scissors-bleeding

·       Scalpel or sharp surgical knife-bleeding

·       Laser-minimal bleeding, faster surgical time, decreased postoperative pain, quick healing

How long will the procedure take?

·       The amount of time needed for the frenectomy procedure depends on the technique used.  The entire procedure may be 30 to 60 minutes; includes pre-treatment preparation, post treatment instructions and the actual surgical (incision) procedure may take only a few minutes.

Post treatment care after the frenectomy procedure

·       Pain-relief medication may be needed

·       Salt water rinses for the next 5 days, 2-3 times per day

·       Soft food diets for 3-5 days; avoid hard, crunchy and spicy foods

·       Gentle tooth brushing

·       Follow-up visit

Orofacial Myofunctional Therapy before and after frenectomy

·       Pre- and post-frenectomy orofacial myofunctional therapy (OMT) helps re-educate the tongue and orofacial muscles during movement and at rest to create new neuromuscular patterns for proper oral function, including chewing, swallowing, speaking, and breathing.7

7 Camacho M, Certal V, Abdullatif J, Zaghi S, Ruoff CM, Cappasso R, Kushida CA. Myofunctional Therapy to Treat Obstructive Sleep Apnea; A Systematic Review and Meta-analysis. Sleep. 2015 May 1; 38(5):669-75. Doi: 10.5665/sleep.4652

If you are suffering from any problems related to lip and/tongue ties.  Dr. Anna Lee is here to help you with the diagnosis and treatment. Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  Dr. Anna Lee is an experienced provider for Laser lip and tongue tied frenectomy.  If you have any question about lip and tongue tied frenectomy, please visit us at www.annaleedds.com or call for a consultation at 626-335-5114.