Aerophagia & reflux symptoms associate with lip and tongue tied babies

One of the complaints from breastfeeding mothers is that babies have difficulty in achieving a good latch at the breasts during breastfeeding. Dr. Ghaheri and Kotlow write blogs and articles on both the lip and/or tongue ties that restrict the movement of the lip and tongue and cause problems for the baby to latch on the mothers’ breasts incorrectly during breastfeeding. Some moms describe the latching as weak or shallow.  How does weak or shallow latching at the breasts affect the breastfeeding babies?  Some babies swallow an excessive amount of air, which reaches the stomach and causes abdominal distension, gassiness, and pain.  Some parents describe their babies having symptoms of reflux; difficulty sleeping when lying down, problems swallowing, spitting up, and constant crying among other symptoms.

What is aerophagia?

Aerophagia originates from the Greek word aerophagein, which means to “eat air,” is the excessive swallowing air (Chitkara et al., 2005; Courtiol, 2100; Fernando, 1998: Loening-Baucke, 2000).        Babies with lip tie attempt to latch the mother’s breasts; the upper lip frenum restricts the upper lip to flange outward and the baby will either pop off the breast completely or briefly relax and latch off the breast.  Tongue tie babies have a difficult time lifting the tongue; the frenum restricts the movement of the tongue and causes problems for the baby to latch onto the mother’s breast during breastfeeding. Tongue and/or lip ties may cause incorrect latching.  The consequences of an incorrect latch at the breast during breast feeding may include poor suck, poor seal around the breast, loud clicking noises, extended feeding times, poor infant weight gain, infant fussiness, and irritability during and after breastfeeding.

An inadequate seal around the breasts during breastfeeding may cause the baby to experience aerophagia, swallowing or sucking air into the stomach.  The babies may experience these symptoms:

·       abdominal distension

·       gassiness (flatulence)

·       belching (burping-swallow excessive air)

What is reflux?

*Reflux or GER (gastroesophageal reflux) in a baby may show up as irritability and pain, sometimes with constant or sudden crying, or colic-like symptoms.  Babies can be inconsolable, especially when laid down flat.

Signs & symptoms:

·       Difficulty sleeping when lying down

·       Arching their necks and back during or after feeding

·       Problems swallowing, gagging, coughing

·       Hiccupping and drooling

·       Feeding refusal or constant feeding

*Normal movement of the tongue is difficult or impossible if the tongue is tethered to the floor of the mouth     *Clinical Lactation 2011, Vol.2-4

Treatment

Aerophagia and reflux symptoms are experienced in lip and tongue tied babies and can be misdiagnosed as Gastroesophageal Reflux Disease (GERD).   Unfortunately, some babies are treated with prescription medications, such as Zantac or Prevacid to reduce the reflux symptoms.

* Dr. Larry Kotlow’s article, Infant Reflux and Aerophagia Associated with Maxillary Lip-tie and Ankyloglossia (Tongue-tie), suggests that a maxillary lip and/or tongue ties may be a contributing factor of babies’ inability to create an adequate seal for correct latching at the breasts during breastfeeding.

**There is a lack of literature and research looking at a potential causal relationship with aerophagia and reflux in breastfeeding infants.  More studies and researches are needed.

*Clinical Lactation 2100, Vol.2-4

**Int J Clin Pediatr.2016; 5(1):6-8

How to treat lip and tongue tied babies?

Both lip and tongue ties can be treated in quick procedure that is nearly painless, it usually may not require anesthesia.  The procedure is called frenectomy; the removal of frenum that connects to the lip or tongue.  Frenectomy can be performed with the following instruments:

·       Scissors-bleeding

·       Scalpel or sharp surgical knife-bleeding

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

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 (releases).  If you have any questions about lip and tongue tied frenectomy, please visit us at www.annaleedds.com or call for a consultation at                  626-335-5114. 

Periodontal Disease Bacteria Linked to Alzheimer’s disease

A recent study published in the journal Science Advances found evidence linking bacteria associated with periodontal disease and Alzheimer’s.  Researchers analyzed brain tissue, spinal fluid and saliva from Alzheimer’s patients; both living and deceased and found the bacteria, P. gingivalis may play a role in the development and progression of Alzheimer’s.  However, Alzheimer’s experts not involved in the research caution that not enough research has been done to prove the association between periodontal disease and Alzheimer’s.

Research studies: possible link of Periodontal Disease and Alzheimer’s

·       *In January 2019, a new study published in the journal Science Advances, found a potential link between P. gingivalis, the bacteria associated with periodontal disease and Alzheimer’s.  **The co-founder of Cortexyme Inc., Dr. Dominy and his team found P. gingivalis in the brain tissue, spinal fluid and saliva from Alzheimer’s patients, both living and deceased.  The Cortexyme team did a mice study.  The team swabbed the gums of healthy mice with P. gingivalis every other day for 6 weeks to cause gum infection.  The team later detected P. gingivalis in the mice’s brain tissues along with dying neurons and higher than normal level of proteins that cause Alzheimer’s.

*American Academy of Periodontology. Perio.org   Article January 28, 2019                                                                      **Science Magazine January 23, 2019

·       *Researchers at the University of Illinois, Chicago (UIC) College of Dentistry performed a study on wild mice.  The mice received 22 weeks of repeated oral application of the periodontal bacteria.  The researchers found that the mice had more brain inflammation and fewer intact neurons due to degeneration than those mice without oral application of periodontal bacteria.                  Keiko Watanabe, D.D.S., Professor of periodontics at UIC said, “Our data not only demonstrate the movement of bacteria from the mouth the brain, but also that chronic infection leads to neural effects similar to Alzheimer’s.  Periodontal bacteria may kick start the development of the Alzheimer’s.”

*Dentistry Today  October 4, 2018

·       *Mark I. Ryder, DMD, Professor of Periodontology at the University of California, San Francisco noted that the presence of P. gingivalis increased the production of amyloid beta (plaque buildup in the brain) which contributes to Alzeimer’s.  Dr. Ryder confirmed the mice study that P. gingvalis can travel from the mouth to the brain and can destroy brain neurons.

*American Academy of Periodontology.  Perio.org  Article January 28, 2019

Gum Disease is a common condition for older adults

Richard Kao, DDS, PhD, president of the American Academy of Periodontology (AAP), encourages older adults to maintain diligent oral care and treat periodontal disease to help mitigate Alzheimer’s risks.  Dr. Kao said, “Periodontal disease increases to 68 percent for people age 65 and older…visiting a periodontist can help identify any disease and treated as needed, potentially diminishing the risk of developing Alzheimer’s.”  

More research is needed

P. gingivalis is likely to be one of a variety of pathogens that contributes to the amyloid beta (plaque buildup in the brain) that causes Alzheimer’s.  More studies are needed to support the link between periodontal disease and Alzheimer’s.  An upcoming FDA phase II clinical trial will assess and add further insight to the link between periodontal disease and Alzheimer’s.

Dr. Anna Lee is a General & Cosmetic dentist in Glendora, CA.   Periodontal disease can occur at any age. If you notice any signs and symptoms of periodontal disease, please call for a consultation.  You can visit us at www.annaleedds.com or call to schedule for an appointment at 626-335-5114. 

*Visit our website to read about periodontal disease on Dr. Lee’s blog.