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.
Thanks for taking the time to share this wonderful article with us. I enjoyed all the detailed information that you provided. Have a great rest of your day and keep up the wonderful work.
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