Treatment for tongue-tie is controversial. Some doctors and lactation consultants recommend correcting it right away — even before a newborn is discharged from the hospital. Others prefer to take a wait-and-see approach.
Sometimes the lingual frenulum loosens over time and tongue-tie resolves on its own. In other cases, tongue-tie persists without causing problems.
If tongue-tie interferes with breast-feeding, it can be treated with a simple surgical procedure called a frenotomy. For older children or adults experiencing difficulties with tongue-tie, a more extensive procedure known as a frenuloplasty might be recommended.
Surgical treatment for infants
Frenotomy alters the way a baby latches on to the breast. This helps promote successful breast-feeding.
Frenotomy can be done with or without anesthesia in the hospital nursery or doctor's office.
During the procedure, the baby will be swaddled or otherwise restrained on an exam surface. An assistant will hold the baby's head, and the doctor will examine the lingual frenulum and then use sterile scissors to snip the frenulum free. The procedure is quick, and discomfort is minimal since there are few nerve endings or blood vessels in the lingual frenulum.
If any bleeding is present, it's likely to be only a drop or two of blood. After the procedure, the baby can breast-feed immediately.
Complications of frenotomy are rare — but could include bleeding, infection, or damage to the tongue or salivary glands. It's also possible for the frenulum to reattach to the base of the tongue.
Surgical treatment for older children or adults
If additional repair is needed or the lingual frenulum is too thick for frenotomy, a more extensive procedure known as frenuloplasty might be an option.
Frenuloplasty is done under general anesthesia with surgical tools. After the frenulum is released, the wound is usually closed with sutures that absorb on their own as the tongue heals.
Complications of frenuloplasty are similar to frenotomy — bleeding, infection, or damage to the tongue or salivary glands. Scarring is possible due to the more extensive nature of the procedure, as are reactions to the anesthesia.
After frenuloplasty, tongue exercises might be recommended to enhance tongue movement and reduce the potential for scarring.
May 16, 2012
- Isaacson GC. Ankyloglossia (tongue-tie) in infants and children. www.uptodate.com/index. Accessed Feb. 6, 2012.
- Buryk M, et al. Efficacy of neonatal release of ankyloglossia: A randomized trial. Pediatrics. 2011;128:280.
- Suter VG, et al. Ankyloglossia: Facts and myths in diagnosis and treatment. Journal of Periodontology. 2009;80:1204.
- Edmunds J, et al. Tongue-tie and breastfeeding: A review of the literature. Breastfeeding Review. 2011;19:19.
- Block SL. Ankyloglossia: When frenectomy is the right choice. Pediatric Annals. 2012;41:14.
- Beatty CW (expert opinion). Mayo Clinic, Rochester, Minn. March 11, 2012.
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