Frenectomy: Tongue & Lip Tie Treatment

TMJ Plus Wellness Center performs frenectomy procedures (tongue tie treatment) in Grapevine, TX. We treat patients from throughout the greater Dallas area. Call us at 817-481-6888 to schedule an appointment.

In practicing holistic dentistry, we recognize the interconnection between the mouth, the oral tissues, and the entire head and neck area. Tongue and Lip Tie Releases are simple surgical procedures performed to release the connection of the “frenum,” a connective muscle between two tissues. There are two types of oral releases that can be performed on both adults and children for relief from a variety of symptoms.

Working with an osteopathic physician, Dr. Matt Barker, we can identify the tight areas of the neck and shoulders that are related to your restricted tongue. As we perform the tongue release, Dr. Barker will locate pressure points on the back of your neck and head to help ensure that you get the best possible relief from the procedure.

A labial frenectomy, or Lip Tie Release, is performed on the tissue that connects the lip to the gums. Performed on either the upper or lower lip, or even both, this  procedure can aid with orthodontic treatment or assist with the proper fitting for an orthotic appliance to relieve symptoms of TMJ or sleep apnea.

A lingual frenectomy, or Tongue Release, may also be referred to as the release of tongue-ties (ankyloglossia). This release is performed on the connective tissue beneath the tongue. Once the tongue is released from the floor of the mouth, patients often experience immediate relief from tightness and pain in the mouth, neck and even shoulders. The tongue fascia is connected to the diaphragm, hips, knees, and feet. This means that a tight tongue muscle impacts our entire body.

A frenum is the piece of tissue that connects the lip or tongue to the jaw.  A frenectomy is a procedure during which that piece of skin is cut. It may be cut by scalpel, scissors or laser. Early detection of the need for a lingual or labial frenectomy can help your child with feeding, breathing better, and assist in your lactation consultation.

Some people need a frenectomy when the piece of skin connecting the lip or tongue to the jaw is too short, too tight, or attached in a poor place. Poor placement may cause dental issues, a narrow face, breathing issues, misshapen jaws, neck and jaw pain, feeding issues, speech issues, or even sleep issues.

A frenectomy may be needed when the abnormal attachment of the lip or tongue prevents a proper latch while breast or bottle feeding. Your baby could be experiencing difficulty latching, fussiness, colic issues from poor digestion, neck pain, torticollis, and breathing issues.

Many older children need a frenectomy when the tissue connecting the lip or tongue pulls improperly on the gums, causing gingival (gum) recession and difficulty brushing. Some children need a frenectomy to allow their permanent teeth to come together for better aesthetics from orthodontics. Other children need a frenectomy to aid in proper speech and swallowing. A frenuloplasty can help to get the tongue to the roof of the mouth to positively reinforce mouth size and development. If your child cannot place their tongue on the roof of their mouth while keeping their mouth wide open, they likely have a tight frenulum. Make sure your child’s mouth stays open wide and does not close down during this assessment. A tongue tie or restriction can result in breathing difficulties, slow growth, possible ADHD behavior issues, and poor and misshapen mouth development that can result in severe crowding, possible TMJ, and sleep apnea issues as an adult.

Sometimes a tight frenulum (the piece of tissue under the tongue) can prevent children from moving their tongue to the correct position needed to make certain sounds. Removing this tissue can aid in speech therapy, dental arch development, and the reduction of behavior issues such as ADHD and other learning difficulties.

Individual costs can vary depending on the diagnosis of a lip or buccal tie in a addition to the frenuloplasty procedure. Our frenectomies are very affordable and we offer payment plans as needed. Call our office so we can discuss the benefits of this health procedure.

A lingual frenectomy should be performed when the tissue under the tongue causes problems with feeding, speech, swallowing, speech, neck pain, jaw pain, breathing issues, snoring and underdevelopment of the dental arch.

Frenectomies can be performed using a variety of tools: a scalpel, scissors, a diode laser, or a C02 Laser. When we perform a frenectomy, it is virtually painless and very quick. When using LLLT, or low level light therapy, patients report less postoperative pain and better function after the frenectomy procedure. The laser itself encourages healing of the tissues in the mouth at cellular level by decreasing pain and inflammation at a cellular level.

Dr. Coats will first numb the area for comfort. If desired, you can have nitrous oxide and or nu calm to help you relax during the procedure. The precision of the procedure comes through the use of a team approach of guided functional frenuloplasty. After the procedure is complete, the healing is faster than you would assume because we use LLLT, or lower level light therapy, to help healing of the muscles, tissues and reduced pain and inflammation at a cellular level. The use of ozone gel helps jumpstart a quick recovery along with our post procedure instructions that will help provide a smooth experience. Please refer to our youtube page for patient testimonials of how a frenuloplasty has improved their lives.

Because a frenectomy can be performed very quickly with a laser, children are typically not put to sleep in our office.

Frenectomies are a common procedure for both dentists and ENTs. Dr. Becky Coats knows how to perform functional frenuloplasty that will not only help the tongue but will also address any associated conditions such as TMJ, airway constriction, snoring, and neck pain. A functional frenuloplasty approach means that Dr. Becky Coats works together with a myofunctional therapist, lactation consultant, and/or an osteopath physician to achieve a collaborative patient approach.

While many dentists may perform a frenectomy, we believe that extra training with the use of a guided team approach, myofunctional therapy, osteopathy and body connection is best. Our team is trained and experienced in laser technology, myofunctional therapy, and body connection. Dr. Becky Coats has also been trained by a world class ENT surgeon in Los Angeles.

While some patients are able to overcome the physical limitations of tethered oral tissues, a simple procedure may make speech and feeding issues much easier. Frenectomies can also be an important part of orthodontic treatment as the dentist moves teeth closer together. An unusual tissue attachment can also impact overall gingival health and oral hygiene. A tongue frenum issue can also negatively affect the growth of the jaws, causing a misshapened jaw to develop and preventing full genetic potential with a low tongue placement. This can result in a long narrow face, breathing issues, possible learning and behavior issues, snoring and potential long term sleep apnea, head and neck pain, and TMJ issues.

Most children heal in a few days and all children can return to normal activities in a few hours. Some babies may be fussy for a few days. You may also see a wet scab for a week or more and complete healing may take a few weeks.

Babies are actually encouraged to breastfeed immediately after a frenectomy to increase healing and to comfort the baby. For this reason, it is recommended that a lactation consultant and osteopath be present right after the procedure to help ensure the infant is able to breastfeed right away. Older children who are still numb following the procedure may need to wait about one hour before eating. For older children, ice pops are a great post procedure treat that also feels great! When they do finally eat, have them avoid rough foods like chips and pretzels and hot spicy foods.

A lip tie is a piece of connective tissue that stretches from the gum tissue to the lip. A lip or buccal tie can cause pain in the shoulders and or the neck muscles. An assessment of buccal and lip ties should occur when assessing a tongue frenulum as well. Many patients address the buccal and lip ties at the same time as the functional frenuloplasty procedure for complete relief and optimal results as all are associated with pain as well.

While some tongue ties are obvious and easy to identify, some can be difficult to diagnose because they are less visible. These may still cause feeding issues and should be treated for infants. Working with a myofunctional therapist is key to retraining the tongue muscles for the best possible outcome from the posterior frenuloplasty procedure.

A guided functional frenuloplasty involves using a team approach to deliver the most precise results for each patient’s anatomy and tension. As the dentist, Dr. Becky Coats performs the frenuloplasty while an osteopath physician sits behind the patient to pre-stretch the body’s fascia and tight muscles prior to the procedure. During the procedure, Dr. Coats and the osteopath communicate to determine the precise muscle fibers that are referring pain to other areas such as a sore shoulder, neck pain, and any other associated body structures to make sure that the release not only helps with your breathing/airway and TMJ pain but also your body’s stiffness.

The collaborative approach results in better treatment outcomes as the patient feels released in other areas of the body other than just the mouth and airway. The third professional of the team is the myofunctional therapist who works with our patient as a tongue and muscle coach for 4-6 weeks ahead of the procedure providing proper tongue and muscle therapy and also continues after the procedure to help achieve the best results. This team approach to a functional frenuloplasty offers so many benefits for your health. Our tongue-tie release procedure is based on precision, releasing only the appropriate extent of tissues for maximal relief; not too much, and not too little. We are often asked whether we use a laser or scissors. We use a scissors and suture technique which promotes healing with the primary intention of jumpstarting the body’s fastest and most efficient type of wound healing. Our technique offers a more predictable healing sequence and lessens the possibility of partial tissue reattachment and scarring. The tongue is one of the most critical organs in the human body, with the ability to regulate and to shape the orofacial structure and musculature. Our functional frenuloplasty approach honors the changes that occur during a tongue-tie release and prepares the body for acceptance and optimal healing post-treatment.

Our group is highly active in clinical research and committed to promoting optimal outcomes after surgery. In addition, we are delighted by the opportunity to share our knowledge and experience to help inspire the field to move towards higher standards in the delivery of functional frenuloplasty also known as tongue-tie release surgery.