The tongue has many critical functions. Most of which we are unaware and take for granted. It all starts with the tongue being able to move fully and freely. If not, then the following problems can develop:
• Poor facial development/receded chin Narrow upper jaw
• Sleep disorders
• Speech problems
• Irregular positions of teeth
• Incomplete food chewing/reflux
• Receding gums
• Nursing and latching difficulties with newborns and infants
When the tongue is tied down it does not have its normal range of motion and does not assume its normal position up against the roof of the mouth. These can lead to one or more of the above listed conditions. As an aside, not all tongue ties need to be freed up. The decision to eliminate the lingual frenum (the band-like tissue connecting the underside of the tongue to the floor of the mouth) is based on recognizing if any negative impact is happening.
The procedure to free up the tongue involves numbing the frenum area with an anesthetic gel and the use of a laser. There is no cutting, bleeding or sutures since a laser is used. There is minimal discomfort after the procedure. Tongue exercises need to follow the laser visit in order to prevent scaring the tongue back down.
AM I TONGUE-TIED?
The following simple screening test will help you determine if you have a tongue-tied condition:
• Do a finger swipe under your tongue. It should be a smooth transition from side to side. There should be no catch.
• Look and see if there is a flap or band of tissue under the tongue right in the middle. There should be none.
• Open your mouth as wide as you can and without moving or closing your jaw, can you reach the tip of your tongue to a place behind the upper front teeth?
•Are you able to have your tongue easily and comfortably swipe across the outer sides of your top and bottom back teeth and extend to where the gums connect to the cheeks?
• Stick your tongue out straight then can you lift the tip without moving the rest of tongue? Ideally you should be able to tip of the tongue separately from the rest of the tongue.
• Do you have a strong gag reflex?
After release of Tongue-Tie (Lower Frenectomy)
- You will have some swelling of the floor of the mouth/under the tongue. Keep dampened gauze in for 2 hours with good pressure. Then remove gauze and check surgical area for bleeding. If bleeding persists, place fresh dampened gauze over the area with good pressure for 1 hour. Repeat for 1 more hour if needed. Oozing is normal. Do NOT replace the gauze unless there is active bleeding.
- Drink plenty of liquids, but try to avoid liquids with caffeine in them. They will only continue to dehydrate you.
- Once the bleeding has stopped, get something to eat. You can eat whatever you would like, however, do not bite into anything for a few weeks until the area has healed. Make sure your food isn’t too hot, cold, spicy, or sharp as these might increase your discomfort or healing time. You should also stay away from citrus foods.
- No spitting, sucking through a straw, or smoking for 48 hours.
- Begin brushing and salt water rinsing (1/2 tsp salt with 8oz of warm water) the day AFTER surgery. Rinse 3-4 times a day, after you eat and before you go to bed at night for the next several weeks, or until the surgical area has healed completely.
- Try using popsicles in this area as they will not only help to prevent some swelling, but will also give some relief of discomfort in this region.
- The patient needs to practice sticking out their tongue for exercise. Do it every 15 minutes starting the day after surgery until the patient can stick out their tongue without any problem. Now that you have more use of your tongue, there is more of a chance of biting your tongue. Please be careful when chewing.
- As instructed by Dr. Yamin you will have a “hole” in the floor of the mouth under the tongue. This will heal and fill in with time. Do not pick or touch that area as it is healing.
Post-operative Exercises for Laser Assisted Lingual Frenectomy Procedure (Tongue-Tie Release)
THE PURPOSE OF POST-OPERATIVE EXERCISES
- Develop new muscle movements, particularly those involving tongue-tip elevation and protrusion, inside and outside of the mouth Also, to have the tongue rest up against the roof of the mouth which is its natural position.
- Encourage tongue movement related to cleaning the oral cavity, including sweeping the insides of the cheeks, fronts and backs of the teeth, and licking right around both lips.
- These exercises are not designed to improve speech. They are primarily meant to avoid having the tongue scar back down. Please consult a speech pathologist for child specific speech impediments should that exist.
Perform the following exercises, in any order, once or twice a day for 3 to 4 weeks post-operatively. Repeat each exercise 3-5 times in both directions. Have a flashlight or be in a well-lit room and use a hand mirror. Make these exercises FUN!
- Stretch your tongue up towards your nose, then down toward you chin. You can vary this exercise and make it more interesting by putting a dab of food in various positions above the top lip to be retrieved with the tip of your tongue. This game is called, “Elephant Tongue”!
- Open your mouth wide. Touch you big front top teeth with your tongue while keeping your mouth still wide open. FEEL how rough your teeth are.
- Look in the mirror. Still with your mouth open wide, say dar-dar-dar. Now say nar-nar-nar. Then say tar-tar-tar. Look in the mirror to see what you tongue is doing.
- Lick your top and bottom lips from one side to the other. Repeat in the opposite direction.
- Poke your tongue out as far out as it will go. Try to go in-out-in-out-in-out with your tongue.
- See if you can make your top lip fat (pushing it forward without opening your mouth).
- Try to make a lump on one side of you cheek without opening you mouth. Do the same on the other side.
TYLENOL, taken according to packaging instruction, can help for discomfort.
FOR ADDITIONAL INFORMATION GO TO THIS WEBSITE:
www.drghaheri.com (go to downloads for any particular topic).