At Hanover Pediatric Dentistry, we specialize in treating children with tongue and lip ties using the latest techniques and technology. Our goal is to improve your child’s feeding, speech, and overall oral health in a comfortable, caring environment.
A physical condition that limits the use of the tongue is called a tongue-tie. Tongue-tie is usually related to a short, thick frenum, which limits the tongue’s ability to move. This restriction often causes a range of issues, such as difficulty for infants to breastfeed. It can also impact speech and eating in children and adults. Patients often try to compensate for the lack of tongue mobility by changing their jaw position – resulting in other orthodontic issues. Tongue-tie is thought to affect around 20% of the population.
A lip-tie, on the other hand, is a condition where the upper lip is restricted and cannot move normally. This may be evident by a thicker, broader band of connective tissue that prohibits the upper lip from flanging properly or that inserts itself at or between the level of the upper front teeth. It can cause difficulty with nursing, make it harder to brush the top teeth and can also lead to a gap in the teeth.
If left untreated, tongue and lip ties can lead to speech delays, feeding issues, and potential dental complications as your child grows.
If left untreated, Lip and Tongue Ties may lead to feeding, speech, social, orthodontic and gum-related problems in school aged children and adults.
A frenectomy is the simple surgical procedure that involves the removal of one or more frena from the mouth. The frenum is a connective tissue membrane that attaches one surface within the mouth to another. The two types of frenum are known as the labial (lip) frenum and the lingual (tongue) frenum. There are also buccal (cheek) frena that could be present and restrictive to function.
A labial frenectomy is a procedure that removes the piece of connective tissue connecting the upper lip to the upper jaw bone or the lower lip to the lower jaw bone.
A lingual frenectomy is a procedure that removes the lingual frenum or a small fold of connective tissue in the middle of the underside of the tongue.
Patients can be assessed for a tongue or lip tie during a consult appointment specifically for this issue or during a routine cleaning and exam appointment. After listening to your concerns and conducting a comprehensive oral assessment, we’ll help you get to the root cause of the issues your child is experiencing. If a tongue- or lip-tie is the culprit, we’ll go over the options with you on how to correct this issue depending on the patient’s age and individual needs. Sometimes this involves the consultation of therapists for your child’s specific issue, such as a lactation consultant or speech and feeding therapist, or someone known as a myofunctional therapist.
We have two very experienced release providers, Dr. Tara Groff and Dr. Martin Kaplan. Instead of using scissors or a scalpel, we use a CO2 laser called a LightScalpel. This makes the procedure quick with minimal to no bleeding. Depending on the age of the child, we may use a topical anesthetic or Novocain to numb the area to help with immediate discomfort. The procedure is very fast, often taking no more than 5-10 minutes. Most commonly this procedure is completed without the need for sedation but if this is something that you think your child would require, Dr. Groff is capable of providing multiple forms of sedation to alleviate any anxiety associated with the procedure(s) and can be reviewed with you during the consult appointment. It is important to note that parents and guardians are not present in the room during these procedures.
All patients of all ages will meet with our in-house lactation consultant and pediatric nurse Chrissy who will review patient specific aftercare instructions and provide handouts reviewing these as well.
In general, pain should be managed with over-the-counter medications such as Tylenol or Ibuprofen as is indicated for their age and weight. Homeopathic medications such as Camilia and Arnica can also be utilized.
Breast and bottle feeding are encouraged. For solid food eating children, soft, non-spicy, non-acidic foods are tolerated best for up to a couple of days post-operatively.
Patient specific exercises will be reviewed for you and your child to complete at home in order to get the best surgical results.
The following are links to Dr. Groff’s aftercare instructions (clicking the links will download the documents):
Follow-up visits can be scheduled as needed.
It’s important to understand that, when your child has a tongue- or lip-tie released, improvement isn’t always instantaneous. It’s typically just the first step in treatment.
Just like any other muscle in the body, the tongue is used to functioning in a certain way. When it’s restricted by a tongue-tie, the body adapts and other muscles have to help compensate. When a tongue-tie is released, your child will have no muscle memory of how to use the tongue effectively without the restriction, so your child’s brain will need some time to learn the new skill.
This is why it is critical to follow-up with any recommended therapists after the release procedures.
Unfortunately, most dental insurance plans have limited coverage or age restrictions for these procedures. A pre-treatment estimate can be sent in order to determine if your dental insurance provides any coverage and what that amount may be. The dental codes utilized for these procedures are D7961 buccal/labial frenectomy and/or D7962 lingual frenectomy. A separate exam or consultation fee/code may be implemented if this occurs during a different day from the surgical procedure and is dependent on the provider seen as well as the age and/or potential additional needs of the patient. If eligibility for these procedures is unable to be determined or if no coverage is provided, then payment in full is expected at the time of service.
Sometimes, parents are able to submit to their medical insurance plans for coverage, however as dental providers we are not allowed to bill medical insurance plans and we cannot guarantee any payment will be made. You may contact your medical insurance with the following codes to determine if coverage is available and if they will reimburse the subscriber if treatment is performed at Hanover Pediatric Dentistry:
41010- Tongue
40806- Lip
Q38.0- Lip Tie
Q38.1- Tongue Tie
K08.89 Buccal Tie
R63.3- Feeding Difficulty/Mismanagement (not breastfeeding)
P92.2- Slow Feeding Newborn
P92.8- Other Feeding Problems
P92.9- Feeding Problem in Newborn
M26.59-Other Dentofacial Functional Anomalies (Myofunctional disorder)
R47.9- Speech disturbances (articulation disorder not developmental in nature)
R13 code series (various types of dysphagia and swallowing issues)
If there are specific questions, please don’t hesitate to reach out to our office team.
