Frenectomy for Infants: Releasing Labial and Buccal Ties with Laser or Scissors

Bringing a new baby into the world is a beautiful experience, but it can come with unexpected challenges. For some infants, issues like breastfeeding difficulties or trouble moving their tongue, lips, or cheeks might be linked to a common condition that requires gentle intervention. This article will explore everything you need to know about frenectomy for infants and how it can help improve your baby’s comfort and development. From identifying signs of a tongue-tie, lip-tie, or buccal-tie to understanding the procedure itself, our Brisbane dentist is here to provide clear, helpful information. Read on to learn how this simple treatment can make a world of difference for you and your little one.

What is a Frenectomy?

A frenectomy is a quick and simple procedure that helps release tight tissue, called a frenulum, under the tongue, lip, or cheek. This small piece of tissue, when too tight or thick, can limit your baby’s movements in their mouth. By gently adjusting or removing this tissue, a frenectomy allows your baby to move their tongue or lips more freely. This can make a huge difference for activities like breastfeeding, which involves proper latching, and later on, for speech development.

The procedure is safe and usually takes only a few minutes, but the positive effects can be long-lasting, making life easier for both your baby and you.

How Can Tongue, Lip, or Cheek Ties Affect Your Baby?

When your baby has a tight frenulum, it can make simple tasks like feeding more difficult. A restricted frenulum can limit the movement of the tongue, lip, or cheeks, leading to frustration for both you and your baby, especially during breastfeeding. Babies with ties often struggle to latch properly, which may cause nipple pain and prevent adequate milk intake, potentially slowing their weight gain. Feeding times may become stressful rather than a time of bonding.

As your baby grows, untreated tongue ties may occasionally affect speech, particularly certain sounds like “t,” “d,” or “s,” though this is not always the case. Dental issues, such as gaps between the teeth, may also occur, but these problems are less commonly linked to ties. Addressing these ties early can help prevent feeding difficulties and reduce the risk of other complications, making everyday activities like feeding easier for your baby.

Is It a Tongue-Tie, Lip-Tie, or Buccal-Tie?

Tongue-tie, lip-tie, and buccal-tie are conditions where the frenulum, the tissue connecting parts of the mouth, is too tight or restrictive.

• Tongue-Tie: This occurs when the frenulum under the tongue is too tight or short, limiting tongue mobility. It can interfere with breastfeeding and may, in some cases, impact speech articulation.
• Lip-Tie: A lip-tie refers to a tight frenulum connecting the upper lip to the gums. It can affect a baby’s ability to latch properly during breastfeeding and possibly lead to feeding difficulties.
• Buccal-Tie: This is a more debated condition where the frenulum inside the cheeks restricts movement. While some practitioners link it to feeding issues, its role is less clear, and many experts believe it rarely causes significant problems.

These ties can be addressed with a simple frenectomy if they cause functional issues, improving feeding and potentially preventing further complications.

Signs Your Baby Might Have Tongue-Tie, Lip-Tie, or Buccal-Tie

The following signs can all be clues that your baby may have a tongue-tie, lip-tie, or, in some cases, a buccal-tie. If you notice any of these, it might be helpful to speak to a healthcare professional to see if a frenectomy could make feeding, speaking, and growing easier for your little one.

• Difficulty Latching During Breastfeeding: If your baby struggles to latch onto the breast or keeps slipping off, it might be due to restricted movement in their tongue or lips.
• Poor Weight Gain: Babies who have trouble latching often don’t get enough milk, which can lead to slow weight gain. This can be worrying, but a frenectomy can help improve their ability to feed well.
• Mum Experiencing Nipple Pain Or Damage: If breastfeeding is painful for you, or if you notice cracking or damage to your nipples, it could be because your baby is having difficulty latching properly due to a tongue or lip tie.
• Limited Tongue Movement: If your baby has trouble sticking their tongue out or moving it side to side, it might be due to a tongue-tie.
• Heart-Shaped Or Notched Tongue Tip: Sometimes, when a baby tries to stick its tongue out, the tip might look heart-shaped or have a small notch. This can be a sign of a tongue tie.
• Gaps Between The Upper Front Teeth (Due To Lip-Tie): If you notice a gap between your baby’s upper front teeth, it could be caused by a lip-tie. This happens when the frenulum pulls the lip tightly, affecting how the teeth come in.
• Difficulty Moving Lips Or Cheeks: If your baby seems to have trouble moving its lips or cheeks or has a stiff facial expression during feeding, it could be a sign of a buccal tie.
• Speech Difficulties: As your baby grows and starts to talk, they might have trouble making certain sounds clearly. This may happen if the tongue or lips are restricted.
• Trouble Swallowing Or Eating As They Grow Older: As your baby starts eating solid foods, they may have difficulty chewing or swallowing properly, especially if the tongue and cheeks can’t move freely.
• Restricted Lip Flaring Or Cheek Movement: Babies should be able to flare their lips out while feeding, which helps create a proper latch. If your baby’s lips seem tight or they can’t move their cheeks easily, it might be due to a tie.

How is a Frenectomy Performed?

A frenectomy is a simple and quick procedure that can make a big difference in your baby’s life. There are three main techniques used:

• Scissors: This is the traditional method where a doctor uses sterile scissors to cut the tight frenulum. It’s quick, but in some cases, it may require stitches to help the area heal. Even though it sounds a bit scary, it’s over in a matter of seconds, and babies usually calm down quickly afterwards.
• Laser: The laser technique is becoming more popular because it’s less painful and helps the wound heal faster. The laser not only cuts the tight tissue but also cauterises it, which means there is very little bleeding. Babies often feel more comfortable with this method, and parents appreciate the quicker recovery time.
• Diathermy: This method uses heat from electric currents to cut and cauterise the tissue. By reducing bleeding and lowering the risk of infection, diathermy offers a safe and effective way to treat ties. It’s another option that can make the whole process smoother for both you and your baby.

All three methods are designed to help release the tight tissue and allow your baby to move their tongue, lips, or cheeks freely. The procedure is usually done in just a few minutes, and the benefits can be seen almost immediately, especially when it comes to feeding and comfort. It’s amazing how such a small adjustment can lead to such big improvements in your baby’s daily life.

What Happens During the Procedure

A frenectomy is a very straightforward procedure that is over quickly. Here’s what usually happens:

• Local Anaesthetic: The doctor will apply a local anaesthetic to numb the area. This helps make sure your baby feels as little discomfort as possible during the procedure. It’s typically done using a small numbing gel or spray that works fast.
• Quick Surgery: The paediatric dentist will use one of the three techniques (scissors, laser, or diathermy) to release the tight frenulum. The whole process often takes just a few minutes. Your baby might fuss a bit, but it’s over before you know it, and they usually calm down very quickly.
• Comfort and Care: Right after the procedure, you can comfort your baby with cuddles or feeding. Many babies are able to breastfeed right away, and this helps soothe them as well. It’s all about making sure your little one feels secure and relaxed.

What to Expect After the Procedure

After a frenectomy, it’s normal to wonder how your baby will feel and how you can best support their healing. Here’s what you can expect:

Recovery Times and Possible Discomfort

• Most babies recover quickly after a frenectomy. You may notice some fussiness or mild discomfort for a day or two, but it usually passes quite soon.
• The area where the frenulum was released might look a bit white or yellowish as it heals. This is completely normal and part of the healing process.
• Every baby is different, but most will start feeling more comfortable within a few days, and many show improvements in feeding almost immediately.

Tips for Managing Pain

• Infant Pain Relievers: If your baby seems uncomfortable, you can give them an infant-safe pain reliever like paracetamol. Always follow your doctor’s advice for dosage.
• Breastfeeding or Bottle Feeding: Feeding your baby can actually help comfort them after the procedure. The sucking motion can also help the healing process.
• Cuddles and Comfort: Extra cuddles, skin-to-skin contact, and gentle rocking can work wonders to help soothe your baby after their frenectomy. Your love and comfort make a big difference during this time.

Importance of Following Aftercare Instructions

• Keep the Area Clean: It’s important to keep the area clean to avoid any infection. Your doctor may recommend gently cleaning the mouth after feedings.
• Stretching Exercises: You might be given some gentle mouth exercises to do with your baby. These help prevent the frenulum from reattaching and ensure the tissue heals in a way that allows full movement.
• Monitor for Complications: Watch for any signs of infection, like excessive swelling, redness, or if your baby seems to be in a lot of pain. If you notice anything that doesn’t seem right, it’s always best to contact your doctor for advice.

With the right care, your baby will heal well, and you’ll likely notice improvements in their feeding and comfort quite soon. It’s amazing how quickly babies bounce back and how much of a difference a small procedure like a frenectomy can make for both of you.

What is the Healing Process Like?

After the frenectomy, it’s natural to have questions about what happens next and how your baby will recover. The healing process is generally quite smooth and straightforward.

How Long It Takes to Heal

• The healing process for a frenectomy is usually quick. Most babies heal within 1 to 2 weeks.
• During this time, you may notice a few changes in the treated area, but rest assured that the recovery is typically swift, and your little one will be back to their happy self soon.

Signs of Normal Healing

• As your baby heals, you may notice that the area where the frenulum was released turns white or yellowish. This is completely normal and part of the healing process. It’s just how the body works to repair itself.
• You might also see some slight swelling or redness around the area, but this usually goes away after a few days.

When to Contact Your Dentist if Something Doesn’t Seem Right

• While most babies recover without any issues, it’s important to keep an eye out for anything unusual.
• Contact your kids’ dentist if you notice any of the following: excessive swelling that doesn’t go down, continuous bleeding, signs of infection such as increased redness, swelling, or discharge, or if your baby seems to be in a lot of discomfort for more than a couple of days.
• Trust your instincts. If something doesn’t feel right, it’s always better to contact your healthcare provider. They’re there to help and can ensure a smooth recovery.

The healing journey after a frenectomy is typically quick, and most babies feel much better soon after the procedure. With your care and attention, your baby will be on their way to feeding, talking, and smiling more comfortably in no time.

Benefits of Frenectomy

A frenectomy offers several wonderful benefits that can improve your baby’s quality of life:

• Improves Breastfeeding: One of the most immediate benefits of a frenectomy is that it makes breastfeeding much easier. When your baby can move their tongue or lips freely, they can latch on properly. This means feeding times become more comfortable for both of you. No more fussiness or frustration—just peaceful bonding moments with your little one.
• Enhances Speech Development: As your baby grows, being able to move their tongue and lips without restriction helps them form sounds and words more easily. Speech development is such an important part of growing up, and a frenectomy can make sure your child doesn’t have trouble learning how to talk clearly. However, while some believe frenectomy may aid in speech articulation, research shows mixed evidence and speech therapy may still be necessary for certain speech issues.
• Promotes Better Oral Health: By allowing more freedom of movement in the mouth, a frenectomy helps promote better oral hygiene. When the tongue can move around freely, it can help naturally clean the mouth and reduce the risk of issues like food getting stuck, which can lead to decay.
• Prevents Future Dental Issues: Tight frenulum ties can affect how your baby’s teeth come in, sometimes creating gaps or causing misalignment. Addressing the tie early on helps prevent these future dental problems, making sure your child has the best chance for a healthy, beautiful smile.
• Faster Healing and Reduced Discomfort: Compared to older techniques, using methods like laser frenectomy can result in faster healing times and less discomfort for your baby. The laser also reduces bleeding during the procedure, making it a smooth experience for both you and your baby.
• Reduced Risk of Complications: When using modern techniques like laser or diathermy, the risk of complications is lower. Less bleeding, lower chances of infection, and quicker recovery all mean that you can focus more on enjoying your time with your little one rather than worrying about post-procedure issues.

Possible Risks and How They’re Managed

While a frenectomy is generally safe, there are some minimal risks:

• Bleeding: Minimal bleeding is common but usually controlled during the procedure, especially with laser or diathermy, which cauterise the wound as they cut.
• Infection: Post-operative care instructions (like keeping the area clean) help reduce the risk of infection. Antibiotics are rarely needed but may be prescribed in some cases.
• Pain and discomfort: Discomfort is typically mild and managed with infant-safe pain relievers like acetaminophen or ibuprofen.
• Reattachment of tissue: Proper post-operative stretching exercises are recommended to prevent tissue reattachment, ensuring lasting results.
• Swelling: Mild swelling can occur, but this subsides within a few days. Cold compresses may help soothe the area.
• Scar tissue formation: Stretching exercises can also help reduce the formation of scar tissue, keeping the tissue flexible as it heals.

Why Early Intervention Can Be Beneficial

Early intervention for tongue or lip ties can greatly improve your baby’s comfort and development, particularly in terms of breastfeeding. Addressing these issues early on allows your baby to latch properly and feed without frustration, improving nutrition and overall well-being. While early treatment can prevent some dental issues, such as misaligned teeth, claims about improving speech development are more uncertain, as research shows mixed results. Consulting with a Brisbane paediatric dentist can help you make an informed decision about your child’s needs and future health​.

Is Frenectomy Painful for Infants?

One of the common concerns parents have is whether a frenectomy is painful for their baby. The good news is that the procedure is typically very well tolerated by infants, especially when modern techniques like laser frenectomy are used.

Before the procedure, a local anaesthetic is applied to numb the area, ensuring that your baby experiences minimal discomfort. In fact, many babies cry more because they are being held still rather than due to any pain from the procedure itself. The entire process is usually over in just a few minutes, and babies often calm down quickly afterwards, especially if they are breastfed or comforted immediately after.

While some mild discomfort or fussiness is common for a day or two following the procedure, most babies recover quickly. In cases where parents notice signs of discomfort, infant-safe pain relievers like paracetamol can be administered based on the dentist’s advice. Overall, frenectomy is considered a minor procedure, and the short-term discomfort is outweighed by the long-term benefits it can offer, especially in terms of feeding and comfort.

Sleep Dentistry Using General Anaesthesia for Frenectomy

In some cases, particularly when a baby is very anxious, or if multiple areas need to be treated, sleep dentistry using general anaesthesia may be recommended for a frenectomy. This involves performing the procedure while your baby is comfortably asleep under general anaesthesia, ensuring they experience no pain or awareness during the treatment.

General anaesthesia is usually considered for infants who may be too young or unable to tolerate being awake during the procedure. It is typically administered by an anaesthetist in a safe, controlled environment. While general anaesthesia does carry some risks, modern techniques and experienced professionals help minimise these risks, making it a safe option for babies who require this level of care.

The key benefit of sleep dentistry for frenectomy is that it allows the dentist to work without any movement or distress from the baby, which can be particularly useful if both tongue-tie and lip-tie need to be released simultaneously. Recovery from the anaesthesia is typically swift, and most babies are able to feed and return to their normal routine within a few hours. If your dentist recommends general anaesthesia, they will thoroughly discuss the procedure, benefits, and any potential risks with you to ensure the best outcome for your child.

Frequently Asked Questions