Lip Tie Procedure: What to Expect with a Frenectomy

Does your infant or toddler need a lip tie procedure? Here’s what you can expect with a frenectomy procedure in up to a 2 year old child.

As a parent, we worry about our children and want to do everything we can to make sure they are as healthy as possible with as few problems as possible too.

We do everything we can to protect them and prevent any concerns down the road.

When it comes to a lip tie procedure, there is a lot to consider and to understand when deciding if the procedure is best for your family.

Originally published May 23, 2019

What is Lip Tie?

As defined on Healthline: “The piece of tissue behind your upper lip is called the frenulum. When these membranes are too thick or too stiff, they can keep the upper lip from moving freely. This condition is called a lip tie.”

In short, a lip tie is when the upper lip is attached to the upper gums.

It is most often recognized due to breastfeeding issues.

The nursing baby has a hard time latching onto the mother’s breast due to the inability to move their top lip in a way to allow for a proper latch.

In bottle fed infants it may also be a struggle to latch onto the nipple of the bottle at feedings.

The upper lip may naturally curl under a bit and take effort to flange it out.

Lip tie is often diagnosed when babies lose weight or struggle to gain weight and when there are feeding issues present.

If it is not noticed as an infant then it will often present itself as children develop teeth as a common symptom is to have a large gap between the front two teeth.

Both lip and tongue tie are considered genetic.

I found this personally interesting as a wide gap between the front two teeth is a common gene in my family history.

I am curious if it’s the gap that’s the gene or if there is a history of lip tie in our family that just went undiagnosed!

How Do I Seek Advice on Lip Tie?

Our pediatrician first noticed our son’s lip tie early on in infancy.

Because our son was eating fine and had no concerns regarding weight gain they were not concerned about the lip tie.

Since lip tie frequently presents itself with breastfeeding issues, often a lactation consultant may be the first person to notice a child’s lip or tongue tie.

As he got older it was obvious the tie was “tight” which means his upper lip was very close to his gums and didn’t have a lot of ability to move naturally.

Our pediatrician recommended having our pediatric dentist evaluate our son’s lip tie during our next visit when our older children had their cleanings.

While lip tie is often first noticed by a pediatrician, it is best to have it evaluated by a dentist or ENT.

Our local dentist looked at the tie and recommended having a lip tie procedure done.

However, the dentist was not very familiar with the procedure and his lack of experience made me concerned and made my “Mommy instincts” kick in.

Sometimes the internet can be scary when it comes to medical concerns and our children, but sometimes it can be a HUGE resource and in this case, I am so thankful for the internet!

If your child has a lip tie I strongly recommend searching Facebook for the lip tie group in your state.

These women are very knowledgable when it comes to lip and tongue tie and can help you find the most suitable doctor to help evaluate your child and their specific needs.

Through the Facebook group for our state (Georgia) I learned that there are NO dentists in the entire STATE who are certified lip and tongue tie specialists.

I was referred to a dentist about two hours away from us (in Jacksonville, Florida) who is considered one of the top tongue and lip tie specialists in the world (literally people fly in from China to see him!).

I am so, so thankful we went that route and were able to get an appointment with Dr. Myers.

He was SO knowledgable and wise and made us feel very comfortable and confident in moving forward with our son’s (Spear’s) lip tie procedure.

My advice? Search out an expert in this field. It’s worth it!

Does Lip Tie Cause Developmental Delay?

Lip ties may cause some developmental delay.

As previously mentioned, it most often causes concerns during infancy with feeding issues.

As infants become toddlers it may also prevent the forming of some letters and the ability to form certain words which can cause a delay in speech.

Tongue tie plays a larger role in speech delay but the lip plays a part too! If you mouth the word “boy” or “mom” feel how your upper lip moves to form those words.

If your lip was tied and was too tight to your gums you wouldn’t be able to curl it over your upper teeth which is required when making the “b” and “m” sounds.

Our son was able to make both of those sounds and was saying “baba” as well as “mama” even with his lip tie.

However, the movement of the lips does play a role in the ability to speak and form words and while it wasn’t a guarentee to help in his speech development, it also wouldn’t hinder it either.

What is a Frenectomy?

The lip tie procedure is called frenectomy. It is a very quick, outpatient procedure and is not a surgery.

It is the revision of the tight frenulum either by use of laser or snipping with surgical scissors.

This is not a painful experience for an infant and does not typically require any anesthesia.

It is also performed on toddlers with very little side effects and may often be performed on teenagers prior to fitting with braces by an orthodontist.

When is a Lip Tie Release Helpful?

Lip tie release procedure is often not necessary.

In our case, it wasn’t a “must do.”

Often when the frenum is tight a toddler or older child will naturally fall or cause it to release on its own.

However, our son was not yet speaking and was a bit behind in speech development. As a mom I just wanted to know that I did everything I could from my end to make sure he was given the best opportunity to thrive.

I didn’t want to look back and regret not doing something that could have helped him!

It is most often helpful in younger infants who are struggling to drink their bottles or, most often, from their mother’s breasts.

It also is beneficial from a cosmetic standpoint as the thick and stiff frenulum most often causes a wide gap between the two front teeth.

What Is Involved with Lip Tie Procedure?

When performed on babies the frenectomy, lip tie procedure, is a very quick process.

The frenulum tissue is simply snipped with surgical scissors or via a laser.

Our son was 16 months old when we met with the specialist regarding his lip tie.

The pediatric dentist told us that he won’t do the procedure after 18 months old as it can be traumatic at that age and that he will typically recommend having it done either prior to 18 months or to wait until the teenage years when it’s time for braces.

Having the laser frenectomy done as a teen may require an oral surgeon and will help allow permanent teeth to close the gap caused by the frenulum tissue.

Knowing that we were in a limited window for the procedure was another reason we decided to go ahead and have it done.

While it was hard on my mama heart to see my toddler go through it, I can’t even fathom how an older child would deal with that process.

I’d rather get it done now to prevent issues down the road or a more traumatic experience that would be more difficult to forget!

We were in a private room at the pediatric dentistry office.

My son sat in my lap while the dentist evaluated his mouth and we discussed his history and anything we’d noticed as an infant that could be related (Spear did have issues latching onto the bottle but as our first bottle fed baby we just didn’t realize it was an out of the norm!).

The dentist had a large-sized swaddle device that we wrapped our son in on the dentist chair. My husband and a dental assistant helped to hold him down.

First the dentist applied a numbing cream to the area and we let that sit a bit in order to take effect.

Then Spear was laid down again and the dentist injected a numbing agent into the area of soft tissue to keep Spear comfortable and avoid pain during the procedure.

Afterward, we all put on special glasses (including Spear) to protect our eyes from the laser.

My husband and the assistant held Spear down while the dentist released the frenulum by use of laser.

I stood right beside Spear and kept letting him know I was there.

How great he was doing. How proud I was. How close it was to being over.

I appreciated that the dentist encouraged both of us to be in the room with our son and to be in his line of sight throughout the entire process.

Overall it was very quickly, in under 10 minutes.

What is the Healing Process After Frenectomy?

By using a laser for the frenectomy procedure there is very little risk or lingering symptoms following the releasing of the frenulum.

There was no bleeding at all as using release tie laser helps to cauterize the area and avoid bleeding.

Immediately after the lip tie procedure Spear’s upper lip did “stick out” more.

The dentist said it’s like releasing a rubber band – the upper lip was free from that tight pull and would slowly come back into a more normal position.

The numbing agents wear off about 3-4 hours following the procedure so it’s wise to give Motrin in order to help with the pain.

We only did one dose that evening before bed and he never seemed to be in any sort of pain at all.

Even in the minutes immediately following the surgical procedure Spear never seemed in any distress or pain at all.

He was upset during, of course, but as soon as it was over he was happy as could be again!

Spear was eating and drinking normally and had no effects at all from the frenectomy.

The frenectomy recovery process was so smooth and truly painless for us all!

He even did great on the two hour ride back home!

To ensure the tissue did not reattach we had to do a finger sweep along the upper gum line and gently fold the upper lip upward to three times a day for three weeks.

The first few days Spear did not like our fingers in his mouth or near the area, but even that quickly subsided and it was just a quick part of his daily routine!

These stretching exercises with his upper lip help to ensure the laser surgery has a longterm success and that the frenulum doesn’t reattach or cause future concerns.

Having the lip tie procedure done will also allow us to brush Spear’s teeth easier and provide proper oral health and dental health as well!

Do Children with Lip Tie Also Have Tongue Tie?

Yes. Frequently children who have some sort of lip tie also have some sort of tongue tie (typically posterior tongue tie)

Tongue ties are extremely common and are likely to go along with a lip tie.

We were expecting Spear to have a tongue tie and the tongue tie is actually more frequently associated with delayed speech and other symptoms.

When the dentist evaluated Spear he said that Spear does NOT have a tongue tie but that Spear’s body acts like he does.

The dentist we saw was like genius level smart.

Truly, the most intelligent person I’ve ever met in my LIFE. So smart that he was as bit difficult to follow and for me to understand haha!

Basically, the tongue posture can affect the body in many ways and Spear’s is possibly a large part in his speech delay.

He mentioned that Spear’s head shape shows that he has some tightness and compression in his head/skull and that it is probably why he carries his tongue the way he does.

Basically, everything in our body is connected and sometimes one area of the body being “off” can affect other areas.

Literally, I’m pretty dang clueless about this medical stuff but I fully 100 percent trust Dr Myers and want to do everything I can to also help my child to the very best of my ability.

The doctor highly recommended Cranial Sacral Therapy (CST) and/or osteopathic manipulative treatments (OMT) (particularly the focus on the facia) for Spear to help his mouth to properly form words and he felt confident that using that method would help Spear’s speech really take off.

This is a fabulous article from Healthline explaining Cranial Sacral Therapy.

I wrote down those terms and then went on a hunt for a local doctor who could provide what we were needing.

It took a LOT of phone calls but I was finally referred to an incredibly sweet woman who does both the CST and OMT and she’s been working with Spear in these areas and it’s been awesome to see how he responds to the therapies!

Our Personal Experience and Final Thoughts

We are so thankful we found Dr Myers and his staff.

The entire visit was under thirty minutes from start to finish and was well worth the 2 hour drive there followed by the two hour drive home.

Even if you’re not local to the Jacksonville area, it may be well worth it to travel to Dr. Myers office. You can see their website here!

The frenectomy cost was also very low.

We have private dental insurance and our policy covered the same amount using Dr. Myers as they would have if we’d used our local pediatric dentist!

Our oldest daughter, Britt, had tongue-tie as an infant and we had her tongue tie procedure done at a local ENT office.

In our talks with Dr. Myers we realized she may need to have her tongue tie revaluated at some point due to her needs for speech therapy and her frequent complaints of headaches (both are linked to tongue tie!).

So much has changed in the field of lip and tongue tie over the years that at some point we may take her down to see him and be evaluated to make sure she wouldn’t benefit from another tongue tie procedure (obviously with her age this would be something she’d need to REALLY benefit from in order for it to be worthwhile).

The entire process for Spear’s lip tie procedure was very smooth.

I am very thankful we made the decision to go ahead and have it done rather than waiting it out and always wondering “what if” or having to deal with it later down the road when he’s older!

We are now almost a month out from the procedure. He has had no negative side effects and has been doing well with the CST therapy.

Here is a great “after” photo:

Before and After!

A week after his lip tie correction we found the local therapist who specializes in CST.

We’ve been a few times to her office with him and she is wonderful with Spear!

After just a couple of visits his walking really took off and he’s now MUCH more vocal than he was a month ago and is saying a lot more words and letter sounds. We feel confident in this path for him!

We have also had him evaluated for his speech delay (he’s still not yet 18 months old so we’re very early in seeking services but I’m hardcore about early intervention across the board when it comes to my babies!).

The speech therapist did say he may benefit from Babies Can’t Wait (a free local service that comes to the home to work with children on delays and speech therapy).

We’re continuing with the physical therapy and on a waiting list for speech therapy too.

Britt, our oldest daughter, had some speech therapy services and really benefitted from, and enjoyed, them so I’m all about doing anything that may help!

—–> Want to learn more about how to encourage your young child’s communication development? Be sure read this post from Mama’s Organized Chaos!

At Spear’s speech evaluation appointment they strongly recommended using sign language with him as a great tool to encourage communication and to help him learn to communicate his thoughts.

—–> Be sure to read this helpful post on teaching sign language to your child from Chronicles of a Babywise Mom!

As an adoptive mom, I do think I tend to show more concern about Spear than I did with my biological children. The reality is? Spear is the fourth kid!

Every doctor and specialist and basically human that I’ve talked to has encouraged me that he’s FINE. His delays? Are FINE.

Of course, he’s a little later with walking…he’s been CARRIED SO MUCH. I’m busy. We’re going and doing. I scoop him up and carry him from place to place because it’s quicker.

Of course, he’s a little later with talking…he has THREE older siblings who ALL speak for him ALL the time.

The kid can’t get a word in and no one is patient enough to sit and WAIT for him to speak!

—–> Just as a younger sibling may develop at a different pace than older siblings, did you know twins may hit milestones at different ages too? Be sure to check out this post from Team Cartwright!

It is natural to have concerns about our babies.

Whether it’s our first. Our fourth. Our biological. Our adoptive. We are moms.

It’s our job to care about every detail of our children’s lives and want to give them the best we can possibly offer!

The lip tie procedure was a decision we feel was best for our son and we have no regrets!

Here are more pictures from our visit: