Frenectomy of a Tongue Tie
The tongue-tie, also known as a restricted lingual frenum or tethered oral tissue (TOT) is the line or band of tissue under the tongue that connects the tongue to the floor of the mouth. In some cases, the frenum is too short or too tight and will restrict the movement of the tongue. As a result of this tight attachment the tongue doesn’t learn to move the way it was designed to. When this happens, it prevents the tongue from resting against the palate in the roof of the mouth.
As previously discussed, this restricted movement of the tongue can cause airway issues, especially during sleep. If the tongue doesn’t have the ability, coordination, and strength to rest in the palate during the day it definitely won’t be able to at night. The weak tongue can then fall back into the airway and fully or partially block the airway during sleep. In an attempt to open up the airway to breathe better, the lower jaw slides forward. This dysfunctional grinding pattern can cause chronic jaw pain, facial pain, headaches, and clenching along with other dental and orthodontic issues.
Treating a tongue-tie is a simple, fast, and painless procedure. The tethered tissue is released using a laser or scissors and sutures. It should be done by a professional trained and experienced in performing a frenectomy or a functional frenuloplasty.
Studies have shown it is critical to do myofunctional therapy exercises before the procedure and after the procedure to have a successful outcome.
The myofunctional exercises will help strengthen and prepare the muscles of the tongue for the new range of motions it will experience after surgery. Caring for the wound post-surgery is vital to prevent the tissue from reattaching. The tongue and the oral muscles will then need to be retrained and strengthened after the frenum is released.
This video shows the frenectomy performed with a laser, however many professionals will use scissors and sutures.
After a tongue-tie release
many patients see changes in:
Neck & Back Tension
Shoulder & Arm Pain
Chest Tightness
Sinus & Nasal Congestion
Labored or Noisy Breathing
Knee Pain
Anxiety
Improvement in Digestion
Feeling Lighter and Energetic
Better Quality of Sleep
Reduced Headaches and Migraines
Improvement in Jaw Stability
Increased Mouth Opening
Slide credit: Dr. Allen Sprinkle
Frenectomy (Tongue-Tie Release) and Functional Frenuloplasty
Frenectomy is simply an excision of the frenum tissues, whereas a functional frenuloplasty involves a skilled excision of the tissue along with the blunt dissection of fascia to improve the tongue range of motion. Frenuloplasty is the only procedure where a complete release of the fascia is achieved. The complete release will give relief in tension throughout the body. With the tongue playing an important role in so many functions, restricted mobility of the tongue may lead to compensatory behaviors that may contribute to chronic stress on the other muscles of the head and neck.
Functional Frenuloplasty and Fascial Release
The tongue also has connections to the whole body through a system of connective tissue known as fascia a restrictive tongue may place tension on the fascia networks causing neck tension, pain, and postural dysfunction.
“The anterior deep fascial line starts from beneath the tongue and goes till the lungs to the pelvic bones down to the arches of your feet.” This means there is a direct connection between the orofacial function-tongue function - diaphragmatic breathing - cervical posture.
-Information from The Tongue-Tie and Sleep Institute
Before and After Frenectomy
Before (photo on the left), the tongue tie is clearly visible with the tongue unable to lift to the roof of the mouth without closing the jaw. After treatment (photo on the right), the tongue is able to easily reach to the roof of the mouth.
Photo by Smileworks Pediatric Dentistry
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