8 Facts About Ankyloglossia (Tongue Tied)

 

1. How do I know if my child is tongue-tied?

If your child is having a tough time gaining due to difficulty with breast-feeding your child or you are experiencing pain during breastfeeding, your child may be tongue-tied.

2. How do we fix it?

Frenectomy is the procedure used to treat the condition.  The goal of the procedure is to release the thin tissue that can prohibit free movement of the tongue.

  

3. Does it hurt?

The frenulum is a very thin membrane with little to no feeling. Although the procedure usually results in some bleeding, there is only a little discomfort.  Some babies may develop a white patch (called an eschar) 1-2 weeks afterwards.

 

4. Will there be discomfort afterwards?

Most infants will have minimal discomfort after the procedure.  Breastfeeding actually provides natural pain relief.  However, if your child does exhibit symptoms of discomfort you may use Tylenol (acetaminophen) as needed. Please DO NOT use Oragel or teething gels.

5. How will I know if it is healing normally?

Several days after the procedure, the treated area will look yellow or white.  This is NOT pus.  A small amount of bleeding is common during the first few days. However, if you are concerned about infection, please call us immediately to schedule an appointment.

6. What do we need to do while it is healing?

The mouth heals very quickly and ties can reattach if stretching is skipped.  Stretches should be done 6 times per day for 3 weeks.  Then 3-4 times per day for a 4th week.

7. How do I help my child do the exercises?

First and most importantly, WASH YOUR HANDS!!! There are 2 exercises that should be done after the procedure. You should do both 6 times per day for 3 weeks and then 3-4 times per day on the 4th week.

 

Tongue Exercises

First, place your finger under the tongue and lift it towards the roof of the mouth. Hold the tongue there for 1-2 seconds and then relax. Do this 2 times per exercise session. Second, place your finger in the middle of the diamond, turn your finger sideways and lift up, sweeping side to side.

 

Sucking Exercises

Slowly rub the gum line from side to side.  Your baby’s tongue should follow your finger.

 

8.  When should I contact my doctor? 

You should contact our office if:

  • There is uncontrolled bleeding from the area

  • Your child refuses to nurse or take a bottle

  • Your child experiences fevers over 101 degrees Fahrenheit

 

 

CONSENT FOR FRENECTOMY

 

Frenectomy is a simple procedure commonly performed for treatment of Ankyloglossia (tongue-tie). Your baby will be securely wrapped and his/her head gently held still.  The doctor places a finger under the baby’s tongue to gain clear access. Small sterile scissors are used for the release.  Your baby will be returned to you immediately following the procedure so that you can feed and comfort him/her.

 

Please note that as with any procedure there are possible complications.  The possible complications associated with frenectomy are:

  • excessive bleeding or infection

  • occasionally an ulcer may form that heals rapidly (usually within the week)

failure of procedure to resolve symptoms.

 

After reviewing the document, please sign in the space provided below, signifying that you understand 1) the procedure, 2) the steps required after the procedure, and 3) the possible complications of the procedure; and wish to give informed consent to continue with the procedure.

 

I _______________________________(Printed Name), today on _____/_____/_____ (Today’s Date) hereby provide my informed consent to Cyfair Pediatrics,  to provide the aforementioned procedure for my child, ________________________ (Patient Name).

 

Signature of Parent/Legal Guardian

_____________________________________________________

Date: _____/_____/_____ 

Signifying informed consent

 

Witness

_____________________________________________________

Date: _____/_____/_____

 

PROCEDURE NOTE

 

PROCEDURE: CPT CODE 41010 Incision of Lingual Frenum; Frenectomy

INDICATIONS: ICD10 Q38.1 Ankyloglossia

 

DETAILS OF PROCEDURE:

The patient was placed in the semirecumbent position. The tongue was retracted with a grooved retractor and an incision was made with sterile scissors into the area of the frenum.  After the frenum was cut, minimal bleeding was noted. Care was taken to identify and not injure the Sub-mandibular ducts. The patient tolerated the procedure well and was discharged in the accompaniment of parents/legal guardian. The patient will be asked to return to see us as needed. EBL: 0 ml or ____.

 

Signature

_____________________________________________________

Date: _____/_____/_____

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