FAQ

• Cracked, blistered, and bruised nipples
• Bleeding nipples
• Blanched or creased nipples after feeding (flattened)
• Severe pain upon latching infant
• Plugged ducts and mastitis
• Engorged or unemptied breasts
• Nipple thrush
• Infected nipples
• Exhaustion or postpartum depression
• Premature weaning

• Choking, vomiting, or gagging on food
• Persistence of dribbling
• Inability to chew age-appropriate solid foods
• Delayed development of speech or deterioration in speech
• Behavioral problems
• Loss of self-confidence because they feel different
• Dental problems with a high narrow palate, decay, narrow jaws, and recessed jaw
• Improper swallowing habits
• Breathing problems, mouth breathing habit, and snoring sleep apnea

Once you have been diagnosed with a tongue-tie, anyone could benefit from releasing the lingual frenulum to allow better resting position of their tongue to their palate. When the tongue is able to rest effortlessly up on the palate without any downward pull due to a tight lingual frenulum, it will have a chance to function optimally.

The proper starting position of the tongue when initiating a swallow is critical. It is this position that helps support the airway and throat. Therefore, we recommend that everyone goes through some tongue training PT (postural training and myofunctional therapy) before the procedure to learn to position the tongue properly, strengthen it, and stretch it before it gets released.

Afterwards, we recommend post tongue training physical therapy (myofunctional therapy) after the procedure to get optimal function of the tongue, restore optimal breathing pattern with the tongue resting on the palate, and to also get head and neck manual therapy from our specialized physical therapists to optimize your posture.

Yes. In some cases, a tongue-tie and low-tongue rest can be one of the contributing factors for sleep-disordered breathing in children. Pediatric sleep-disordered breathing (SDB) is a general term for breathing difficulties during sleep. A common physical cause of airway narrowing contributing to SDB is enlarged tonsils and adenoids.

Overweight children are at increased risk for SDB because fat deposits around the neck and throat can also narrow the airway. Children with abnormalities involving the lower jaw or tongue-tie where the tongue can obstruct breathing, or neuromuscular deficits such as cerebral palsy, have a higher risk of developing SDB.

• Snoring
• Hyperactivity or irritability
• Bedwetting
• Learning difficulties
• Slow growth
• Cardiovascular difficulties
• Obesity
• Teeth grinding

During the initial examination of your child, Dr. Ramaswami will do an assessment for tongue mobility and function in addition to a screening for sleep-disordered breathing. If SDB is noted, and tongue-tie is a contributing factor, she will discuss treatment with you. Dr. Ramaswami will also reach out to your pediatrician, or refer you to an ENT, so your child can have a complete assessment of adenoids and tonsils.

There is also research that shows that expanding the palate and increasing air flow in the oral cavity can decrease tonsil size and is often one of the non-surgical treatment options that can be provided by our pediatric tongue-tie dentist.

Tongue and lip ties can be treated through a procedure called a tongue-tie release, which involves cutting or releasing the frenulum to allow for greater mobility of the tongue or lip. Tongue-tie release can be done with a scalpel, scissors, or a laser.

Dr. Ramaswami uses a state-of-the-art CO2 laser to quickly and nearly painlessly release the tethered tissue. While there are many laser procedures done by other providers, the benefit of a CO2 laser is that it reduces postoperative swelling and bleeding by sealing off the lymphatic and blood vessels.

Studies have also shown that patients treated with a CO2 laser have significantly less postoperative pain, both on day 1 and day 7, as compared to scalpel surgery, and patients who were treated with a laser require less pain medication after treatment than those who were treated with a scalpel. (Patel, et al., 2015)

A tongue-tie release is a minimally invasive procedure that is typically performed with local anesthesia. While there may be some discomfort or soreness afterward, most children recover quickly and without significant pain.

Recovery time after a tongue-tie release is typically quick, with most children returning to normal activities within a day or two. Parents will need to follow some post-operative instructions to prevent the lip or tongue tie from re-attaching. Our office will share these exercises with you after the tongue-tie release.