Dentician, Dr. Ankita Shah, Mumbai, India, First Breathe Sleep Centre

The tongue is a mighty muscle which is essential for sucking, swallowing, eating, drinking, chewing, breathing, speech, jaw growth and improving digestion.

 

“Ankyloglossia” commonly referred to as a tongue tie is a string of tissue that ties the tongue to the floor of the mouth which restricts tongue movements essential for the above mentioned functions. Lip tie is a similar band of tissue that adheres the lip to the gums at a level much higher than normal which can lead to potential breastfeeding issues, a gap in between upper front teeth, cavities, inability to close the lips without strain and speech difficulties.

 

Breastfeeding is considered crucial not just in terms of weight gain for the infant but also developing the right tongue function for a correct jaw development. Mothers start looking out for help when they have been exhausted from their breastfeeding journey. They in turn start supplementing bottles under the notion that they have insufficient milk production. A failure to diagnose tongue and lip ties supplemented along with bottle feeds affects jaw growth, airway development and much more.

 

For mother’s having trouble breastfeeding, it would be ideal to meet with a pediatric dentist, lactation consultant or a pediatrician who can rule out lactation concerns and then assess if there is any tongue or lip tie that is hindering the process of breastfeeding.

IDENTIFYING IF YOUR CHILD HAS A TIE:

A tongue tie cannot be diagnosed by seeing if the child can stick out the tongue outside the mouth. Evidence based current approach shows that a comprehensive functional assessment of the tongue is essential. Some of the symptoms are mentioned below:

 

Breast Feeding Mother Symptoms Infant Symptoms
  Creased nipples   Prolonged latching / long feeding hours
  Blanched nipples   Unsettled after feeding
  Bleeding nipples   Short sleep duration
  Painful latching   Poor / shallow latch
  Incomplete breast drainage after feeding   Chewing on nipples
  Mastitis / Infected nipples   Reflux symptoms
  Nipple Thrush   Colic symptoms / Gassiness
  Reduced milk supply   Falls asleep during feeds
  State of mind: Anxious / Depressed   Pulls body away from breast while feeding
Toddler Symptoms Children Symptoms
  Bruised (or) bleeding nipple   History of difficulty in breast feeding but not limited to the symptoms mentioned above
  Infected nipples / breast / mastitis   Speech difficulties
  Clicking sounds while feeding   Forward neck and shoulder posture
  Short sleep episodes   Sluggish eater / Picky eater / Slow eater
  Food in faeces   Frequent cold, cough & allergies
  Constipation   Digestive problems – refluxes, colic
  Delayed speech   Grinding teeth at night
  Difficulty in brushing upper front teeth   Restlessness & lack of attention
  Gags easily   Day time sleepiness / Hyperactivity
  Trouble with solids / chewing   Malaligned teeth
   Audible snoring / breathing at night

HOW IS IT TREATED?

After a thorough history taking and clinical examination, depending on the severity of the condition the treatment is advised. In severe cases, a frenotomy is advised. It can be performed using scissor or laser technique.The Laser Procedure is a safe, quick, simple and painless procedure which generally requires no anesthesia. Oral Myofunctional Therapy is given as an adjunct to rehabilitate the tongue function and avoid any relapses. Postoperative stretches and a functional release is the key to a successful frenotomy. This is what sets us apart. Please go through our resources given below and our blogs for additional understanding.

RISKS OF AN UNTREATED TIE

   Selective in chewing solid foods

   Speech defects

   Improper jaw growth

   Crooked teeth

   Sucking habits

   Mouth breathing

   Forward neck and shoulder posture

   Long term bed wetting

   Hyperactivity/ Lack of attention

   Snoring/ Noisy breathing

   Frequent nasal allergies and throat infections

   Teeth grinding

   Picky eating/ Slow eating

 

The above mentioned risks are examples of observed changes in children. NOT ALL TIES SHOW all the above mentioned risks. It takes an experienced provider to thoroughly investigate the tongue function and symptoms associated with each tie.

RESOURCES

SUCCESS STORIES

A doctor who is great with handling babies. We visited Dr Ankita as our 4 week old daughter had a tongue tie that had to be snipped. Her analysis of the condition and what needed to be done was thorough. Dr Ankita explained the pros & cons of the procedure in detail and gave us material to read through and decide without pressure or in a hurry She was extremely gentle with the baby during the procedure and after during our visits for the exercises to help heal the procedure. Would definitely recommend her for this procedure.
- Jessica Irani

Great experience! So knowledgeable and warm with the kids! The facility is completely geared towards kids. Also one of few dentists with deep knowledge on tongue ties.
- Spandana Mulpuri

I had a good experience with Dr Ankita all through my journey of first few weeks of maternity , were i was facing with problems of nipple crack and pain since my baby had both tongue and lip tie. Tongue tie got released and the problems slowly start decreasing , now the baby is able to latch and suck properly, she was helping me with all the exercises that we should do and helped with lactation advices, and iam really thankful...
- Dr. Sneha Krishnan

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