We are a lincense and certified dentist specialized in laser tongue tie and lip tie removal (know as laser frenectomy). Tongue tie revision or removal is a procedure of releasing a thin piece of skin (the frenum) under the tongue and/or upper lip to allow for better range of motion. Children may be born with a combination of conditions called a tongue-tied (ankyloglossia) and a lip-tie causing restrictions in movement that can cause difficulty with breastfeeding. This consition may also lead to other health problems like dental decay and spacing, speech and airway difficulties, and digestive issues.
All these conditions are corrected by a relative quick and simple procedure performed with our minimally invasive laser.
Experiencing life from having a baby with tongue tie it is emotionally exhausting for many mothers. Our great satisfaction in serving our wonderful bady patients with their journey of having laser tongue-tie removal for healthy tongue and tip range of montion, especially when mother’s tears of happiness is present, is difficult to put into words. Every mother having a baby with tongue-tie abnormally has a story to tell…
When we met our patients in real life, we ask questions to get to know them better. We listen to their existing tongue tie experience, and beliefs. We try to unearth their baby mouth and life story, and to tell our own as clinicians. The end goal is find out if we can bring these baby patients back to good oral health and give them a normal tongue range of montion.
In this process of knowing each other during our 1 hr consultation we tap into the underlying reason babies has this abnormally and why they have decided to come to see us– to get to be the best version of their babies; a version they have within them.
How much does tongue tie laser release cost ?
As of 2019, our cost range from $700 for mild case to about $1,200 for an involved tongue tie laser removal on newborn babies with severe tongue tied and lip tied condition. This includes the cost of follow up visits if indicated. The cost for an average of laser tongue tie removal is about $750, while the average cost for tip tie removal is $700.
On average, the patient can expect to spend about $750 for the treatment of tongue tie with specialized laser removal including the consutation cost and follow visits if needed. gingivitis.
Tongue tie laser specialist
We are in-network with all mayor insurance preferred provider list. We offer specilalied laser treatment for a wide selection of newborn baby laser frenectomies procedures including tongue tie and lip tie laser removal (revision).
Our linsenced laser specialist doctor acquired certificates in Soft and Hard tissue lasers and a Laser Fellowship certificate from the World Clinical Laser Institute. Our doctor has taught at the World Clinical Laser Institute about advanced laser techniques. Since his laser certification, hundreds of laser surgeries, for over 10 years, has been performed by Dr. Max Arocha.
Preparing for laser tongue tie procedure
The laser procedure for tongue tie and lip tie revision is relatively quick. Here’s what to expect from the procedure.
It’s not necessary to do anything to prepare for the laser procedure. In certain clinical cases, we may use numbing medication during the procedure, and the use of a laser may provide little discomfort. However, you may give your child some acetaminophen (Tylenol) about 30-60 minutes before the procedure, that may help. Follow the dosage on the over the counter packaging label, using the dropper or syringe that came with the medication. Typical dosing for acetaminophen with 160 mg per 5 mL, a common concentration, is:
- 6-11 lbs 1.25 mL
- 12-17 lbs 2.5 mL
- 18-23 lbs 3.75 mL
- 24-35 lbs 5 mL
For children over the age of six months, ibuprofen may be an option. Consult with your pediatrician and check the dosing on the label. You may also talk to your pediatrician about other methods to reduce discomfort.
Benefits of using laser for tongue tie
Benefits includes highly precise procedure which essentially vaporizes the affected site rather than cutting the tongue-tie tissue with a steel scalpel. During the quick, in-office laser tongue tie removal (frenectomy), the area around the tongue may be numbed with a numbing gel, and the specialized laser will be used to make a small procedure, thereby releasing the tension.
The laser sterilizes the area as is releasing its energy and stimulates healing through bio-regeneration. Laser energy seals the blood vessels so there is little or no bleeding. The entire tongue tie laser surgery procedure takes about a few minutes.
The benefits of using waterlase iPlus (Er,Cr:YSGG) laser for tongue tie and lip tie procedures are many:
- Minimal invasive
- No local anesthesia required
- Minimal bleeding
- No allergic or drug interactions
- Short procedure time
- No stitches
- No hospital visit
- No general anesthesia
- Great healing
- No need for antibiotic
- Can be done on infants as young as two days old
- Maximum precision and control for the doctor; if baby moves, tongue is not cut
- Less collateral heat (thermal) tongue-tie tissue damage and reddening of the skin than CO2 lasers
During laser tongue tie procedure
The minimally invasive laser procedure is a relatively new option suitable for neonates, older children and adults. No general anaesthetic is used, but an analgesic gel might be applied. The procedure is quick, taking about 2 to 3 minutes to perform, but some cooperation from the patient in keeping still is required.
The actual procedure is easy on your child, and we work hard to make it as easy as possible. Since we We have done this many times, and we know the ways to ensure minimum discomfort and stress. For this procedure, general anesthesia is not necessary, and because it has risks, we won’t use it. Instead, we will use topical numbing cream. This works very quickly. For older and larger children (typically over 12 months), we may supplement with an injection of anesthesia to ensure the entire area is adequately numbed (topical cream may only work on the surface).
For safety reasons, we are not allowed to have the mother in the treatment room. We would carry your baby to and from the treatment room. Your baby will be away from the mother for just about three to five minutes, of which the actual laser treatment takes about 30 to 60 seconds.
Crying and fussing are common during and after the procedure. You can soothe your baby in any manner that works, including breastfeeding or bottlefeeding in our office. We do not rush the mother out – she can stay until both the mother and her baby have recovered and feel comfortable leaving.
There is virtually no bleeding, very low risk of infection and the healing period can be as short as few hours. It is best to have this procedure performed by a laser certified clinicain who is experience with tongue tie revision.
Recovery after tongue tie laser procedure
The patietn exhibit improvement in tongue mobility immediately after procedure. Tongue tie laser revision (procedure) has a high success rate. A small white patch is expected to develop at the revision (procedure) site within the first 24-48 hours, which is normal. Over the next two weeks, this tissue would mature and take on normal apperance and pink color.
Oral wounds tend to shrink as they heal, and there is a tendency for the two sides of the wound to want to heal together. To ensure the proper healing, it’s important to perform stretches of the treated area.
Your baby may experience discomfort during stretches. You can administer acetaminophen or ibuprofen as above. We recommend a non-numbing teething gel, which will help your baby feel comfortable during stretches. Apply a small amount of the gel to your finger before performing the stretches.
Stretches should be performed four times a day for the first week, then taper off during the second week.
Wash your hands well before every stretch. You don’t have to wear gloves, though it may be advisable if you have sharp nails.
Upper lip tie Stretches : Begin with the upper lip, if treated. Insert your finger under the upper lip, pushing upward until you encounter resistance. Sweep side to side for several seconds to keep the two parts separated so that it prevents reattachment.
Tongue tie Stretches: Tongue stretches are more involved. Insert both index fingers into your baby’s mouth. It’s easiest to insert one index finger first, using it to stretch the cheek, allowing for the second one. Position both index fingers under the tongue and lift it upward. Hold it as high as it will go for about 1-2 seconds. Repeat this execise twice.
Next, prop the tongue up with one finger and use the other finger to massage the area where the tongue meets the bottom of the mouth using a circular motion few seconds.
Tongue tie sucking exercise
Sucking exercises help your baby develop a good sucking response. They also help encourage positive associations with you that counteract some of the negative sensations associated with stretching.
Start by rubbing your baby’s lower gumline from side to side. Your baby’s tongue will naturally follow, and will develop stronger side-to-side motions.
Next, let your baby suck your finger into their mouth. Then slowly pull your finger back out against the force of suction. Let them pull it back in and then pull it out several times prior to letting your baby suck on your finger while you apply gentle pressure to the palate. Then, turn your finger around and gently press down on the tongue and massage it.
Tongue tie problems
Tongue-tie can affect anyone, it’s more common in boys than girls. Tongue-tie sometimes runs in families . Although it is often overlooked, tongue tie may be an underlying cause of feeding problems that affect a child’s weight gain, but lead many mothers to abandon breast feeding altogether. While the tongue is remarkably able to compensate and many children have no speech impediments due to tongue – tie , others may.
Infant tongue-tie and its impact on dental, breathing, and sleep health have seen a recent spike in attention. The symptoms of an undiagnosed tongue tie can link to mouth breading, poor sleep, sleep apnea, neck pain, digestive issues and anxiety.
For Infants: Inability to breastfeed successfully in the presence of a tongue tie may cause a variety of challenges for the infant. For the baby, these may include:
- negative impact on milk supply
- Termination of breastfeeding
- The baby failing to thrive
- Poor bonding between baby and mother
- Sleep deprivation
- Problems with introducing solids
The maternal experience of breastfeeding a tongue-tied baby may include:
- Pain
- Nipple damage, bleeding, blanching or distortion of the nipples
- Mastitis, nipple thrush or blocked ducts
- Severe pain with latch
- Sleep deprivation caused by baby being unsettled
- Depression and a sense of failure
For Children: Children with a tongue tie have to contend with difficulties which may only be discovered as they grow older. These may include:
- Inability to chew appropriate solid foods
- Gagging, choking and vomiting foods
- Persisting food fads
- Persistence of dribbling
- Delayed development of speech
- Deterioration in speech
- Dental problems
- Loss of self confidence because they feel and sound ‘different’
- Strong, incorrect habits of compensation being acquired
Complimentary tongue tie evaluation
If you are trying to breastfeed your baby and are finding it difficult or painful, come to see us for a complimentary evaluation. We will be able to tell you if your infant is tongue-tied or lip-tied and if this is causing your baby to be unable to nurse successfully. If so, he would explain the minimally invasive laser procedure in detailed.
How does tongue tie and lip tie laser procedure work
Our waterlase iPlus (Er,Cr:YSGG) laser has made the treatment of children safer and easier. Our (Er,Cr:YSGG) laser has an affinity for water within the tongue-tie tissue like the CO2 (Carbon Dioxide) laser for tissue ablation. However, its affinity for water within the tongue-tie tissue is 10 times greater than that of CO2 lasers.
This great affinity allows for a cleaner target issue ablation with less heat (thermal) collateral tissue damage. Therefore, superficial reddening of the skin (erythema) and complications are greatly diminished compared with the CO 2 laser due to the decreased collateral heat (thermal) death of most of the tongue tie skin cells ( necrosis). In certain clinical cases, there is low to no discomfort with the our laser since its light energy is kind, as it only penetrate microns into tissue.
There is almost no bleeding from the laser procedure. Our lasers sterilize at touch therefore have less risk of infection. The fast recovery is about one day and healing is quick due to the fact that laser stimulates bio-regeneration and healing. The result from lasers are beautiful tissue and certain clinical cses less chance of relapse.
Tongue-tie definition
Ankyloglossia know as tongue-tie, is the restriction of tongue movement as a result of adherence of the tongue to the floor of the mouth. A tongue-tie is therefore caused by a piece of skin (frenum) that is abnormally short or attached too close to the tip of the tongue.
Normal tongue function is important for multiple reasons. Normal tongue function will allow a baby to latch adequately and breastfeed efficiently, promote normal speech development, make it possible for a child to self-cleanse the mouth during eating, allow adequate swallowing patterns, allow for proper growth and development, and it makes fun little things like eating ice cream, kissing or sticking your tongue out to catch snowflakes possible.
| Inability to open mouth widely affects speech and eating habits |
| Inability to speak clearly when talking fast and loud |
| Pain in lower jaw |
| Forward motion (protrusion) of the lower jaws |
| Negative effects on social situations, kissing, licking ice cream |
| Tendency to have inflamed gums and increased need for gums treatment including surgery |
It hurts when I breastfeed my baby
Many mistakenly assume that if they cannot successfully breastfeed, there is something wrong with them. Infants may be born with a combination of limiting conditions called a tongue-tie (ankyloglossia) and a lip-tie.
Tongue-ties are normally straight forward to diagnose by clinical observation. It looks like a heart shaped when the baby cries. There is an obviously tight piece of skin (know as frenulum) underneath the tongue that runs from the floor of the mouth to an area close to the tip of the tongue. Tongue-ties varies in severity and can include what we call back tongue-tie which is more difficult to diagnose. The piece of skin (frenulum) looks like it is that there so the first instinct is to think that tongue-tie can’t cause any problems.
The tongue looks squared off with the floor of the mouth tenting the tongue. The edges of the tongue will form a cup when crying as it is unable to go up. The tongue cannot move side to side and instead it twists side to side. The tongue can not extend out of the mouth and stick out when the mouth is wide open, which is the ideal position for breastfeeding.
Mothers who try to breastfeed their tongue-tied baby suffer emotionally and physically. She may require to re-latch the baby multiple times during a feed and deal with feedings that may last few hours longer than required. She may experience trauma to her nipples including bruises and pain during feeding. Her risks of breast infection increases and her milk supply can be greatly reduced due to the lack of stimulation from an inefficient latch.
Tongue-ties may couse the baby to loose weight and get sleepy during feeds (as they work much harder than other babies to stay latched), and become extremely gassy and irritable making the parent’s experience even more frustrating. Lip-tied babies end up with blisters on their lips from trying so hard to stay latched. Babies tend to feed a lot more often because their inefficiency results in less intake of milk so hunger kicks in faster.
Laser Procedure To Help Babies Nurse
Babies may have trouble nursing when a fold of tissue in their mouth is too strong or too short restricting the movement of their tongue and lips. Babies with this condition are said to be tongue-tied or lip-tied. Dr. Arocha is a laser certified in correcting this situation. I n certain clinical cases, he uses a noninvasive dental laser to remove the excess tissue during a simple, gentle and fast procedure. Infants as young as two days old can receive this laser treatment.
The laser quickly and gently corrects the overly restrictive frenum, with minimal scar tissue, and restores free movement of the tongue or lip for proper feeding. Our office has helped hunders of patients using this minimal-invasive technique.
While the existence of tongue tie (ankyloglossia) has never been questioned, the decision on whether surgery is an appropriate treatment has been the subject of many debates. Even today, the literature available tends to focus on different aspects depending on whether the author is a dentist, lactation consultant, speech-language pathologist, surgeon or general practitioner.
Although there is little consensus of opinion, there is still an ingrained reluctance to recommend surgery. As a result, there are many children who undergo several years of speech therapy with little or no improvement until the tongue tie is detected (often, by chance) and remedied. In fact, the possibility of a tongue tie being the cause should be part of the differential diagnosis performed when a speech pathologist sees a new patient. Surgical treatment of the structural defect should be the next step to be considered.
Tongue tie surgical options
There are three main options available for tongue tie treatment:
- minimally invasive laser removal of neonates without a general anesthetic.
- Invasive surgical scalpel revision under a general anaesthetic at or after 6 months of age.
- Revision by electrocautery ( electrically heated) using a local anaesthetic.
How common is tongue tie
It seems that every year, more and more mothers are reporting breast feeding difficulty and pain as well as more infants are being diagnosed with tongue tie now than in the past. Tongue-tie affects about 4%-11% of newborn babies. It’s slighly more common in boys than girls, and sometimes runs in families. Five scientific studies using different diagnostic criteria found a prevalence of tongue tie (ankyloglossia) between 4% and 10%