Frenectomy/Tie or Lip Tied
Denver and Centennial CO
Breastfeeding and Oral Health Problems in the Infant
The need for dental intervention with the nursing child is becoming more and more a concern. What do I mean by that?
Breastfeeding has become the norm for feeding the infant. An indication that there may be an oral health problem in the infant can often become apparent almost immediately after birth. The lingual frenum which connects the tongue to the floor of the mouth may be attached too closely to the tip of tongue and causes it to be tongue-tied (termed “ankyloglossia”). This condition inhibits the infant from nursing effectively by keeping the infant from latching on to the breast and suckling.
Aside from the obvious concern of difficulty in nursing and failure to thrive, this can lead to other oral problems in the future. Without the tongue pressure against the palate with every swallow, the palate grows narrow and high instead of broad and flat. This impacts tooth alignment, the way the teeth bite together (occlusion), and airway development as the child grows and develops. Hello orthodontist and pulmonologist!
The mother is also affected. The tongue-tied tongue does not reach far out enough to rest over the gum pad. In these cases, the nursing mother’s nipple rubs against the gum pad and not the baby’s tongue, which can cause severe pain and denuding of the nipple. Infection of the nipple, mastitis and thrush can then result.
Infants with ankyloglossia can also suffer symptoms of colic due to swallowing air when a proper seal with the breast is not made.
How would I know if my child has this? Well, other than noticing the visual appearance of the tongue, there are a few symptoms that could be indicators. For instance, ankyloglossia can lead to mouth breathing, snoring, chewing the mouth open (sorry, can’t completely attribute this to bad manners!), crowded teeth, a narrow palate, speech problems, and skeletal changes.
Not only can ankyloglossia lead to the problems mentioned, but the maxillary labial frenum (lip-tie) can also contribute to problems during breastfeeding. The upper attachment of the upper lip can sometimes attach too close to the ridge of the gums near the area where the central incisors would be. The lip-tie restricts movement of the upper lip and can make latching onto the breast difficult. Loud clicking sounds means the infant is sucking in air.
There have even been links with increase caries (cavities) in lip-tied and tongue-tied toddlers. In some households, the infant sleeps next to the mother and engages in at-will breastfeeding. The milk can then sit on the teeth for prolonged periods which can lead to caries. The tongue is also a protectant from caries of the lower anterior teeth in that it rests over the incisal surfaces of the mandibular teeth which buffer the teeth. A tongue tied infant would thus not have this protectant.
Lip-tie and ankylossglossia can be the cause of aerophagia as well. Infants with breastfeeding problems often swallow more air which can lead to abdominal distention, belching, flatulence, crying and screaming for long time periods, reflux and GERD.
The good news about all this is that the remedy is a relatively easy and quick solution called a frenectomy where the attachment that is interfering with the nursing is incised and released with immediate results.
The bottom line is that dental and medical professionals should be aware of these conditions and should be evaluating the lips, tongue and frenal attachments. If any of the above symptoms are seen, consider lip-tie or tongue-tie as possible culprits.
*If you would like more information, please contact us at Downtown Denver Office Phone Number 303-296-8527.