Treatment of Tie

Tongue Tie release in India

Treatment of Ties in Infants / Toddlers

The common term for ankyloglossia is tongue-tie. In this condition, the tongue is literally “tied,” or tethered, to the floor of the mouth, inhibiting both speech and eating. A child is born with this condition. The tongue is one of the most important muscles involved in swallowing and speech. Without a free range of motion, these activities can be impaired. However, the severity of tongue-tie varies among children, so the condition may be detected early or late.

The treatment is done using diode laser under topical anesthetic gel that cuts & seals the tissues resulting in very little (or) no bleeding & the procedure itself is completed within a minute or two. Babies may cry during the procedure, not because they are in pain, but because they are being wrapped up &something is in their mouth.

What to expect after a tie release:

The discomfort from tongue &lip tie release may last for about 24-48 hours in infants/toddlers for which a pain medication would be prescribed. If a lip tie release is done you may notice mild swelling for a few days after the procedure. Drops of blood may be noticed with saliva which is usually not a concern & settles in few hours. The area where the ties were released will be creamy white or yellowish a day or two after the procedure which depicts normal healing. Complete healing takes 10-15 days.

Improvement in symptoms:

Tongue-tied children practice sucking against resistance up to the moment their ties are released. When a tie is released, the child has no muscle memory of how to use their tongue without any restriction. So the amount of time that a child takes to relearn and get adapted to the new pattern of swallowing may vary from child to child and the duration for which the child has been practicing the resisted swallowing movements.

Stretching exercises:

Any open oral wound is likely to contract towards the center of that wound as it is healing. The main risk of frenectomy is that the mouth heals so quickly that it may prematurely reattach at the same site causing a new limitation in mobility & persistence or the return of symptoms may occur. Breastfeeding is a very helpful function of the mouth that assists to minimize rapid closure of wound borders post-surgery & also gentle & regularly repeated pressure on the wound is strongly recommended to prevent reattachment of frenum to its former position. For the lips, try pulling out & extending it to its maximum. For the tongue, position your baby on your lap with their head towards you. Use your index finger & place it on top of the released area & press the tongue up & back while at the same time pressing chin down with your thumb finger. Hold in this position for 3 seconds.

Supportive measures:

Sometimes infants/toddlers may require additional help from a bodyworker or lactation consultant to address certain muscle tone or habit.

Treatment of Tie in Children

Tongue-tie in children/adults is similar to those found in infants but it may be underlying to a broader set of conditions & diseases. In case of an untreated tie, the oral restrictions that remain throughout leading to development in the form of “COMPENSATION”. Over time these compensations for sub-optimal function can cause much harm to good functions of the body starting from malocclusion to obstructive sleep apnea. The treatment of tie is similar to how it is treated in an infant. The procedure takes less than two minutes & is done under topical local anesthesia using a diode laser.

Supportive Measures:

    • The tongue itself connects to 18 muscles & muscle groups in the head, neck & chest. So the prolonged restrictions could have caused significant postural problems & descended compensations, which could be best treated by a craniosacral therapist/bodyworker..
    • The restricted tongue over a period of time could have caused speech-related issues. Patients with speech challenges are encouraged to work with a speech pathologist for speech-related problems.
    • Myofunctional therapy: Due to the compensation that has already been existing there is a need for myofunctional therapy to retrain muscles to function normally & overcome the compensated muscular movements.
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