Infant Frenectomy

What is a Labial Frenulum?

A labial frenum helps to anchor the lip to the jaw for proper movement and facial development. An abnormally tight labial frenulum can disrupt the seal around the breast or bottle nipple, leading to increased air intake contributing to reflux, gas symptoms or breast pain. In toddlerhood, a short or restrictive labial frenulum may affect forming a seal on a straw or cleaning food from a spoon. Brushing may be difficult in the area and could make your child higher risk for tooth decay.

What is a Lingual Frenum?

The Lingual frenulum is the name given to the connective tissue remnant under the tongue that serves to support and limit its movement in different directions.

The presentation can vary in thickness, elasticity, specific location on the tongue, and the floor of the mouth. If restrictive it may impact oral motor development, feeding, speech, and breathing habits.

About the procedure

A frenectomy is a quick procedure (a few minutes or less) that gives your child improved mobility of their lips and tongue. The timing of a frenectomy procedure is important, and our doctors will help determine this. Our doctors have received extensive training in diagnosing frenum issues and performing frenectomy procedures. They are certified in the use of soft tissue lasers.

Infant frenectomy

At Smiles in Motion, we are dedicated and determined to provide you and your baby with exceptional care and want to help you achieve your feeding goals through proper diagnosis and treatment of restrictive frenula. We encourage a multidisciplinary approach and recommend mothers work with professionals who have extended knowledge and experience with infants and infant feeding as they seek answers to their nursing and feeding questions. These specialists provide crucial insights on a baby’s oral motor skills. These providers include:

• IBCLC/Lactation
• SLP (speech & language)
• Primary medical provider

Furthermore, best practices include bodywork sessions with a skilled body worker (Chiropractor, Cranial Sacral therapist, Physical Therapist) familiar with infants before and after the procedure.

Soft tissue laser

At Smiles in Motion, we use a state-of-the-art carbon dioxide (CO2) laser to perform our frenectomy procedures on infants. No general anesthesia is required and local anesthetic (numbing) is not always necessary. Laser procedures are relatively quick and reduces the risk of bleeding and inflammation. Healing time is quicker and there is less post-operative discomfort than when compared to traditional methods of removing tissue which requires a scalpel.

Signs and Symptoms

The tongue, lips, and cheeks are important for all oral functions. In infancy, when the mobility of those muscles is restricted, it can cause problems with nursing, feeding, swallowing, sleeping, and breathing. Many of these problems can persist into adulthood along with speech problems, difficulty brushing the top teeth, tooth decay, headaches, neck pain, shoulder pain, excessive spacing, and gum recession.

Shallow latch
Lip curls under while feeding
Loses suction
Prolonged/incomplete feedings
Falls asleep in the middle of feeding
Gagging or coughing while feeding
Chewing nipples while feeding

Clicking/smacking noises while feeding
Milk leakage out of their mouth
Poor or slow weight gain
Frequently gassiness and fussiness
Inability to hold pacifier
Lip blisters
High palate

Painful nursing
Nipples are creased, flattened, and/or blanched
Nipples are cracked, blistered, and/or bleeding
Poor or incomplete breast drainage

Plugged ducts or mastitis
Inability to nurse without a nipple shield
Decreased milk supply

What to expect after release

• A white and/or yellow diamond-shaped patch at the healing site is normal. This is not an infection.

• A “notch” in the maxillary bone after a lip tie release is common. This will slowly fill with tissue and close when the two top front baby teeth erupt.

• Increased sleeping may be due to exhaustion, or simply that your baby is feeding better and is more satisfied. A slight amount of bleeding while doing the stretches is normal during the first week.

• Increased drooling due to increased tongue movement.

• Extra fussiness and inconsolable crying during the first week. Discomfort usually starts a few hours after the surgery when the numbing effect of the laser wears off. Most babies experience mild to moderate discomfort that lasts 12–24 hours, although sometimes it may last longer. It can peak around days 3–5.

After Care

Lip Stretches

Place your finger under the lip and elongate the treatment site by moving the lip up as high as it will go (until it bumps into resistance). Then gently sweep your finger from side to side over the treatment site for a few seconds.

Cheek Stretches

Use index fingers to do a “fishhook” sweep and lift the cheek areas. It is ok to rub the treatment site with your index fingers and use a “C” or “U” shape movement with the finger

Tounge Stretches

Stretch 1: Place your index fingers together at the top of the diamond under your baby’s tongue and stretch it up towards the roof of their mouth and back towards the throat. Hold it for 1-2 seconds and then relax. The goal is to narrow/elongate the diamond.

Stretch 2: Place your finger in the middle of the diamond. Turn your finger sideways and use a sweeping or rolling pin motion to lift the tongue in the up direction. This stretch should not be forceful or rough within the wound.

Stretch 3: Massage on either side of the floor of the mouth (outside the diamond) to loosen up the musculature of the remainder of the floor of mouth

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Parent Testimonials

Google Reviews

We had an incredible experience at Smiles in Motion Pediatric Dentistry. We brought our newborn in for a lip and tongue tie revision, and from the initial assessment to the procedure itself, everything was handled with care and professionalism. As chiropractors who have referred many children here, it was amazing to experience their expertise firsthand as parents. We’re so grateful to have this invaluable service available in our area. A big thank you to Dr. Winn and the entire SIM team for providing such exceptional care!”

– Courtney K.

“My son had a lip, tongue; and cheek tie. We had a consultation with the SIM Team and the laser procedure done. The entire experience was great even though I was so nervous and worried about the procedure. They made sure all of my questions were answered and were very thorough and kind. They even called us in the afternoon after the procedure to check in with us. I would definitely recommend seeing the team at Smiles in Motion"

– Kayla H.

“We came to Smiles in Motion desperate for answers as to why our little 6 week old was struggling to latch and feed which was resulting in sleepless nights full of gas and acid reflux. We found out that our girl had three oral ties and from there we were able to get them released and now we are on the road to recovery with high hopes for her ability to latch and feed. From the moment we stepped into the office, we were treated with kindness and compassion. We were given the space we’d need to care for our little girl comfortably during our visit and had everything that was to happen explained in great detail so that we felt comfortable and confident with our decision. When it came time for the procedure I felt incredibly comfortable with them releasing our daughter’s ties and could tell that she felt comfortable and safe with them, which for me as a mom, is the most important thing! I can’t thank the team enough for the care and support we have received!”

– Olivia H.

Scheduling your appointment

Our specialty trained team is available to assist you in scheduling, review what to expect at the appointment, and help answer any questions you may have regarding the procedure.

At Smiles in Motion Pediatric Dentistry, our board-certified dentists have received extensive training in diagnosing frenum issues and performing frenectomy procedures.

Schedule your appointment