Tongue Tie Specialist in London (Chelsea Clinic)
Children may be born with a combination of conditions called a tongue tie and/or a lip tie, causing restrictions in tongue movement. This can result in difficulty with breastfeeding and, in some instances, other health problems such as speech difficulties, airway difficulties and digestive issues. These can generally be corrected by a simple procedure called a frenectomy.
How Does Tongue Tie Surgery (Frenectomy) Work?
More and more, parents are opting for a safe, fast-healing laser frenectomy. Rather than using scissors or scalpel , we use a laser for all of our frenectomies at Happy Kids Dental, because we know the laser has superior healing properties.
At Happy Kids Dental we have 3 lasers to choose from:
- The Epic™ X Laser, developed by Biolase. This is a diode laser and is recognised worldwide as the best method for tongue tie and lip tie treatment.
- Waterlase laser - is an erbium laser that is used to treat revisions after patients were unsuccessfully treated elsewhere.
- CO2 laser delivers dependable results with no re-attachment and is considered gold standard in oral surgery.
There are multiple benefits to using this laser:
- Efficiency - the procedure takes less than 30mins and no stitches are necessary.
- A laser works with light energy so there is very little discomfort. There is almost no bleeding and some babies and children sleep through the procedure.
- The laser sterilises upon touch, therefore the risk of infection is minimal, if any.
- Healing occurs quicker and without complications. The result is healthy, well-healed tissue with less chance of reattachment (relapse).
At Happy Kids Dental we may only use topical anaesthetic during frenectomy, since it is a painless procedure when performed with a laser.
What is Tongue Tie ?
Tongue tie occurs when the piece of skin under a baby’s tongue becomes attached to the tongue. In most babies, this piece of skin separates from the front end of the tongue before they’re born.
A tongue-tie is sometimes diagnosed during a baby’s routine newborn check, but it’s not always easy to spot. It may not become apparent until your baby has problems feeding.
Normal tongue function is important for multiple reasons - it will allow a baby to latch adequately and breastfeed efficiently, promote normal speech development and make it possible for a child to self-cleanse their mouth while eating. It also encourages adequate swallowing patterns and allows for proper growth and development, not to mention it makes it possible to experience fun little things like eating ice cream, playing a wind instrument and sticking out their tongue to catch snowflakes!
We have asked Camilla Oates to answer a few questions about the Tongue Tie procedure
Camilla (BSc, M.Ost, DPO) is an experienced osteopath, working at Kane & Ross osteopathy specialists. She holds a Masters in Osteopathy, an Honours Degree in Biomedical Science, Postgraduate Certificate in Paediatric Osteopathy and treats babies, children and pregnant women.
How do you diagnose a Tongue Tie?
Should you get your baby's tongue tie cut?
Caring for your baby after tongue-tie release
Tongue Tie Clinic - Q&A
- The tip of your baby’s tongue looks notched or heart-shaped when they stick it out.
- They have difficulty sticking their tongue out.
- The tip of your baby’s tongue can’t reach the roof of their mouth or further than the edge of their lower lip.
- They have difficulty moving their tongue from side to side.
- Trouble latching on or staying attached to your breast
- Feeding for a long time, having a short break, then feeding again
- Being unsettled and seeming hungry all the time
- Failing to gain weight as quickly as they should
- Making a “clicking” sound when feeding
- Excessive gassiness
- Excessive drooling
- Poor weight gain
- Taking a long time to feed
- Excessive gassiness
Tongue tie can sometimes cause problems such as speech difficulties, difficulty eating certain foods and difficulty cleaning teeth. Some other problems are appearance-related, such as a wide gap between the bottom two front teeth, or a V-shaped notch in the end of the tongue.
Check with a speech and language therapist if more than half of a three-year-old child’s speech is not understood by people outside of the family, or if the child has difficulty licking an ice cream cone.
It is possible that latching will be a struggle at first, since we would use a small amount of anaesthetic to complete the procedure. The numbness will wear off about 30-45 minutes afterwards, so do not be alarmed if latching is difficult at first.
Tongue ties can vary in severity and can include what we call a “posterior tongue tie”, which may require a few weeks of practice before you see the benefits of the frenectomy.
We recommend to be thorough with the prescribed post-treatment exercises and to work with a lactation consultant and an osteopath to achieve optimal results and avoid reattachment.
Is your child’s lingual tongue tie or lip tie causing discomfort, or limiting their ability to eat, speak or swallow? Complete the form or call us to arrange your appointment.
- Tongue-tie typically affects boys more often than girls.
- Tongue-tie is not the only reason for breastfeeding difficulty.
- Sometimes tongue-tie does not cause speech delay, but can affect a child’s speech articulation - the ability to form sounds and pronounce words.
- Tongue-tie diagnoses are increasing as breastfeeding becomes more commonplace.
All patients are booked for diagnosis with our oral surgeon for the consultation (£175 that stands with or without treatment) and where appropriate, we have enough time for the release (£415 for one release - £520 for both tongue and lip tie releases). We will then invite you for a post-procedure review (£115) 1-2 weeks later to ensure the healing is progressing well.
Go ahead and book your consultation online here and we'll follow up with a questionnaire and consent pack
If you wish, we can offer an online consultation if more convenient - simply book here and add the note VIRTUAL so we may send the Zoom link across.
Unfortunately we only carry out these procedures at our clinic in Chelsea, Sloane Square with Dr. Suraj Vatish.
Dr Suraj (DDS Imp Dent RCS(Ed), Cert Perio RCS, Implant Surgeon with special interest in Oral Surgery & Periodontics) started providing Frenectomy releases at our practice 3 years ago and has carried out 500+ procedures to date, with great success using the CO2 laser we have in house.
In terms of compliance we unfortunately cannot offer full sedation (General Anaesthetic) with this kind of treatment - however in our experience we have completed many procedures with great success as the laser procedure is so fast and our staff are specifically trained to treat children. We also use a topical numbing gel on the treatment area to make it even more comfortable.
We often ask parents to lie in the dental chair with the child on your front, your arms across them to help keep them still - we do not pin down or force any treatment without their cooperation or your consent.
They will not feel the pain no, as the numbing gel is strong and works incredibly fast - but of course it's not so pleasant for them and they usually do cry as this it feels uncomfortable and they'll need to be as still as they can.
The procedure is quick and clean without bleeding - it is very rare, but for older children (5+) a stitch may be required, to aid with the healing process.
Complete tissue healing takes 6 weeks, but they will feel their normal selves within 3-5 days, that means it may be uncomfortable or sensitive for a few days after their treatment.
Yes they may eat and drink straight after the procedure, just be mindful that they may be still numb so watch out for biting their cheek or tongue when chewing and stick to soft foods for the first 3-5 days - ice cream is particularly good for healing!
Here are some links that demonstrate how to complete the massages from the evening of the procedure until your review - Dr Suraj will of course show you before you leave.
One drop of Vitamin E oil on the treated area when massaging can really help the healing - here's the brand we recommend.
Do NOT exceed more than 6 hours in between stretches, and you do not need to wake your child to complete the exercises overnight.
With successful exercises and the efficiency of the laser, re-attachments are very rare - if it does occur however, the surgeon will notify you and we may re-release on your review appointment or we'll ask you to come back after the healing is complete, then re-release - Dr Suraj will discuss this with you.
Lip tie in babies & children
A lip tie occurs when the upper lip remains attached to the upper gum. Challenges that can occur in children and infants with moderate to severe lip ties:
- Pain with breastfeeding
- Issues with attachment during breastfeeding, as a baby will not be able to raise the upper lip and attach well to the breast
- Spacing between the two central teeth (a large gap can form, called a diastema)
- Difficulties with brushing and flossing
- Increased risk of dental decay
Adult Tongue Tie
- There are many symptoms which can occur with Tongue Tie in Adults. Visit our sister website for more information about specialist diagnosis and treatment of Adult Tongue Tie.
Did you know that speech is one of the most sophisticated fine motor functions of our body?
Our speech requires the complex systems of our mouth to work together.
There are several components of speech production - articulation is one of them. It is a way of producing sound by constricting air flow in particular way. Lips, tongue, teeth as well hard and soft palate are the main structures in the oral cavity that are articulators. It might come as a surprise that the tongue is one of the most important articulators, which is used in every speech sound.
If tongue movement is restricted by a tie, we can hear many articulation errors. Have you heard your child saying “yeyow” instead of Yellow or “tat” instead of cat ? This might sound adorable to you when your child is 2 years old, however it becomes a concern once children go to school. Sometimes the child copes with tongue restriction by omitting speech sounds - saying pen for open or bi for big.
A good way of understanding tongue ties is to think about how your child's speech changes when the front tooth is lost, this is a temporary alteration that is noticeable, however when your child has a tongue tie - you might not realise that their speech might sound very different when the restriction is released.
Depending on when tongue tie is discovered some children will find a compensating mechanism - which means they adapted their other muscles to produce sounds in ineffective way. This often causes narrow palate, neck tension, headaches, and sinus infections.
If your child is experiencing any these symptoms or has difficulties with speech - it might be time to check for Tongue or Lip Tie.
Dr. Zoi Tzelepi
DDS, DDent Paediatric Dentistry Certificate, Special Care Dentistry
Dr. Zoi is a paediatric dentistry specialist and has been registered with the General Dental Council (GDC) since October 2011. Her areas of interest lie in the fields of inhalation sedation, behaviour management and soft-tissue laser application.