The frenum is the stretch of fibrous soft tissue that attaches the lips to our gums, or our tongue to the floor of our mouth. We all have them. Go ahead and feel under your upper lip and your tongue. That webbing you feel on the top is your lip frenum and on the bottom is your tongue frenum. Some people are born with very relaxed frenum, and some are born with very thick or short frenum. If there is any restriction for the lip or tongue to perform their natural functions, this is called a Lip Tie or Tongue Tie. This condition can be very obvious to the untrained eye, like the photo below, but also can be almost impossible to see.
Breastfeeding parents may notice a difficulty in their baby's ability to latch or feed properly. Sometimes this can be due to a frenum tether or restriction of either the tongue, the lip or both. During breastfeeding the lip is supposed to relax and create an adequate seal which allows the tongue to move appropriately to deliver milk. If the lip is unable to relax because of a tight frenum, the child may compensate by curling in their lip. If the tongue’s movement is restricted, many infants have to compensate by moving their lower jaw more than ideal. Either or both restrictions can cause maternal pain and or infant frustration during breastfeeding. Overly tight frenums, can cause symptoms including a blister on the upper lip (milk blister) from lip being sucked on, excessive chewing motions that can lead to exhaustion and short feeding time, audible clicking sounds when the child is trying to draw milk or milk leaking out the sides of the mouth during feeding. The tongue needs to be able to come forward, up and back enough to create a rolling motion to deliver the milk. If the tongue can’t make any of those motions adequately because of a tight frenum then the child may strain and suck rather than suckle. If you think your child has a lip or tongue tie, what should you do? One option is to talk to a therapist with training in this area. This could be a lactation consultant, feeding specialist, speech and language pathologist, physical therapist, or myofunctional therapist. They can instruct a parent on exercises to help stretch this tissue to allow for better mobility and adequate feeding. Sometimes, therapy alone is not adequate and the best treatment may be to have a professional release a tongue tie or lip tie. This procedure is called a Frenectomy. At Dentistry for Kids a frenectomy can be performed with a laser to improve the degree of mobility of the lip or tongue to feed without pain to the parent or stress to the child. Procedures done in conjunction with quality therapy have the highest success rates.
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