Lingual Frenotomy for Tongue Tie

What is a tongue tie?

Tongue tie (ankyloglossia) occurs when the thin strip of tissue under the tongue that attaches it to the floor of mouth (lingual frenulum) is too tight or attaches too close to the tip of the tongue and limits tongue movement. This is primarily noticed shortly after birth with difficult breast feeding. It’s unlikely to cause any problems later in life and does not cause speech delays, though it can cause problems pronouncing certain sounds. It can also limit sticking out the tongue, such as when licking popsicles or ice cream cones.

Why would my child need treatment for tongue tie?

Releasing the tongue tie is a minor surgical procedure (frenotomy) and may be considered when an ear, nose, and throat provider finds a tight lingual frenulum and difficulty moving the tip of the tongue. A speech and language pathologist should also be part of this decision for older children, especially if there are speech concerns.

Although tongue tie can be associated with difficulty nursing, difficulty saying words, and difficulty sticking out the tongue, it’s important to understand that predicting improvement from a frenotomy is difficult.

How is a lingual frenotomy performed?

In newborns, the procedure is performed quickly and easily in the office by first clamping and then cutting the tight frenulum. This usually takes about 5 minutes and minor discomfort can often be soothed with sugar drops. Immediately after the procedure the baby is returned to parents and nursing can be attempted immediately.

In older babies, children, and teenagers, it is performed in an operating room and does require general anesthesia. This means your child will be fully asleep and carefully monitored during this procedure. The technique is very similar and usually involves clamping and then clipping the frenulum. Some self-dissolving stitches may be placed and do not require separate removal. You will have a chance to talk with the anesthesiologist on the day of surgery to discuss any questions you may have about the safety and risks of anesthesia.

Are there any instructions I need to follow before surgery?

Your child must have a physical examination by their primary care provider within 30 days before surgery.. The provider you see needs to complete the History and Physical form provided by our office. You must bring the completed form with you the day of surgery.

For your child's safety, it is very important that he or she have an empty stomach when anesthesia is given. Please follow Children’s Hospitals’ Eating and Drinking Guidelines. If you do not follow these guidelines, your child's surgery will be cancelled.

What can I expect after lingual frenotomy if anesthesia is necessary?

The procedure itself usually takes no more than 10 or 15 minutes. Your child will wake up in the recovery room after surgery. This usually takes no more than 20 to 40 minutes. When your child is awake, he or she will be taken to the discharge area to complete the recovery. You can be with your child once he or she has been transferred to the discharge area.

• There can be mild to moderate tongue soreness or swelling for a few days after the procedure. This can be treated with Tylenol® (acetaminophen) or Children's Motrin® (ibuprofen) as needed. You will receive discharge instructions indicating how much medicine can be used.
• There may be stitches that will dissolve on their own and do not need to be removed
• No stretches or exercises are necessary after surgery. The possibility of a tongue tie recurrence is very low.
• If your child is working with a speech therapist please continue to follow their recommendations for ongoing therapy.
• Fevers up to 102.0 F are considered normal after surgery. Call your provider for fevers over 102.0 F that do not come down with acetaminophen (Tylenol) and/or Ibuprofen.

Questions?

The information provided in this brochure is not specific to your child. This information is provided as a service to our patients. The information is for educational and informational purposes only and should NOT be used as a substitute for the advice of your child’s physician.

If you have any questions, please call your Ear, Nose, and Throat clinic.

Reviewed 10/2022

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