Let’s talk tongues. Actually…let’s talk tongues and oral tissue and periodontal procedures.
WARNING: IF MOUTHS, TONGUES, ORAL PROCEDURES GROSS YOU THE HECK OUT…this is not the post for you. Back away from the laptop.
This post is more for those moms out there that might benefit from a recap of our experience with tongue ties, lip ties and frenectomy options. I FULLY encourage you to remember that every child is different and has different needs and that your DOCTOR, DENTIST, and PERIODONTIST is the educated expert in these fields…not me. I am only an expert in one thing…my kids. I do not make any recommendations for anyone else out there.
Ok, now that the full disclaimer is out there…let me tell ya our story. First of all, Jeremy has a tongue tie. He never had it clipped and as an adult, it does not affect him other than he looks hilarious trying to lick an ice cream cone. But that has never stopped him from pulling into a Bruster’s 🙂 His tongue extends to his lips but other than that, it doesn’t really go much further and even at that extension, it shows the classic ‘heart shaped’ on the end associated with tongue ties. If he talked on the phone or at a meeting for extensive periods of time, he does start to slur certain letter sounds but that is so rare (like maybe three or four times in the last ten years) that I would say that it really doesn’t affect him negatively.
Well, when I had Will, I had a really hard experience with breastfeeding. To say that it was the most challenging year of my life is a complete understatement. It was excruciating and I asked two different doctors (and a couple different lactation consultants) if the pain was from Will being tongue tied. They all checked his mouth and said no…he was not. I, being a first time mom, completely trusted my doctors and lactation consultants and just stuck my breastfeeding flag further in the ground, determined to continue and dead set on the fact that whether or not he was or wasn’t, this was our journey and I was gonna keep on going. I blogged about that experience and how it changed me…my heart…and my thoughts on motherhood here.
Well, over the course of that first year with Will, we continued and I just figured that he would rather put things into his mouth rather than put the tongue all the way out. I labeled it ‘the short tongue’. I didn’t really give it much more thought…because after all, the breastfeeding (although worse pain than tearing my ACL) was our mountain to conquer.
I went through all my photos of Will to show you every single one that he had his tongue out. This is it.
We had weight gain issues with him at one point (which in hindsight was probably due to the fact that it was hard for him to nurse effectively) where he went from being in the 90th percentile to the 27th percentile in six months but our pediatrician was a huge breastfeeding cheerleader and she told us outright…he was a giant swollen baby and he will probably be a slim child genetically speaking (both Jer and I were on the skinny side) and that he didn’t appear unhappy or hungry. When he started solid foods at six months, his weight growth curve did even out and there wasn’t anything else we worried about nutrition wise.
As far as the rest of Will’s mouth, it was perfectly normal other than some slightly protruding front teeth. His front two teeth slightly stuck out due to his paci. OH THE PACI. He loved that thing. It was the same exact one that he got in the hospital and it was the only one that he would use. Both boys have chosen paci’s and stuck with them…much to our chagrin. Jeremy and I learned that the paci was the most important thing in our possession…besides Will. At two years old, we did wean him off it (that’s hopefully what we will do with Weston too) and his teeth became much straighter so there was a sense of no-harm-no-foul with it.
At 17 months, this is Will….with the only shot I have of him fully sticking out his tongue. ever. the only photo ever. And note the open mouth…it’s much shorter otherwise.
And this is him now trying to lift his tongue as high as it can go. This is a stage III tongue tie….which is the most difficult stage to identify because it does allow for some mobility and it appears normal to some physicians (which is why his was not diagnosed until much later).
So the question is…why didn’t we just have it clipped when he was an infant?
Well…because the doctors told us that he wasn’t tongue tied. And because as he grew, the need diminished. Afterall…Jeremy didn’t and he is a perfect example to us that it didn’t affect him, his ability for speech development, etc. Plus, once we realized that he was tongue tied, we were done with breastfeeding. It had become a non-issue.
Here is the other way that this genetic gift can affect someone….in the form of a lip tie. A lip tie is when there is tissue that attaches from the upper lip down to either the gums or the palate. Depending on the thickness of the tissue, it can be a trial in of itself. The location of where it attaches determines what class it is. Will’s lip tie is a class III which means that it attaches just in front of the anterior papilla. As an infant, it did not seem to affect his teeth, the ability to brush them and our dentist said that they look fine.
Of course, this was something we had NOT A CLUE about when we had Will and all his breastfeeding issues…so it wasn’t even on our radar. Jeremy does not have a lip tie but it isn’t uncommon for someone to be both tongue tied and have a lip tie. (as you can see below, Will does have accidents and sometimes gets small cuts on his lip tie but he doesn’t complain about them and they are really really rare).
So now that you kinda know what our experience is with Will and with Jeremy (we didn’t do anything!), let’s move on to Mr. Munchie 🙂
From birth I knew that Weston was very different. Afterall there was a whole lot of this in the first 24 hours of his life…
Breastfeeding FELT different and our breastfeeding relationship (although it only last 10.5 months) was a much easier and happier time. I knew that there was a difference physically and that the hard times that Will and I endured with breastfeeding had to be due to something more than just inexperience. Honestly speaking…if I had Weston first, I probably would known instantly that Will was tongue tied and had it clipped within minutes because I would have known that the pain I was feeling wasn’t just in my head or an exaggeration. With Weston I had true ‘transitional discomfort’. With Will I felt like I had a fire-breathing dragon on my nipples. I’d like to be clear that I do believe I went through that experience with Will for a reason and that he was just as much of a victim as I was in that scenario…if not more. Poor guy. He was just hungry 🙁 So in general, I would love to encourage anyone out there that is dealing with this kinda pain that nobody can make the right decisions for you and your little one like you. Trust your gut mamas and don’t let others shame ya if your journey is different than theirs.
The thing about having one kid with ‘a short tongue’ and a painful nursing journey was that it made me double check Weston’s mouth…all the time. I knew more. I was better educated on the ramifications of a tongue tie and what it could mean. I knew that an oral frenulum also could be lip ties and that it could affect the child later when their teeth came in.
So here’s where it gets emotional for me to talk about….
we knew that Weston had a lip tie since birth but it didn’t ever seem to affect his ability to latch correctly or nurse effectively. In fact, for the first eight months of his life, we didn’t pay much attention to it. But then he started to walk. He was such an early walker and we figured that it was just a blessing in disguise because we found out we were expecting LJ and it would be really quite hard to have a newborn and a new-to-walking-toddler. The hardest part about him walking was that he would fall and when he did, it seemed like he would always be bleeding from his mouth. I started to notice that he was frequently busting the lip tie or the gums very close to it….even though he didn’t have all his teeth. About that time, I started keeping a notepad where I would write down why he was bleeding (from a fall, brushing teeth, from sticking his fingers in his mouth, for no reason at all!, etc.) and realized that it was happening about once a week and becoming more and more frequent.
On top of the bleeding, his front two teeth were becoming increasingly more difficult to brush (especially since I didn’t want to cause him to bleed!) and even though he hadn’t been to a dentist yet, I knew exactly what they would say.
At his one year appointment, we switched pediatricians and the new doctor mentioned that we should definitely have a dentist or periodontist look at his mouth. I started googling around trying to read a little more on lip ties because my limited experience was definitely not enough.
Then at Christmas time, we were visiting Jeremy’s folks and were at church and I was walking behind Weston in a hallway. He turned around and there was just blood all over his face, down his chin and neck and onto his clothes. He didn’t fall, he was just walking along…and it busted open. It was really the last straw for me and I knew that this wasn’t normal…that we needed to talk to an expert about it pronto.
After reading numerous accounts of moms and their little ones, Jeremy and I decided that we should take him to a periodontist and hear what they recommended and that if it meant having a procedure, that we would opt for it to be done as soon as possible, clipped via laser and under no circumstances did we want him to be put under. If they couldn’t do those things…we would find someone who could.
I started doing the homework and found one periodontist in Atlanta that would consider doing this procedure on a one year old. We used Dr. Nancy Mclaurin of Atlanta Periodontics. Most of the time, a lip tie is ‘fixed’ by other methods….a scalpel and sutures, waiting until their permanent teeth are in, or putting the child under general anesthesia. I understand all the reasons behind those methods but I just weighed the benefits and disadvantages and knew what I wanted for my kid.
We made our appointment and on the day of the assessment, the periodontist came into the waiting room…took one look at his mouth and said, this lip tie will absolutely need to be taken care of before the age of 8. I asked her what she recommended…and she said that because it was at least a class III, most likely a class IV (at the time she couldn’t see because he didn’t want to open his mouth), that it would not resolve on it’s own (like Will’s and she applauded us for waiting for him because that is what she did with her own son’s tongue tie). And then she said that if we were to choose to take care of it sooner than later, it would be much less painful now and have a quicker recovery time.
I called Jeremy and he and I both said instantly that we wanted it done as soon as possible.
The procedure itself was about two minutes long. I walked him in to the back room, handed over his lovie, his remote control (don’t ask), his light up Spiderman toy, and his playstation controller (again…don’t ask)….and they told me that it would be painless but he would definitely cry because they would have to hold his head still and his mouth open. They said that it would probably be best if I left the room and on the way out, I snapped this photo. It was very comforting knowing that someone would be holding him…that’s something that nobody mentioned in the other accounts I read and even though I knew they would be restraining him, it seemed like the safest way to do this procedure with a little one.
The laser itself is about the size of a pen…so they get very very close to the tie itself. And our periodontist first put on numbing cream which apparently tastes awful and my little guy hated it. I asked the periodontist to call out what she was doing… “NUMBING CREAM!” and then “REVISING!” and “ALL DONE!”…it was nice to hear that over his cries and it seemed like it was over really fast. About two minutes after I left the room, they carried him back out into the hall where I was waiting and they said that he could have any comfort item or if I was still nursing that he could breastfeed. I gave him his sippy cup of almond milk and noticed just a tiny bit of blood on his lip but it was nothing compared to when he falls and bleeds.
They gave me a list of instructions on how to stretch the lip and rub the ‘wound’ ten times three times a day so that it doesn’t heal back together. That is the worst part about the entire experience. Here’s a photo of me stretching it up…you can see he is not a fan…
Other than that, there were no further instructions. I asked if it would help if he had Orajel put on it and she said that if he looked like he was in a lot of discomfort that it couldn’t hurt. She also said that with her older patients that she recommended swishing their mouths with salt water. I said that I could possibly use saline spray (like the kind you get for their noses) and spray it a little each day and she said that would probably be the best aid in healing. Other than that, he could drink and eat anything immediately and a little bit of infant Tylenol that evening would help with any discomfort from food or the sippy cup on the wound.
The next day I noticed that it was already much easier on him and that some of the rawness was healing.
Here it is after five days…(sorry about the messy breakfast face)…
And here it is after one week. You can see there is barely anything else left to heal near the teeth and we resumed our normal brushing routine…
I asked about the little bit of tissue that is left under his front two teeth and that should stretch out to form a normal gum line in the back as he grows. We just have to watch it and make sure to keep it flossed and clean.
Overall, I am SO SO SO glad we did it. We did have to pay out of pocket for the procedure because it is not considered a health risk or covered under our dental insurance but it was well worth the money not to see my little guy bleed nearly every day. And now it seems as if he is much happier too. He is trying new foods (like crunchy stuff that he would have to bite was always avoided by him before but now it’s like a whole new world), he actually doesn’t cry whenever I brush his teeth, and I am noticing with photos that his two front teeth are coming slightly closer together even in just a weeks time. A lip tie can cause a gap in between those two front teeth so that is just an added perk.
In the end, it is definitely not a one-cure-fits-all type of decision. This absolutely needs to be a decision made by you and your team of physicians…but personally speaking, we have two boys with two very positive outcomes with two very different roads traveled. I think that the hardest part was stepping back and asking ourselves “is this going to get better with time? or worse?” and in the end, our theory in parenting decisions is that we want to choose things to benefit the boys in the future. One just required more patience and the other required more research….but with both boys, as we choose to forego a frenectomy and choose to get one, we feel like we cleared one more parenting hurdle and are very happy with the results.