Surgery op­tions for tongue-tied in­fants & young chil­dren

Great Health Guide - - CONTENTS - Dr David McIntosh

INthe pre­vi­ous ar­ti­cle, Tongue Tie & a Child’s Devel­op­ment:

Part 1, tongue tie de­scribes a con­di­tion in the mouth where the at­tach­ment of the un­der sur­face of the tongue to the bot­tom of the mouth is too tight and the abil­ity to lift the tongue is com­pro­mised. This con­di­tion is not very com­mon, only af­fect­ing be­tween 1-4% of ba­bies. How­ever, tongue tie surgery for chil­dren is a sim­ple but skilled op­er­a­tion.


De­spite only a small num­ber of ba­bies hav­ing this is­sue, it’s very im­por­tant to have a tongue tie di­ag­nosed and treated early.

2. Speech:

As the child be­comes older and be­gins to talk and since the tongue is in­volved in speech, there can be pro­nun­ci­a­tion is­sues with cer­tain sounds. How­ever, the far more com­mon causes of speech prob­lems in chil­dren are hear­ing loss, ear in­fec­tions and de­vel­op­men­tal de­lay.


So, if your child is di­ag­nosed with a tongue tie, the skill of the provider is more im­por­tant than the method used. Lasers were pop­u­lar back in the 1990’s and sounded fancy. They were the worst thing ever, for cer­tain ear, nose and throat (ENT) pro­ce­dures. Presently they are be­ing touted for tongue ties. The truth is that a pair of sim­ple scis­sors in tongue tie surgery for chil­dren, can achieve the same thing with­out the burn­ing of flesh that oc­curs with a laser.

2. Prac­ti­tioner:

Pro­fes­sion­als who of­fer tongue tie surgery for chil­dren, in­clude doc­tors such as ENT spe­cial­ists, pae­di­atric sur­geons and oral sur­geons, as well as den­tists. Given the com­plex­ity of prob­lems, the best per­son to see de­pends on the prob­lem. If it is a con­cern about speech, see an ENT spe­cial­ist, as they

will look at ALL causes and in­volve a speech ther­a­pist if needs be. If it is a con­cern about jaw devel­op­ment, then a den­tist will prob­a­bly be in­volved. In­for­ma­tion on tongue ties are gen­er­ally not taught at univer­sity level to den­tists, thus many will not be fa­mil­iar with pro­ce­dures for them. Usu­ally the den­tist will then re­fer to one of their col­leagues, usu­ally an ENT spe­cial­ist or an oral sur­geon for tongue tie surgery for chil­dren.

3. Pae­di­atric sur­geons and pae­di­atric ENT spe­cial­ist for ba­bies:

When it comes to ba­bies, den­tists and doc­tors in gen­eral have ab­so­lutely no train­ing in op­er­at­ing on in­fants. The group most fa­mil­iar with the del­i­cate needs of in­fants are pae­di­atric sur­geons and pae­di­atric ENT’s. There would also be some plas­tic sur­geons and some oral sur­geons that work with chil­dren with com­plex cran­io­fa­cial con­di­tions in in­fants and they are more than fa­mil­iar with tongue ties. A pae­di­atric den­tist would of­ten be more than fa­mil­iar with tongue ties as well.

4. Choose a skilled provider:

Just re­mem­ber that tongue tie surgery for chil­dren is an op­er­a­tion. So, choose a provider trained in the pro­ce­dure and one that works col­lab­o­ra­tively with in­de­pen­dent (rather than in house) team mem­bers to avoid any bias in the de­ci­sion-mak­ing process and treat­ment plans of­fered to you.

5. Be aware of un­nec­es­sary pro­ce­dures:

We are see­ing a grow­ing num­ber of un­nec­es­sary pro­ce­dures be­ing done, so be wary that cer­tain ‘tongue tie clin­ics’ have sprung up of­fer­ing a one stop shop for tongue tie surgery for chil­dren. In in­fants, you should al­ways clar­ify what spe­cific train­ing a provider has had in do­ing pro­ce­dures on such lit­tle ones. In New Zealand for ex­am­ple, in one re­gion, 15% of all ba­bies were hav­ing their ‘tongue ties’ fixed. The health author­i­ties stepped in and within 2 years this dropped to 4% of all ba­bies with no detri­ment to breast feed­ing out­comes.

6. And lastly, get a sec­ond opin­ion:

You may come across the idea of ‘stretch­ing ex­er­cises’ for wound man­age­ment. Firstly, there is no ev­i­dence to sup­port this idea and se­condly, it adds to the trauma a child ex­pe­ri­ences for no proven gain. If your provider rec­om­mends that you visit a Face­book sup­port group or ad­vo­cates stretch­ing ex­er­cises after tongue tie surgery for chil­dren, then it may be worth­while seek­ing a sec­ond opin­ion. Sug­gest­ing that par­ents go to Face­book for an­swers to their prob­lems is hardly a good idea. If you want good qual­ity in­for­ma­tion, then visit a site called which is where valid sci­en­tific re­search is to be found.

Dr David McIntosh is a Pae­di­atric ENT Spe­cial­ist with a par­tic­u­lar in­ter­est in air­way ob­struc­tion, fa­cial and den­tal devel­op­ment and its re­la­tion­ship to ENT air­way prob­lems and mid­dle ear dis­ease. He also spe­cialises in si­nus dis­ease and pro­vides opin­ions on the ben­e­fit of re­vi­sion of pre­vi­ous si­nus op­er­a­tions. Dr McIntosh can be con­tacted via web­site.

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