TONGUE TIE SURGERY FOR CHILDREN: PART 2

Surgery options for tongue-tied infants & young children

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.

WHAT ISSUES CAN TONGUE TIE CAUSE? 1. Breastfeeding:

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.

WHAT TONGUE TIE SURGERY FOR CHILDREN IS AVAILABLE & WHICH TYPE OF PRACTITIONER? 1. Procedures:

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 pubmed.com 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.