Oral Restriction Specialists Melbourne

WHAT ARE ORAL RESTRICTIONS?

Upper lip tie (upper labial frenum) is the piece of connective tissue on the inside of your upper lip. When the connective tissue is too thick or too stiff, it can keep the upper lip from moving freely. This condition is called a restricted lip tie.

Tongue-tie, (short lingual frenum ) or partial ankyloglossia, is an inherited condition in which the connective tissue on the underside of the tongue is too tight or too short. It keeps the tongue from performing its full range of motion and can thereby affect infant feeding, eating, chewing, speech, orofacial and dental arch development, and it can affect breathing pattern if left untreated for too long. However, a tongue tie has different impact on different individuals. Some individuals may have more problems than others, whereas others may not experience any of these.

Tongue Tie

Tongue tie (Ankyloglossia) occurs when the connecting tissue under the tongue is too short or extends too far towards the front of the tongue. Although tongue-tie affects only approximately 4% of children, it can have profound impact on some individuals.

What is an Upper Lip Tie?

A upper lip tie, or upper labial frenum, is the connective tissue that attaches  the inside of the upper lip to the upper gums. The main function of the frenum is to provide stability and support for the lip. It looks different in each child’s mouth, can vary in length and thickness, but appears more prominent in infants and toddlers.

Concerned about Tongue Tie?
Tongue-tie can contribute to  the following challenges:
• Difficult breastfeeding (see our Infant Tongue Tie page)
• Swallowing issues
• Speech issues
• Dental decay
• Upper and lower jaw development
• Tooth alignment problems and disharmony.

Concerned about Upper Lip Ties?
What are some challenges that may be associated with upper lip tie:
• Difficult breastfeeding (see our Infant Tongue Tie page)
• Prone to injuries/tears
• Disruption to the growth of the upper front teeth, potentially causing a gap in between
• Difficulty maintaining cleanliness, leading to decay
• Receding gums

What are the facts you need to know about treatment for upper lip tie?

• The tension from the frenum (the tie) to the gum will be reduced after treatment.

• The shape/ tension of the upper lip may change – may be noticeable or not noticeable.

• Once healed, it is easier to perform oral hygiene eg. easier to perform brushing, less irritation during brushing, and more easy to keep teeth clean.

• There may be scarring in individuals who are more prone to scarring.

• The gap between upper front teeth may not close after treatment – this is unpredictable because the gap can be caused by many factors (multifactorial) other than caused by the upper lip tie alone.

• After treatment, the alignment of future upper front teeth may not be straight/ aligned/ perfect – this is unpredictable because the alignment of teeth can be caused by many factors (multifactorial) other than the upper lip tie alone.

• It is an oral surgery – which involves the use of local anaesthetic (needle injection), cutting instrument (blade, scissors, laser) and suturing (a few stitches to close the wound).

• Due to the invasive nature of such treatment, children will be required to have this procedure under General Anaesthetic (GA) in hospital / day procedure centre.

• It is an elective procedure – it is not an illness/necessary treatment that must be treated.

• Some swelling, and pain will be experienced for up to 1 week.

• Stitches are self dissolvable.

• Reduced oral function eg. less talking, eating is expected post treatment for up to 1 week.

WHO MAY BENEFIT FROM AN ASSESSMENT?

Children and Adults with:
• Speech issues – accuracy, clarity, speech sound and speech speed
• Eating/ Swallowing issues – limited tongue movement can lead to impaired swallow motions, choking and fussy eating.
• Inadequate Dental Health – tongue unable to clean food out of the back teeth and gums. Short, restricted upper lip tie can interfere with brushing.
• Upper airway restriction – low tongue positioning resulting in an underdeveloped palate, a narrow constricted soft palate means a small oral airway.

Oral Restriction Treatment (Laser Frenectomy)

At Kiddies Dental Care we provide the following service for children and adults with Tongue Tie and Upper Lip Tie:

Thorough medical and functional history taking

Comprehensive intraoral examination and classification of ties

Discussion of management and management options

Performing surgical management 

Tongue Tie FAQs

No, it is subject to individual needs, limitations, symptoms, goals.

Dentist assess structure (anatomy) where as Speech pathologist assess function, in particular, the function of the oral, and facial muscles (hence, it is called orofacial myofunctional assessment) Please click on this link to read more about Oral Myology at Kiddies Dental Care.

The negative impact of tongue-tie varies from person to person. For some, the impact is very slight; for others the impact can be substantial and affect the daily quality of life. Outcome varies from people to people. Some may be functionally (speech, swallow etc) sound, but present other symptoms (malocclusion, sleep disordered breathing, strains in muscles due to long term compensations). Others may develop functional symptoms eg speech problems, fussy eating etc.

Upper Lip Tie FAQs

This is entirely up to you.
The specialist will be able to define how severe, restricted is the upper lip tie for your child.
To proceed with treatment or not – it will be determined by parents subject to the advice from the specialist.

No one is entirely sure what will happen if the upper lip tie is not treated. Some (not all) children may develop these problems/ inconveniences:

• Challenges in brushing teeth as the upper lip tie is in the way and may get irritated.
• Cavities may develop if teeth are not thoroughly cleaned
• Teeth may be misaligned or have gap (but remember this is not solely caused by the upper lip tie)
• Mouthguard for sports may irritate the upper lip tie
• If there is a fall/ trauma to the area – the upper lip tie may be lacerated/ ripped
• Tension in the gum – uncomfortable.

Certainly – treatment modality is still the same. In chair (if your child can tolerate the process) or GA.

Not sure if your child has a Tongue Tie or an Upper Lip Tie?

Please call our friendly team on 03 9372 8960 or email and we’ll go through your concerns together and see what the best course of management is for your child.