lip tie

Here is an amazing fact: by the time your child reaches kindergarten class, more than 5 out of his or her 20 classmates will have dental cavities! Imagine that for a moment. Your child has just started the first phase of his or her educational journey and now more than a quarter of his or her classmates have a dental cavity.  It's 28 percent to be exact, per the National Institute of Craniofacial Research.

Maybe you, as a parent, remember having dental cavities, as a child.  And you might be thinking, "What's the big deal. Don't those teeth fall out anyway?" The answer comes later in this blog.

The CDC reports that dental cavities is the most prevalent chronic disease that our children are facing.  This is more common that getting diagnosed with asthma or allergies!

What's the big deal. Don't those Baby Teeth Fall Out Anyway?

First, as a parent, I do not want to expose my child to any forms of disease, especially something that can be avoided by following a few simple steps at home.

Second, think about the time you had to have a filling at the dentist as a child. Though there are now modern advances to decrease pain and discomfort, there is still an experience that may not be all too pleasant.

Thirdly, a child who is in pain from a cavity will not be able to focus properly at school or at home.  Sleep at home can also be disturbed, not only by your child, but in everyone at home.

Finally, there is cost associated with treating dental cavities.  There is direct costs from the procedure.  Also indirect costs need to be factored in such as, loss of income from taking your child to have a filling done, travel time, and time away from school.

There are physical and psychological factors that are associated with treating dental decay.

Instead of treating a problem after it has already occurred why not prevent the problem in the first place!

According to the American College of Obstetricians and Gynecologists, 89 percent of children age one year had an office based physician visit, while only 1.5 percent had a dental office visit.

Recommendations for Oral Health Care for your Infant.

Here are some recommendations that will give your child the best possible outcome of having optimal oral health care.  Establish a dental home by age 1 for your child.  This means having your child seen by the dentist by your child's 1st birthday.  During the initial exam several areas will be discussed.  This includes:

1. Oral exam of your child's mouth.

This will include an age appropriate demonstration of gum and teeth cleaning with fluoride treatment.

2. Assessment of your child's risk for dental decay.

This will include a road map to fend off any potential risks for getting cavities and recommendations for diet, flouride use, and the frequency for checkup appointments.

3. Cavities management.

If your child does have a cavity, then your dentist can give you ways to treat the cavity at an early stage.  Most general dentists do not want to see infants, so make sure to seek out a pediatric dentist.

4. Injury prevention.

Learn how to decrease the risk to dental injury at home and also learn what to do if there is a dental injury, should that occur.

5. Teething.

Find out the signs and symptoms of teething and ways to treat it in easy steps at home.

6. Lip and tongue tie assessment.

If you child has had difficulty with breastfeeding or bottle feeding, then you would want to see your pediatric dentist as soon as you notice this issue.  You can find more information about this here.

7. Non nutritive oral habits.

If your child loves to use her pacifier, sucks her finger, grinds her teeth, or has an abnormal tongue thrust, then all of these areas can be addressed by your pediatric dentist.

Instead of worrying about cavities, give your child the best chance of having a great start by seeing a dentist by age one!  Your child will have many milestones in their future.  Having a cavity shouldn't be one of them!

All Smiles Pediatric Dentistry

At All Smiles Pediatric Dentistry, we incorporate proven techniques to share with you and your child at each dental checkup visit. Dr. Allen Job and his team are committed to providing the latest in oral health care prevention. Check out our monthly blog posts! Our practice is centrally located in San Diego, CA.

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Dr. Allen Job, DDS, MS, MPH, MS is a board certified pediatric dentist who practices in San Diego, California, where he specializes in prevention. For more than a decade, served as assistant professor for the Department of Pediatric Dentistry at Loma Linda University School of Dentistry (LLUSD). He is currently an instructor at LLUSD.

 

 

 

What is a tongue tie?

A tongue tie or ankyloglossia occurs when there is an abnormal band of thick tissue, also known as the frenum, which is located below the tongue.

How does a tongue tie affect feeding of newborn babies?

A tongue tie prevents the tongue from having the full range of motion.  This is considered a developmental problem since it arises before a baby is born.  Tongue tie restricts how a newborn nurses, often causing improper latch with the mother’s nipple.

What other problems can arise from having a tongue tie?

Having a tongue tie can create speech difficulties, malocclusion, and gum recession.¹

Is having a tongue tie pretty common?

Tongue tie occurs between 4% - 10.7% of the population.²

Are there different types of tongue tie?

Anterior Tongue Tie

Yes, there are two primary forms of tongue ties complete and partial.³  When the frenum has limited tongue movement it is considered a partial ankyloglossia.  This is known as an anterior tongue tie. Often, one can see an anterior tongue tie since it appears as a thin band of tissue under the tongue.

Posterior Tongue Tie

However, if  the tongue appears to be fused to the floor of the mouth it is then considered to be a total ankyloglossia.  This is known as a posterior tongue tie. Posterior tongue ties are much harder to visualize.  The tongue has to be elevated from the floor of the mouth in order to diagnose a posterior tongue tie.

What is a lip tie?

An upper lip tie is present when the upper lip is lifted and the band of connective tissue (frenum) is tight, causing the gums to blanch (turn white).  There are four classifications for lip tie, ranging from mild (Class 1) to severe (Class 4).

What are the 4 classifications of Lip Tie?

Class I: Mucosal

Class 2: Gingival

Class 3: Papillary

Class 4:  Papilla Penetrating

Upper Lip, Lower Lip, and Tongue Ties. Can someone have more than 1 lip tie?

A lip tie can occur on either, the upper lip, the lower lip, or both.  Often a lip tie accompanies a tongue tie.

How does a lip tie affect a baby?

Lip ties can be associated with breastfeeding difficulties in infants.⁴   They can be associated with facial cervical caries (tooth decay at the gumline), due to interference with proper oral hygiene.⁵  Moreover, they can also be associated with the gum recession. ⁶

How are tongue and lip ties treated?

Physicians, such as an ENT (Ear Nose Throat Specialist), usually will treat tongue and lip ties with a scalpel or surgical scissors.  They may also require treatment to be completed with some form of sedation, ranging from local anesthetic to general anesthesia.  Sutures or stitches may also need to be placed.

Today, pediatric dentists and some physicians trained in treating tongue tie and lip ties can perform this procedure in an outpatient setting, using a laser.  With using a laser, there is less pain, less bleeding, and no need for sutures.  This translates to faster healing and in most cases quicker resolution to the problem.  This form of treatment usually requires using just a topical anesthetic and occasionally, a local anesthetic.

How long does the procedure take?

The procedure usually takes less than 10 minutes from start to finish.  Mothers are able to nurse right after procedure with their infant.

What happens after the procedure?

In order to get optimal results and to ensure proper healing, it is essential that parents complete the post treatment therapy exercises with their infant and also follow-up with a daily oral hygiene routine.  Moreover, a series of follow-up care appointments will be setup to monitor the healing process.

What about older children or adults?

Older children and adults can also benefit from lip tie and tongue tie correction.  The benefits include: improved oral hygiene, decreasing orthodontic severity especially from lip tie treatment, and improved speech.

 

If your child is showing signs of tongue tie or lip tie, contact Dr. Allen Job at All Smiles Pediatric Dentistry, to for a comprehensive evaluation to see if your child will be a good candidate for laser treatment.

References

1. Segal L, Stephenson R, Dawes M, Feldman P. Prevalence, diagnosis, and treatment of ankyloglossia. Can Fam Physician 2007;53(6):1027-33
2. Boutsi EZ, Tatakis DN. Maxillary labial frenum attachment in children. Int J Paediatr Dent 2011;21(4):284-8.
3. McDonald RE, Avery DR, Weddell JA. Gingivitis and periodontal disease. In: Dean JA, Avery DR, McDonald RE, eds. McDonald and Avery’s Dentistry for the Child and Adolescent. 9th ed. Maryland Heights, Mo: Mosby Elsevier; 2011:389-91.
4. Coryllos E, Genna CW, Salloum A. Congenital tongue-tie and its impact on breastfeeding. Breastfeeding: Best for baby and mother. Am Acad Pedia (newsletter) 2004; Summer:1-7.
5. Kotlow L. The influence of the maxillary frenum on the development and pattern of dental caries on anterior teeth in breastfeeding infants: Prevention, diagnosis, and treatment. J Hum Lact 2010;26(3):304-8.
6. Minsk L. The frenectomy as an adjunct to periodontal Compend Contin Educ Dent 2002;23(5): 424-6, 428.

*This blog is part of the Baby Steps Series. Look for future blogs in this series.

Dr. Allen Job, DDS, MS, MPH, MS is a board certified pediatric dentist who practices in San Diego, California, where he specializes in prevention.  He is also an assistant professor at Loma Linda University Department of Pediatric Dentistry.