Tongue tie, 10 yr old

[Anonymous]

At a recent pediatric dentist visit, dentist said DS has a tongue tie. Recommended that it be treated by laser by this dentist at a future visit. DS is in speech therapy, which the dentist did not know about prior. Does it make sense for dentist to treat this or should we get 2nd opinion elsewhere? Has anyone had an older child treated for this, and if so how was the recovery?

[Anonymous]

Has their speech therapist mentioned the tongue tie as an issue that needs to be resolved? Has your kid had any other issues related to the tongue tie? Be guided by that, not your dentist who is likely trying to drive up laser procedures.

My kid has a short frenulum, as well. When he was born, a nurse noted it and said it might affect his ability to nurse, and that if it did we should consider addressing it. No issues with nursing or anything else. Needed speech therapy, but it was unrelated to the short frenulum. He’s 18 now, never had an issue.

Read this and ask lots of questions of any provider suggesting this procedure: https://www.nytimes.com/2023/12/18/health/tongue-tie-release-breastfeeding.html

[Anonymous]

My kid’s tongue tie came up when we were looking into orthodontia—there was a concern that the tie was pulling on teeth, if that makes sense. We went with the laser procedure because anything else required general anesthesia. Procedure was quick, as was recovery. There was no association between the ortho and the dentist that eventually did the procedure, so I didn’t feel like there was anything nefarious going on.

[Anonymous]

My DS had it done at 4 but with a scalpel not a laser. Would run it by the SLP first.

[Anonymous]

My son had it done when he was 12. When he was young our dentist commented that he would probably need the procedure when he got braces, but that the orthodontist should confirm.
The orthodontist recommended it, but dentist performed the procedure with laser.

My son was in terrible pain from it, the whole drive home from the dentist (45 min) was agony for both of us. Later that day he was fine.

[Anonymous]

This is OP - thank you for sharing. The speech therapist said that DS can currently make all the sounds, with her guidance. She did say that she had other kids who benefitted from the procedure. The pediatric dentist said that she is noticing mouth breathing effects on the teeth, or something like that.

[Anonymous]

Anonymous wrote:This is OP - thank you for sharing. The speech therapist said that DS can currently make all the sounds, with her guidance. She did say that she had other kids who benefitted from the procedure. The pediatric dentist said that she is noticing mouth breathing effects on the teeth, or something like that.

Why did you do it when the therapist said that. Sheesh, give your kid a fighting chance.

[Anonymous]

I had a tongue tie clipped in late elementary and remember it. I had my DDs tongue tie clipped at 1 mo. I pushed back on recommendation to have it clipped again around 1st grade at same time DD was in speech therapy.

Here’s my story and two cents FWIW:

I could speak fine but could not lick an ice cream cone normally or stick out my tongue at kids normally and was embarrassed. I said the pulling on bottom of my mouth was irritating but I’m not sure it was. Memory is too old but I’m certainly sure I cared socially. It was no big deal to me at the time and I got ice cream after the procedure and it healed quickly - maybe same day.

DD and I had some latch issues and since I’d had a bad tongue tie, I didn’t need persuading at 1 month. Easy time to do it no regrets although I’m not convinced the entire problem wasn’t incurable thrush (thanks low estrogen in post partum!)

DD, now 8, had trouble with tons of sounds obvious from age 4/5 but it was COVID and masks didnt help. DH was able to use YouTube to figure out how to teach her a bunch himself - it was crazy covid times. BUT by end of COVID, she was still clearly struggling with S sounds and lateral lisp. School did annual evaluation by speech therapist as courtesy and school therapist identified problems each year with less problematic sounds each year.

Along the way we talked to dentist at regular cleanings. We had regular dentist suggest a narrow upper palate was an issue and not a tongue tie. We asked speech therapist to work with DD while we continued to work with dentists / orthos and therapist refused on the basis of the tongue tie needing to be fixed first although I think it was actually her way of putting us off bc she was busy. We ended up getting our dentist option, a pediatric dentist opinion, and an ortho opinion. All said the tongue tie was kinda tight but not really (skin can grow back after being cut first time) but they all agreed it was high palate causing issues. Clipping a tongue tie is not risky really but it’s possible to snip too much and make speech issues worse. To treat high palate, we had to wait for molars to grow in.

I asked school therapist - on the basis of 3 dentist/ortho recommendations - to work with daughter until molars grew in and we could treat high palate. She refused. Wrote a nasty eval at the latest school eval that parents were ignoring treatment of tongue tie. I was livid.

Post-Covid lot of kids had speech issues from masks and delayed treatment so it was hard to find someone but I found a great speech therapist (I had to take off work middle of day to make it work, of course), but she was great and she and ortho coordinated beautifully on treatment. I asked both good speech therapist and ortho what was up with school speech therapist insisting tongue tie get clipped and they said some folks are often just insistent on that procedure for poor reasons. DD spent about 4 months in speech therapy and made good progress. We stopped speech therapy when DDs molars grew in and we could address high palate. Speech has been excellent since.

So as much trouble as it is, I’d get second options. Medical care is just what it is in this country. Second opinions for everything.

So yes, as much as the procedure is no big deal (I had it and DD did at 1 month), you need to identify the root of the problem. I think tongue ties can be a scapegoat. I’d get multiple options and follow the advice.

[Anonymous]

Get a second opinion. It’s probably a tongue tie. But it’s surgery. Get a second opinion.

[Anonymous]

Ask how many of these procedures the dentist does. My former dentist thinks everyone needs to get their tongue in-tied. I think she started by trying to help people but at some point she went nuts. I do not even want to think about how many unnecessary procedures she does. She is very convincing.

I would suggest a second opinion.

[Anonymous]

There are some dentists who are gung-ho about the procedure, more often pediatric dentists than others IME.
I no longer treat many young persons for this (I guess the pediatric dentists are increasingly doing these procedures) but I do this procedure on preteens and adults. It's quite minor for most patients, healing is rapid, low complication rate. As with any type of medical procedure, some patients are more reactive than others.
If the patient has a speech issue, that's one reason I generally recommend surgery. I'm surprised that the patient wasn't assessed for an anatomical issue before starting speech therapy; I would think the patient would be checked for hearing deficits and tongue tie during the work-up phase?
In other cases, the orthodontist requests the treatment as the tongue tie can interfere with the planned treatment or the long-term stability post-treatment
I've also seen adults where sadly a tongue tie has caused gum recession and actual loss of the teeth in the area, so if there are signs that the tie is high enough to be a problem, I also recommend the treatment.

[Anonymous]

I’d get a second opinion. A pediatric dentist said this for my ds. He goes to an ent for something else and this ent happens to also specialize in tongue ties. He disagreed and said no. I then took him to smile wonders which also specializes in tongue ties and also said no. I’m so mad that I almost jumped w/ the first dentist and also paid them a fee of $385 for some pre-procedure stuff they required. Absolutely get another opinion.

[Anonymous]

My son had a frenectomy at 15. I wish we had done it sooner. He did not have problems with his speech, but had a hard time taking pills and moving food around with his tongue. We had an oral surgeon do the procedure and the recovery was quick and easy.

[Anonymous]

If your kid is mouth breathing then yes, that’s serious. Tongue tie results in poor resting tongue posture which results in a high palate which results in less room for your nasal/sinus cavities which results in mouth breathing. Mouth breathing causes cavities, among other things. Later in life it also causes sleep apnea and even things like adhd. So yeah, it’s serious and needs to be handled by qualified provider(s). Fixing the tie might not be enough to correct the other issues with the palate, etc. So, dig more into it to figure out what is best in your situation.

[Anonymous]

Thank you much everybody. This is OP. I hadn’t realized all these possibilities. I am going to get a 2nd opinion from an ENT, got a referral for one, now will make the appointment.