With laser treatment, our Nepean, Ottawa dentists take a patient-focused approach to performing a frenectomy. This method is safer and offers faster recovery than conventional means of treating the condition.
The Frenectomy Procedure
The first step of treatment consists of an examination of your child and consultation with Dr. Fayad.
Secondly, if diagnosed, the frenulum will be revised and treated using the LightScalpel CO2 Laser. Laser reduces bleeding and can promote faster healing. This treatment can be performed at the time a positive diagnosis is made, or can be scheduled at a later date. Immediately following the procedure, breastfeeding is recommended. Using our facilities for breastfeeding immediately after the procedure is available for as long as needed.
The Procedure
When performing the procedure on children or adults, the area of the frenum may be numbed with a local anaesthetic, depending on the age of the patient.
The soft tissue is then released using the LightScalpel CO2 Laser. Stitches are not usually required. The area may treated with vitamin and covered with a cotton roll to control any bleeding that may occur, and this is often minimal. The procedure only takes a few minutes once the area is adequately numbed.
When using the laser, post-operative discomfort is minimal and often requires no pain medication in most cases.
If you or your child experience discomfort, you can use children’s Motrin or a similar product.
Aftercare Instructions
- Immediately After the Procedure
It would be best to avoid sharp crunchy foods and hot liquids initially during this healing time. Please refrain from pulling up on the lip as this may cause further tearing and bleeding, as well as delay healing.
Rinsing the area with one-half teaspoon of salt dissolved in warm water will reduce healing time. Initial healing occurs rapidly in 3-5 days.
Limit activities which could result in the area being traumatized.
Children can return to school the day after the treatment is completed.
If any unusual bleeding or pain occurs please call the office as soon as possible, or if you have any questions that may have not already been addressed.
- Pain Relief
After your procedure, you will leave well informed of the aftercare instructions. These instructions are meant to manage re-attachment, maximize success and improve the overall quality of the breastfeeding experience.
Most babies experience only minimal discomfort after the procedure, and breastfeeding provides natural pain relief and has antibiotic properties.
We do not immediately suggest the use of pain medication for babies under three months old. If however, your baby seems uncomfortable, acetaminophen can be given to help with the discomfort. All-natural remedies can also be another viable option post-revision to ensure your baby’s comfort. Please speak to your doctor/dentist/pharmacist/naturopath/lactation consultant if you are unsure about what dose of medication to give, and remember that medication dosages should always be based on your baby’s weight.
- Notice
You may notice some dark streaks in your baby’s diaper in the 24hrs after the procedure. This is from the small amount of blood that your baby may have swallowed during and after the procedure,. It should be no cause for concern.
If you are noticing dark streaks in your baby’s diaper and it persists for more than 24hrs after the procedure or if you are concerned, then contact our office or your baby’s pediatrician.
If a laser or electrocautery tool was used for the procedure, you may notice small burns around your child’s lips or tongue (small white areas). Although every effort is make to ensure that this does not happen, the potential for these small burns is unavoidable since babies don’t understand the need to stay still during the procedure. These white spots heal and disappear quickly, and will not cause any lasting damage.
- Stretching Exercises
Your baby’s mouth heals quickly, and stretching exercises are very important after the procedure to make sure that the area that was released doesn’t heal back together (what some people call re-attachment). Exercises should always be done when your baby is calm and alert, not tired or hungry. If your baby is resisting the exercises, then stop and try again later
Before starting the exercises, make sure that your hands are clean, and your fingernails are short.
Starting at the second feeding after the procedure, place your thumb and index finger under your baby’s tongue on either side of the incision. Lift your baby’s tongue while gently pushing back at the same time so that you can see the diamond shaped area where the cut was made, and hold it for 3 seconds.
There may be a small amount of blood as the area stretches but this is normal. Do the stretching exercise 5-8 times a day (every three to four hours) for 3-4 weeks after the procedure. For some babies, healing may take a little longer, so if you stop the stretching exercises and breastfeeding becomes uncomfortable again, resume the stretching exercises for another few days.
- Tongue Mobility
Breastfeeding is the most effective exercise for encouraging effective sucking. For breastfeeding babies under the age of 3 months, sucking issues related to tongue-tie often resolve spontaneously after the tongue-tie is released, with no other intervention needed.
If breastfeeding has not greatly improved by about day 5 after the procedure, there are other exercises that can be done to help encourage your baby to use his/her tongue effectively. These exercises should be tailored to your baby’s specific needs with the help of an International Board Certified Lactation Consultant (IBCLC) or a specialized physiotherapist.
- Craniosacral Therapy
Craniosacral therapy (CST) is a form of light touch therapy that can be very effective for many kinds of sucking issues, including helping a baby to learn how to nurse effectively positioning while nursing, CST may be beneficial.
Speak to a local IBCLC or La Leche League Leader to find out if there is someone experienced in Paediatric CST in your area. This is particularly important if the birth of your child was considered traumatic or required more than the usual delivery interventions.