Frenectomy Expectations and Post-Operative Care
A frenectomy is a procedure to correct a congenital condition in which the tongue (lingual) or upper lip (labial) Frenum is too tight, causing restrictions in movement. These restrictions can cause difficulty with breastfeeding and in some instances other health problems like dental decay, spacing, speech difficulty, and digestive issues. Approximately 5% of the population has this condition, so your lactation consultant or doctor may feel that a procedure is necessary to improve symptoms.
What to Expect
- Due to laser safety regulations, parents are not permitted in the treatment room during the procedure. Your infant will be away from you for approximately 10 minutes. The actual time of laser procedure is 30-45 seconds.
- Crying and fussing are common during and after the procedure. You may breastfeed, bottle feed or soothe your baby in any manner you’d like following the procedure.
- 30-60 minutes prior to the procedure, the use of Tylenol is recommended to minimize discomfort. Dosage, using the dropper in manufactures packaging:
- • 6-11 lbs 1.25ml
- • 12-17 lbs 2.5ml
- • 18-35 lbs 3.75ml
- • 24-35 lbs 5 ml
Post-Procedure stretches are key to getting optimal result
The main risk of a frenectomy is that the mouth heals so quickly, it may prematurely reattach, causing a new limitation in mobility or return of symptoms. A small amount of bleeding or spotting is common after the procedure, especially in the first few days.
These are NOT meant to be forceful or prolonged. It’s best to be quick and precise with your movements. Getting an affordable LED headlamp (like for camping) allows you to see better during stretches. The exercises are best done with the baby placed in your lap or laying on a bed with feet away from you.
TIMING: DO ONE STRETCH ON THE EVENING OF THE RELEASE. NEXT STRETCH WILL BE THE FOLLOWING MORNING (KEEP IN MIND THIS IS THE ONLY TIME YOU SHOULD SKIP THE OVERNIGHT STRETCH). My recommendation is that stretches be done 6x/day for the first 3 weeks and then spending the 4th week quickly tapering from 6 to 5, 4 to 3, 2 to 1 per day before quitting completely at the end of the 4th week. I find it’s easiest for parents to do 5 of the stretches during their waking hours and at least 1 of those stretches in the middle of the night, do not go longer than 4 hours between stretches, it is acceptable to stretch more frequently than 4 hours. Diaper changes or feedings are a good time to do the exercises. You may also use Tylenol to help with pain control recommended by your medical doctor.
The Upper Lip
-Wash your hands well prior to your stretches (gloves may be used but not necessary). – Lift lip up stretching it almost like you are trying to stretch it up over the nose, repeating this for five seconds. –
-Second stretch is a scooping motion massaging over the wound, starting at the base of the gum tissue scooping up towards the nose, repeating for five seconds.
The Tongue
Insert both index fingers into the mouth (insert one in the mouth and go towards the cheek to stretch out the mouth, making room for your other index finger). Then use both index fingers to dive under the tongue and pick it up towards the roof of the baby’s mouth.
- The tongue needs two separate stretching exercises:
- Once you are under the tongue, try to elevate the tongue as high as it will go (towards the roof of the mouth). Hold it there for 5 seconds, relax and repeat once more. The goal is to completely unfold the diamond so it is flat in orientation (remember, the fold across the middle is the first place it will reattach).
- With one finger propping up the tongue, place your other finger in the middle of the diamond and do a gentle scooping stretch for 5 seconds up toward the roof of the mouth.
Sucking Exercises
Babies can have weak or disorganized sucking patterns that benefit from exercises.
– Slowly rub the lower gum line from side to side and your baby’s tongue will follow your finger. This will help strengthen the movements of the tongue.
– Let your child suck on your finger, do tug-of-war, slowly trying to pull your finger out while they try to suck it back in. This strengthens the tongue itself.
– Let your child suck your finger and apply gentle pressure to the roof of the mouth, then roll your finger over and gently press down.
Several days after the procedure, the wound(s) will look white and/or yellow and will look similar to pus. This is a completely normal inflammatory response. Do not let your child’s doctor, lactation consultant, friend who thinks they’re an expert or anyone else make the determination for you. If you think an infection exists, give our office a call. It is essential to follow-up with your lactation consultant after the procedure to ensure optimal results
Post OP
There will be a follow up in 7-10 days at our office. Please take photos and email or text our office with any concerns. Two people are needed to take the photo.
Email: [email protected]
Call of our office for any of the following:
- Questions about stretching
- Uncontrolled bleeding
- Refusing to nurse or take a bottle
- Fever > 101.5
For more information:
Call our office (470) 523-8090
Visit www.toothtownpd.com
Videos on Lip and Tongue Ties and Aftercare:
https://www.youtube.com/watch?v=62pZw0LqYv8