The decision to release a restricted or “tied” tongue and/or lip is not one to be taken lightly. While the procedure itself is a minor surgery with relatively quick recovery, several factors should be considered prior to committing.
- Research
- Professional Confirmation
- Pre- and Post-procedural exercise regimen
- Recovery timeline and commitment
Research
Believe it or not, tongue ties and releases fluctuate in popularity. In the early to mid 20th century, midwives used to release the restricted tongue with one swipe of a sharp fingernail. Through the years the trends have shifted and medicine has steered away from diagnosing or recommending frenectomy in newborns. Bottle feeding newborns and braces are the new norms. Perhaps in the next 15-20 years we may see a return in the popularity of early releases. Until then we are in a current state where there are children and even adults who have frequently visited a dentist or physician and have never once been informed of their tongue tie. The physician literally looks into the mouth everytime they see you and request you say, “ah.” The dentist works almost exclusively within the mouth and is seen more frequently by some people than the physician.
These providers should have an obligation to look within the oral cavity and inform their patients of any abnormalities. Granted a physician may see patients that are suffering from deadly, debilitating and life-altering diseases. So a tongue tie that is not impacting speech or quality of life does not alarm or alert their senses to do no harm.
Limited teaching is done on tongue ties in medical and dental schools. So while it may be personally disturbing to think that you have gone your whole life only to have a dental hygienist at your new dental office inform you of your tongue tie, despite your 60+ years of medical and dental encounters previously, rest assured you are not alone. Dentists and MDs are not trained thoroughly on the impact and presentation of tongue ties. New research is presenting frequently with connections to health and tongue ties.
It is critical that you invest your time in looking into ALL the researched associations and implications of living with a tongue tie prior to deciding to go for release.
Professional Confirmation
Perhaps your enlightened and knowledgeable dental hygienist, dentist, speech-language pathologist, bodyworker or doctor has informed you that you and/or your child has a tongue tie. What should you do with this information?
Get a second professional opinion from another enlightened and knowledgeable healthcare provider. Preferrably one who specializes in tongue ties such as a dentist that performs releases, a bodyworker, or a myofunctional therapist (a.k.a. orofacial myologist).
The later is able to determine if your tongue tie is functional or not. In other words, do you have a tongue tie that can be rehabilitated to maintain proper oral resting posture; or do you need a frenectomy in order to establish and maintain proper oral resting posture.
Pre and Post Exercises Analogy
Imagine that your arms have been attached to your torso from the armpit down to the wrist. If a doctor informed you that a release was necessary would you know what to do with your arms once they were freed? Would your muscles be strong enough to perform all the directional pulls, lifts, twists and bends that you are capable of? If you failed to utilize those movements post-release how would the arm heal?
The last of these questions is of the utmost importance. Scar tissue is the body’s natural healing response. An arm released that does not move would naturally form scar tissue between the torso and the arm. You may not be fully restricted, but you would have failed to gain the complete release you could have achieved.
Making the most of your decision to release has to include work with a myofunctional therapist to perform pre- and post-frenectomy exercises. The exercises will not establish a proper oral resting posture, but they will stretch and strengthen the muscles, and prepare some muscle memory for the healing process. This a short part of a complete myofunctional therapy program that focuses on preparing the patient to be eligible for release and prevent the re-restrictive development of scar tissue.
Recovery Timeline & Goals
A minor surgery is a surgery. Recovery is necessary. Listen to the releasing provider and plan your schedule accordingly. You will need to take some time off of work or your child may need to take a day or two out of school.
Be sure to plan for pain management. Some people have minimal pain post-procedural, while others take longer to recover from pain. Prepare for the worst while expecting the best.
Move that tongue as much as possible. Perform your post-procedural exercise regimen as much as possible in the first 72 hours. Remember to follow-up with your myofunctional therapist in addition to your releasing provider to ensure your recovery is going smoothly.
Conclusion
Nothing guarantees a better outcome than preparedness.
Go into the decision to have a tie released by doing your research on possible consequences, getting an informed second opinion, working with a myofunctional therapist to prepare and understand your recovery prognosis.
