Infant Frenectomy

At the Craniofacial Pain, Headache and Sleep Medicine Center of Pennsylvania, Dr. Nelly Silva focuses on compassionate, comprehensive, and conservative care. We pride ourselves in a team approach in order to best support our mothers and babies. A dyad that is struggling with nursing or bottle-feeding should typically be referred to an International Board-Certified Lactation Consultant (IBCLC) and/or Speech-Language (SLP) for a comprehensive assessment of mother, baby, and the nursing dyad. If a tongue-tie is suspected, a full specialized assessment of tongue function is performed– HATLFF (Hazelbaker Assessment of Lingual Frenulum Function) in order to achieve a quantitative assessment of tongue function. In addition, it is our belief that every baby/mother dyad needs pre and post-operative care to ensure proper counseling, education, and most importantly, a strong support system postoperatively to maximize success.

How is tongue-tie or lip-tie treated in an infant?

A frenectomy or “release” is a procedure that consists of releasing the band of tissue under the tongue or upper lip to allow for a better range of motion and allow proper function during swallowing and/or latching at the breast or bottle. Certified by the Academy of Laser Dentistry, Dr. Silva is safely and proudly using the latest and most innovative laser technology, a LightScalpel CO2 laser. Using this technology, we can achieve controlled and precise removal of tissue with paramount safety, minimal bleeding, and less post-operative pain. A release typically takes 15-20 seconds for each area, and we offer EMLA as an infant safe topical numbing agent.

Child/Adult Functional Frenuloplasty

A surgical procedure to release genioglossal myofascial restrictions or tethered oral tissues (tongue, lip, and buccal ties) that may contribute to problems with sleep, breathing, swallowing speech, and posture.

The success in our practice is based on our ability to provide a complete and effective release of tethered oral tissues with functional frenuloplasty without the use of laser or cautery. We use a multidisciplinary protocol that integrates myofunctional therapy (and sometimes physical therapy) both before, during, and after surgery.

Our technique is based on precision: releasing the appropriate extent of tissues for maximal relief; not too much, and not too little using scissors and suture technique. There is no thermal damage and allows for the placement of sutures to promote healing by primary intention. This technique was developed by world-renown ENT and researcher, Dr. Soroush Zaghi.

Frenectomy Consultation

We ask that the patient brings in a referral either from the pediatrician and/or IBCLC/SLP. During the patient’s consultation with Dr. Silva, she will perform an evaluation of the baby’s entire mouth, discuss findings of the IBCLC/SLP, as well as mother’s symptoms. Dr. Silva will also discuss growth and development as it pertains to tongue and lip function. After taking into consideration all aspects, we will discuss the risks and benefits of treatment to allow parents to make an informed decision.