Pediatric Dentistry: Role of a Pediatric Dentist in diagnosis of tongue tie:
Tongue-tie is referred to as an embryological remnant of the tissue in the midline between the undersurface of the tongue and the floor of the mouth. This tissue is known to inhibit the normal flexible movements of the tongue. The attachments of this tissue can be normal or multiple variants of the normal. Many times, tongue tie presents with subtle signs which explains why more than frequently the condition is missed on evaluation and subsequent diagnosis by various professionals.
Most common pointer that brings parents or the providers to check for the tongue tie is speech alteration. Children with tongue tie are unable to pronounce some of the speech sounds such as, CH, S, M, K, G, N, G, T, D, N, L , R, Z. They might stutter and may also be observed to avoid certain talking situations and words.
Apart from speech alteration, there are many other signs and symptoms that start to surface from birth. These signs are divided into: baby’s signs and mother’s signs and experiences.
In depth knowledge and awareness is mandatory in order to evaluate the following sigs that show right from the time of birth:
Some of the concerns faced by babies may include:
- Poor latch at breast or bottle
- Falling asleep while feeding as babies feel exhausted
- Fussy baby
- Frequent crying
- Reflux symptoms
- Poor weight gain
- Short sleep patterns
- Congested nose
- Eating more frequently
- Gassy burps
Some of the common concerns and experiences of mothers include:
- Difficulty in feeding
- Cracked nipples
- Painful nursing
- Poor latch
- Poor breast drainage
- Nipple thrush
- Feeling like feeding the baby is full time job
When the diagnosis is confirmed, treatment should be considered as like any other condition, tongue tie needs expert attention and does not subside on its own. The team of experts that are involved in proper diagnosis and evaluation of tongue tie include:
- Gynaecologist
- Pediatric Dentist
- Speech therapist
- Lactation consultant
- Myofunctional trainer
- Body worker
- ENT
Tongue-tie release using Erbium or Diode lasers is a short, quick, simple procedure performed in-office, with or without the use of Conscious sedation (laughing gas). Lasers exempt the need for post-operative sutures, antibiotics, and at times even pain killers. Follow up appointments are scheduled in one week, two weeks, and stretch exercises are practiced three to four times a day for four to six weeks.
The benefits of evaluation, diagnosis and treatment of tongue tie release far outweigh the complications that can otherwise occur if we wait too long. Some of these complications are:
- High arched palate
- Crowded teeth
- Untimely, unplanned extractions for orthodontic purposes
- Mouth breathing
- Bruxism
- Snoring
- Sleep disorders.
The skill and expertise of Pediatric Dentistry is loyally married to art and science of developmental tissues. Thereby, the factors that raise concerns at this level should be addressed and treated at the pediatric office as a mandatory protocol.
