We use Ultracaine D-S forte for anesthesia.
Ultracaine D-S forte does not affect breastfeeding, because anesthesia is only locally applied and absorbed.

Below are several videos about oral motor exercises.

Suction training before treatment.

Short oral motor exercises before treatment. This helps the baby to switch to a better drinking technique more quickly afterwards.

Oral motor exercises for older baby.

Important oral motor exercises. This baby shows that she doesn’t want mouth training for a while, but wants to be helped with cramps!

Weak sucking with teat training.

Oral motor exercises for gagging and high palate.

Respect signs that baby doesn’t want to exercise.

Stretch and relax tense lips.

Oral motor exercises, extra exercises to help relax tense jaw and cheek muscles.

It is best to keep a minimum of 2 weeks between vaccinations and a possible release at the Tongue Tie Clinic.
Sometimes babies get a fever due to the reaction to the vaccination and sometimes they have muscle pain in and around the tongue after the surgery.
This is why it is not a nice combination for the baby.

In older babies, children and adults with a tongue tie, compensatory oral habits may be present. During pregnancy, a baby swallows amniotic fluid with a tongue tie, which means that hiccups may already be present. An older child and adults have exhibited compensatory behaviors for years as surrounding muscles and tissues compensate for the limited functional movement of the tongue. Think of moving food in the mouth from side to side, swallowing well without choking, wiping your teeth after eating and talking. Often the patient swallows with his tongue forward instead up and back, which is called a tongue thrust. This can affect the position of the teeth, jaws and the overall body posture.

The preparation for a treatment is therefore twofold:

1. Compensatory movements in the head and neck region can be quite “stuck” and therefore better checked and treated by a special therapist before a tongue tie release. We hear from patients that they have this done by a physiotherapist, manual therapist, orofacial therapist, chiropractor or osteopath for complaints such as incorrect posture, stiff neck, jaw clenching, grinding and headaches. Treating a tongue tie alone is not sufficient if the surrounding muscles keep the compensating behaviour and restrict functional movements.

2. Treatment also improves if the patient goes to a specialized speech therapist in OMT (oromyofunctional therapy) before and after the treatment. This can help to analyze incorrect oral habits and swallowing and train or unlearn these. If an OMT speech therapist is not available, the Kieferfreund app is an option to train and practice (see www.kieferfreund.com and https://www.tonguetieclinic.com/tongue-tie-therapy/https://www.tonguetieclinic.com/tongue-tie-therapy/)

At the Tongue Tie Clinic we regurarly get the question why a child (still) drools after the treatment. Or that baby has little bubbles of saliva on the lips.
About 2000 times we swallow on reflex day and night. To be able to swallow saliva properly, a fully mobile tongue is required. With a tight tongue tie, the tongue cannot move up and back properly and swallow food, drink and saliva in a wave motion towards the esophagus. When the tongue becomes more mobile due to the treatment, a tongue has in fact never been able to make this movement (completely) and it still has to be learned. In a baby up to about 3 months everything goes on reflex but it can still take weeks to months to learn to swallow properly. After 3 months, a baby or child has already found its own way to swallow food and drink. It therefore takes some time before the tongue has learned a good / new swallow and drooling can occur or become worse. The brain has to also learn to control these movements. Oromyofunctional therapy OMFT can help the older child besides speech therapy. See the FAQs about OMFT. In addition, it is important that a child closes their mouth properly and breathes through the nose, and that they can close their lips properly. Parents can close their mouth when they see that their baby or child has an open mouth position by gently moving their chin up when he or she is sleeping or playing, for example. It is important that a pacifier is only used for comfort and falling asleep because when using a pacifier, the tongue is prevented from (learning to) properly swallow upwards and backwards towards the throat.

The baby still needs to learn how to use the tongue optimally. It is therefore advisable to do stimulate more movements by exercises.

The Tongue Tie Clinic has the following videos with possible exercises:

and this video for training a good tongue rest position against the palate:

Do not immediately expect the baby to understand what he can do with his tongue, sometimes it takes a few weeks for results. Keep short nails and clean fingers, you can use a medical glove or finger condom (these are not necessary). A cold finger could be more pleasant for your child. Anesthetic gel (teething gel) can also be used to make wound aftercare more comfortable for the baby:

The video https://vimeo.com/55658345 takes 3 minutes and can also serve as an example for young babies. The following video is also available for older babies: https://www.youtube.com/watch?v=q9Io3Ush-S4.

Make it a fun game, sing or chat with the baby. Do not immediately expect the baby to understand what he can do with his tongue, sometimes it takes a few weeks to see results.

Short sequence of exercises in the video:

1: Massage palate (rubbing palate)

2: Suck finger, pull it a little so that he tries to hold on even more tightly (“tug of war” game)

3: Middle tongue rub, finger out to stimulate “cupping”, holding the nipple in the mouth.

4: Massage the jaws, as if the teeth are being brushed with the tip of the finger, to stimulate the movements to the side, because the tongue wants to follow the finger.

5. Touch the chin, tip of the nose, upper lip to stimulate wide opening of the mouth.

6: Stretching / lifting lip and tongue and rubbing the wounds, on the video you can see how she turns her finger into a “rolling pin” (rolling pin).

Further guidance and help with drinking, eating or talking:
The Lactation Consultant can help with breastfeeding, in addition the Pre-verbal Speech Therapist for bottlefeeding and learning to eat solids. For the older children the speech therapist who is specialised in oromyofunctional therapy (OMFT).

The release of a tongue or lip tie has been performed for years by various medical specialists or dentists. Often it concerns older children or adults with a functional limitation that requires surgical intervention. When drinking for babies or young children was difficult, formula was often used in the past. Nowadays people diagnose and treat rather at an early stage when there are (functional) problems. So it’s not so much a hype or trend, but has to do with early diagnostics. When functional problems are present, it is better to be treated at a young age than at an older age.

This video shows in Dutch how a consultation at the Chiropractor’s office goes. The baby is four weeks old. And this video in English at the Tongue Tie Clinic.