Join the Meeting Place for Moms!
Talk to other moms, share advice, and have fun!

(minimum 6 characters)

Breastfeeding Moms Breastfeeding Moms

lip tie (OT)

Posted by on Mar. 4, 2013 at 10:07 PM
  • 8 Replies

How do I tell if my son has upper lip tie? And if he latches fine is it something I should be concerned with or just let it be? Hes 6mo and has been an awesome latcher since birth but Ive always noticed has a pretty prominent piece of skin from his gum to his upper lip. Im almost positive hes going to have a gap like DH has. I remember my boss saying her daughter had a pretty big lip tie and ended up having it cut when she was like 5? She had a reason for it, I just dont recall.

If I need to do that Id like to do it before he gets much older. 

Lilypie - Personal pictureLilypie First Birthday tickers
baby wearing, cloth diapering, attachment parenting, breastfeeding first time mamma
by on Mar. 4, 2013 at 10:07 PM
Add your quick reply below:
You must be a member to reply to this post.
Replies (1-8):
maggiemom2000
by Ruby Member on Mar. 4, 2013 at 10:21 PM

I've had several friends tell me recently how they had a lip tie clipped in their 8-12 yr old because they had braces and the orthodontist said if they did not get the LT clipped it would undo all of the orthodontic work.

This article has a lot of good info on possible long term consequences of not getting it clipped (I've pasted that section, but if you click on the article there are several photos you can compare DS to):

http://thefunnyshapedwoman.blogspot.com/2011/03/introducing-maxillary-labial-frenulum.html

What could other impacts be of not having my baby's upper lip tie divided?


"There are no medical or dental benefits of having a tight [...] labial frenulum. There are many major medical and dental consequences that result from tight frenulums." (3) These consequences very much depend on the severity of the tie.


Apart from breastfeeding problems, an upper labial tie has been linked with:

  • having a gap between the two front teeth (2,4)
  • poor lip mobility, affecting smiling and speech (2)
  • increased dental decay on the upper front teeth (2)
Good dental hygiene is of particular importance for a baby with an upper labial tie. Althoughbreastfeeding alone may not cause tooth decay, breastfeeding in conjunction with an abnormal maxillary frenulum attachment may be a contributing cause of tooth decay in a breastfeeding infant (7). This may be because the area around the upper labial tie is difficult to clean, so food particles remain trapped in the oral mucosa.


A study undertaken in 1999 found that although human breastmilk did not cause tooth decay, adding a small amount of sugar to breastmilk did cause tooth decay (8). Therefore it would be wise for children with an upper labial tie to avoid sugary foods which, in conjunction with breastmilk, might accelerate tooth decay.


There is some evidence suggesting a link between childhood tooth decay and low levels of vitamin D (9). Breastmilk is naturally low in vitamin D, so vitamin D supplementation may be a consideration for a breastfed baby with an upper labial tie.


An upper labial tie can cause dental issues later on, so even if you decide against having the procedure done in infancy, your child's dentist may suggest dividing the upper labial tie when your child is older. "Tight frenulums rarely go away by themselves (3)"; however, they can sometimes break: my eldest child accidentally tore hers on a badly-aimed dinner fork, and one of my sons fell and tore his in the skate park. My two youngest sons also have severe upper labial ties. Despite overcoming the obstacle of their upper labial ties without having them divided and breastfeeding them both successfully, I probably won't be able to help that momentary feeling of having been just a little bit short-changed if I'm told a division is necessary in future.
Terpsichore
by Bronze Member on Mar. 4, 2013 at 10:32 PM

DD just had hers corrected. Her latch did improve slightly afterwards, which I was not expecting. She's always had a decent latch. Her lip tie went between her front teeth and gave her a slight gap in her top front teeth, and it doesn't seem to affect her speech. The big thing for me was the decay in her top four front teeth. A lip tie can make it difficult for saliva to keep those teeth clean, and difficult to brush adequately. The side two have crumbled to stubs and the front two are severely decayed and starting to crumble too. I worked hard on her oral hygiene. The rest of her teeth and her gums are great. Hubby and I did lots of research and soul-searching before deciding to get it clipped. We decided to get it clipped before her permanent teeth came in, which I know is a few years away.

It was a bit of a fight to get a referral to an oral surgeon. Two pediatric dentists blamed night nursing, and the PCP didn't understand that lip tie could affect anything except speech. The oral surgeon was familiar with it, checked out the lip tie and the posterior tongue tie. He said the lip tie would likely need correcting later on anyway, but the posterior tongue tie (which often accompanies a lip tie) didn't seem to be problematic for her, and I'm not aware of it causing problems. So the lip tie is clipped. Her teeth are too far decayed to help, though I'm trying to keep them from crumbling as long as possible. 

Edit: forgot to say, she's 2 now. Her stiches just finished coming out. She could nurse and drink from bottles, but sippy cups hurt her the first few days.

Jujubee12
by Bronze Member on Mar. 5, 2013 at 2:17 AM

thank you!

Quoting maggiemom2000:



Lilypie - Personal pictureLilypie First Birthday tickers
baby wearing, cloth diapering, attachment parenting, breastfeeding first time mamma
Jujubee12
by Bronze Member on Mar. 5, 2013 at 2:23 AM


Quoting Terpsichore:

DD just had hers corrected. Her latch did improve slightly afterwards, which I was not expecting. She's always had a decent latch. Her lip tie went between her front teeth and gave her a slight gap in her top front teeth, and it doesn't seem to affect her speech. The big thing for me was the decay in her top four front teeth. A lip tie can make it difficult for saliva to keep those teeth clean, and difficult to brush adequately. The side two have crumbled to stubs and the front two are severely decayed and starting to crumble too. I worked hard on her oral hygiene. The rest of her teeth and her gums are great. Hubby and I did lots of research and soul-searching before deciding to get it clipped. We decided to get it clipped before her permanent teeth came in, which I know is a few years away.

It was a bit of a fight to get a referral to an oral surgeon. Two pediatric dentists blamed night nursing, and the PCP didn't understand that lip tie could affect anything except speech. The oral surgeon was familiar with it, checked out the lip tie and the posterior tongue tie. He said the lip tie would likely need correcting later on anyway, but the posterior tongue tie (which often accompanies a lip tie) didn't seem to be problematic for her, and I'm not aware of it causing problems. So the lip tie is clipped. Her teeth are too far decayed to help, though I'm trying to keep them from crumbling as long as possible. 

Edit: forgot to say, she's 2 now. Her stiches just finished coming out. She could nurse and drink from bottles, but sippy cups hurt her the first few days.

Oh I think the speach thing was why my boss had her daughters cut. Thanks for all the info. I definitely think that he has a lip tie now that I looked hard at it (as much as he let me). It goes straight from that bump to his lip and is really thick. Im going to bring it up to his ped at his 6 month appointment. What it covered by insurance? I want to avoid things like tooth decay and stuff. 

What was the procedure like and how much did it affect nursing during the healing process? 

Lilypie - Personal pictureLilypie First Birthday tickers
baby wearing, cloth diapering, attachment parenting, breastfeeding first time mamma
Cruz-s-mommy
by Amanda on Mar. 5, 2013 at 8:54 AM
Oh no, think DS might have this as well. His front to teeth have quite a bit of decay on his 2 front teeth for an 18 month old, and I brush his teeth regularly, though it's hard to get to those top ones. Never noticed it before since he's always had such a great latch, it never occurred to me that it was a possibility, I didn't know lip ties could cause tooth decay! I will have to have a good look in his mouth when he wakes up!

OP: Good luck at your check-up, hope you figure it out and get what you need if he does have a tie that needs correcting.


Quoting Terpsichore:

DD just had hers corrected. Her latch did improve slightly afterwards, which I was not expecting. She's always had a decent latch. Her lip tie went between her front teeth and gave her a slight gap in her top front teeth, and it doesn't seem to affect her speech. The big thing for me was the decay in her top four front teeth. A lip tie can make it difficult for saliva to keep those teeth clean, and difficult to brush adequately. The side two have crumbled to stubs and the front two are severely decayed and starting to crumble too. I worked hard on her oral hygiene. The rest of her teeth and her gums are great. Hubby and I did lots of research and soul-searching before deciding to get it clipped. We decided to get it clipped before her permanent teeth came in, which I know is a few years away.

It was a bit of a fight to get a referral to an oral surgeon. Two pediatric dentists blamed night nursing, and the PCP didn't understand that lip tie could affect anything except speech. The oral surgeon was familiar with it, checked out the lip tie and the posterior tongue tie. He said the lip tie would likely need correcting later on anyway, but the posterior tongue tie (which often accompanies a lip tie) didn't seem to be problematic for her, and I'm not aware of it causing problems. So the lip tie is clipped. Her teeth are too far decayed to help, though I'm trying to keep them from crumbling as long as possible. 

Edit: forgot to say, she's 2 now. Her stiches just finished coming out. She could nurse and drink from bottles, but sippy cups hurt her the first few days.


Posted on the NEW CafeMom Mobile
Terpsichore
by Bronze Member on Mar. 5, 2013 at 11:50 AM

Oh I think the speach thing was why my boss had her daughters cut. Thanks for all the info. I definitely think that he has a lip tie now that I looked hard at it (as much as he let me). It goes straight from that bump to his lip and is really thick. Im going to bring it up to his ped at his 6 month appointment. What it covered by insurance? I want to avoid things like tooth decay and stuff. 

What was the procedure like and how much did it affect nursing during the healing process? 

What insurance covers depends on the insurance. Charges vary per provider as well. Our costs:

$88 oral evaluation (covered by our dental insurance)

$103 nitrous oxide, not covered by insurance. IV sedation would have been covered but we did some research prior and felt nitrous oxide was safest.

$509 Labial Frenectomy. This part I've yet to find out what's covered. I called our health insurance ahead of time, they said it should be covered after a $50 specialist copay if I got a referral from the PCP. It takes a couple weeks for the Explanation of Benefits to come in the mail, usually right after the bill comes, insurance is so efficient that way.

Now, getting the referral was a fight. Usually you get referred to an oral surgeon from the pediatric dentist. Two different pediatric dentists seemed to know zip about lip tie, and I don't believe our dental covers any part of a lip-tie.  Our health insurance supposedly covers tie correction, and they require a referral from a PCP. The PCP didn't want to give a referral, wanted the referral to come from a pediatric dentist. 

I'd like to point out that not all ties need correcting. I have a tie in my upper lip, lower lip, and posterior tongue tie. None of them have inhibited my speech, eating, mobility, oral hygiene, or anything else enough to warrant a correction. The oral surgeon, who IS educated about ties, determined that my daughter's lip tie was inhibiting enough to warrant a correction and her postior tongue tie was not.

Laser correction is preferable, but my insurance doesn't cover it, so it was the old scapel technique for us. Daddy was present but I was not, since I'm pregnant and didn't need to inhale any nitrous oxide accidentally. It took maybe 20 minutes. First they put a numbing gel on, then used nitrous oxide through a nose mask, and lastly put in a small shot of novacaine. Her tie was cut with a scapel, and the skin was sutured to the top of her lip. Anesthesia is probably done differently for different ages.

We gave her liquid Tylenol when we got home less than an hour later, which is about the time the anesthesia fully wore off. She hadn't eaten or drunk anything for 8 hours for safety reasons, so she was very hungry and thirsty. She had no problem nursing, but it took a while to fill her up with foods she could handle, like yogurt and ice cream. Sippy cups hurt too much, but she could drink from baby bottles. She bit them some, but they're replaceable. Any time she wasn't hungry or thirsty, she was her normal active, happy self. 

It will be one week tomorrow, the stitches are gone, she's not fully healed, but she's back to being able to eat and drink just about anything she normally can.

mommaoftwo
by on Mar. 5, 2013 at 11:52 AM
1 mom liked this

we just got lip and tongue ties fixed yesterday



he said your lip should be able to touch your nose

PoodleMum
by Silver Member on Mar. 5, 2013 at 2:21 PM
We had my toddlers clipped again since it was causing decay, there was a gap too. Within two weeks, it had closed and her other teeth are straightening out. Why pay the orthodontist to fix something you can take care of now? Evie's was done too, to help her nurse.
Posted on CafeMom Mobile
Add your quick reply below:
You must be a member to reply to this post.
Join the Meeting Place for Moms!
Talk to other moms, share advice, and have fun!

(minimum 6 characters)