Infant Lingual and Maxillary Frenectomies | Case Study

Case Summary:

The patient, a 10-week-old male infant, presented with a Class III maxillary lip tie and a Class III tongue tie. He was referred to the practice by a lactation consultant (IBCLC) for inability to achieve a proper latch on the breast. This resulted in inadequate feeding and also the swallowing of air resulted in colicky syndrome. In addition, the mother complained of very raw and sore nipples, a common occurrence when there are latch issues. The oral evaluation revealed that the baby was not able to flange the upper lip or extend and elevate the tongue which significantly impacted his ability to latch onto the breast and achieve a palatal seal for ideal expression and swallowing of milk. Lingual and maxillary labial frenectomies were performed.

Technique Used:

With Solea, the entire treatment took less than three minutes and performed with no anesthesia (neither topical nor injectable). The infant was swaddled and stabilized with the help from the assistant. An instrument called a “grooved director ” – a unique forked instrument that straddles the frenum and elevates the tongue – was utilized to assist with access. For the maxillary labial frenum, lip is retracted slightly outwards and upwards. The dentist used the Solea straight handpiece and 0.75 mm spot size with cutting speed between 30-40% in a low power mode, using no mist and no air to avoid gagging issues or aspiration of saliva/water. The laser was directed perpendicular to each frenum, ablating up and down as well as slightly laterally, severing fibers until no tight band of tissue was palpated and the classic diamond shaped surgical site was seen. Stretching exercises were demonstrated and prescribed, 5 times a day for two weeks. The mom and the baby followed up with the IBCLC.

Results:

Solea’s precision enabled complete control of the soft tissue, yielding outstanding results. The baby was breastfed as soon as the treatment was finished, and his mother noticed an immediate improvement in the way he was nursing and swallowing. She said, “It’s the first time it hasn’t hurt!” Hearing that is one of the most rewarding and moving words that you could ask for.

Solea Advantage:

• The treatment was completed quickly with no bleeding and no sutures.
• No anesthetic was used.
• The mother noticed an immediate improvement in her comfort and the quality of the latch.