.png)
.png)
Dr. Giridhar Veerula has specialized in tongue-tie surgeries since 1992 and Diode Laser frenectomies since 2016. He treats patients of all ages, with half being over 18 months. Dr. Veerula collaborates with lactation consultants, speech-language pathologists, chiropractors, and other pediatricians to address feeding issues early. His use of a Diode Laser improves patient outcomes and lessens the risk for reattachment and has performed over 4,000 successful procedures.
In 2024, Dr. Vijay Veerula, who is trained in laser frenectomies and osteopathic frenectomy aftercare, joined the practice. Together, they advocate for the benefits of laser frenectomies and comprehensive holistic aftercare protocols.
For a frenectomy consultation call 260-436-7722 today!
What Are Tongue and Lip Ties?
Tongue and lip ties occur when the frenulum—the band of tissue under the tongue or upper lip—is unusually tight or thick. This restriction can limit movement and lead to feeding issues, speech concerns, dental problems, and more.
A frenectomy is a quick, in-office procedure to release the restricted tissue. We use a diode laser for precision, minimal discomfort, and fast healing—no stitches, no general anesthesia, and very little downtime.
Symptoms of Tongue and Lip Ties
In Infants:
-
Painful or shallow latch during breastfeeding
-
Frequent popping off the breast or bottle
-
Clicking, gasping, or excessive air swallowing
-
Reflux, gassiness, or poor weight gain
-
Difficulty keeping pacifier in mouth
In Mothers:
-
Nipple pain, cracking, or bruising
-
Recurrent clogged ducts or mastitis
-
Low milk supply or poor breast drainage
-
Fatigue, stress, or postpartum frustration
In Children:
-
Speech delays or unclear pronunciation
-
Mouth breathing, snoring, or restless sleep
-
Difficulty with certain foods or textures
-
Gagging, choking, or messy eating
-
Orthodontic concerns or crowded teeth
In Adults:
-
Jaw tension, TMJ symptoms, or headaches
-
Neck or shoulder strain
-
Trouble swallowing pills or certain foods
-
Chronic cavities or poor oral hygiene
-
Speech fatigue, difficulty enunciating clearly
-
Challenges with instruments, kissing, singing, or public speaking
Tongue Tie
Before
After
Lip Tie
Before
After
Why choose us:
At JFPM, we provide in-office procedures using diode laser and numbing agents that eliminate the need for general anesthesia and reduce complications. Our method enhances comfort and facilitates efficient healing with bleeding. Dr. Giridhar Veerula brings laser treatment experience, while Dr. Vijay Veerula offers a holistic approach, including OMT and cranial sacral therapy for post-frenectomy care. Surgery may be needed for moderate to severe oral ties, but OMT can alleviate mild symptoms. Our team is dedicated to delivering comprehensive care for optimal recovery. Dr. Giridhar Veerula and Dr. Vijay Veerula collaborate on oral tie cases, ensuring patients receive the most comprehensive and effective aftercare!
Diode Laser Benefits include:
-
Minimal bleeding and swelling
-
Lower risk of infection
-
No general anesthesia
-
Quick in-office procedure (often under 10 minutes)
-
Fast healing with less discomfort
-
Immediate return to the parent after infant procedures
What Is A Frenectomy:
A frenectomy is a minor surgical procedure that removes or alters the tissue (frenulum) connecting the lips or tongue to the gums. While everyone has these connections, their tightness can vary, with labial (lip) and lingual (tongue) ties being the most common needing revision. At JPFM, we use a Diode Laser for frenectomies instead of scalpels or scissors.
Common Types of Oral Ties:
Labial (Lip) Tie: A too short or stiff maxillary labial frenulum can restrict the upper lip's movement. and cause a gap between the two front teeth in older patients.
Lingual (Tongue) Tie: an unusually short or thick lingual frenulum, a membrane that connects the tongue to the floor of the mouth.
-
Anterior tongue tie: Near the tip, easily diagnosed, with lower risk of reattachment and need for revision.
-
Posterior tongue tie: Located in the middle or back, often hidden and harder to diagnose, may require multiple procedures. A laser frenectomy can reduce reattachment risk, but children may still need a second revision around ages 2 or 3 if speech issues arise.
Benefits of Laser Frenectomies: A diode laser targets specific tissue, preserving healthy areas and minimizing complications. It causes minimal bleeding compared to scissors, enhancing visibility for a more complete frenectomy and reducing reattachment risk. The laser also cauterizes tissue to lower infection risk and can be adjusted quickly to suit the patient's anatomy.
What to Expect:
Before the procedure, we will consult to assess oral ties, discuss options, and develop a personalized aftercare plan. For newborns with feeding issues, we recommend the procedure on the same day as the consultation if immediate action is needed, as delays can increase negative outcomes. The quick procedure lasts a minute and is generally well-tolerated, with numbing cream and anxiety medication available. Parents must wait outside for safety, but staff will bring you back immediately afterward for comfort. Following the procedure, nursing or bottle-feeding can be attempted right away, and we encourage adherence to personalized aftercare for optimal outcomes. If hesitant about a fren, alternatives like OMT and cranial-sacral therapy can be considered; severe ties may require surgery for full resolution.
Preparation for the Procedure:
We recommend having the necessary medications ready for post-procedure care and have your lactation consultant on-call the day of the procedure for troubleshooting and feeding issues.
Tylenol, 160mg/5mL concentration (using the dose recommended by the provider.)
For children 6 months and older, ibuprofen can be used as directed.
Homeopathic remedies like Arnica Montana 30c, Rescue Remedy, or Camellia Teething drops are also recommended to have on hand. No medicated comfort measures are also recommended. We can discuss your specific needs at your first appointment!
Familiarize your child with aftercare stretches before their frenectomy appointment. Starting these tolerance exercises early helps them adapt to the sensation and supports recovery.
To increase oral tolerance, we suggest:
-
Gently Rubbing the lower and upper gumline side to side.
-
Let your child suck your finger while playing tug-of-war.
-
Apply gentle pressure to the palate while they suck your finger.
-
Massage the cheeks to reduce tension.
-
and incorporate playing together with a teething toy or baby safe teething brush into your daily routine. (using teething brush on your baby's gums daily is great practice for future toothbrushing tolerance)
Performing these activities multiple times daily will enhance tolerance and make aftercare easier..
Post-Procedure:
The numbing medicine should wear off in 30 minutes or less. It's rare but if your older child needs local anesthetic, it will wear off in 1-4 hours. Soreness and fussiness are common. Comfort younger kids with nursing or cold toys, while older kids should start with a cold diet. Administer Tylenol and Motrin as prescribed. Stretches at home 4-5 times daily 4-6 weeks.
Contact us with any concerns. Follow-up appointments can be scheduled anytime with Dr. Veerula. We are here to support you!
We recognize that this procedure may appear daunting; however, we are committed to providing you with support every step of the way!