Mouth Wounds & Oral Stretches:

Open mouth wounds heal quickly, which can lead to premature reattachment of the tongue or lip after a frenectomy. This may cause limited movement and a tighter frenulum. To prevent this, it's important to keep the wounds open with post-procedure stretches for at least two weeks, (although 6 weeks is encouraged) ensuring a loose frenulum with minimal scar tissue.

 

Proper stretches should be quick and precise, requiring no force, though they may feel uncomfortable for a young baby. Some crying is expected from infants and children. Research and feedback from adult frenectomy patients indicate that there is little to no discomfort when the procedure is followed correctly and compassionately.

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Best practice indicates that stretches reduce the risk of reattachment when 

performed 4-5 times daily for 4-6 weeks.

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This may not be achievable for everyone. We ask parents to do the best they can with regard to their child's individual needs. Call us if you feel your child cannot handle the prescribed aftercare plan. We will work with you to find the best solution for your child.

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Holistic Therapies and Treatments:

​Our Osteopath, Dr, Vijay Veerula can provide a range of therapies and osteopathic treatments to help eliminate symptoms after the release of oral ties.

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• Myofacial and Myofunctional therapy:

  This therapy helps to retrain the muscles of the face, mouth, and throat to improve function. It can help with tongue-tie by addressing physical limitations and functional issues while improving swallowing, breathing patterns, and speech clarity. Myofascial/Myofunctional therapy often involves exercises and techniques to improve muscle function, particularly in the jaw and face, and can be part of your comprehensive treatment plan provided by our Osteopath.

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• Craniosacral therapy

  This therapy can help prepare for a tongue tie release and can be used both before and after the release. Craniosacral therapy can help with tension in the muscles, which can impact the structure of the tongue and mouth. 

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• OMT & Birth Trauma Bodywork

  Osteopathic manipulative treatment can help with muscle tension and structural imbalances, and as a result can improve symptoms like reflux, gas, colic, and sleep in infants.

 

Other professionals who may have training with oral ties: Lactation consultants, Speech therapists, Occupational therapists, Chiropractors, and Osteopaths (DO).

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At Jefferson Pediatrics & Family Medicine, we encourage collaborating with other specialists for better patient outcomes.

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Basic Stretching Procedures:

 Note: This is only an example of basic aftercare procedure. Dr. Veerula may have different recommendations depending on you or your child's individual situation. As research increases our physicians review these practices and update accordingly. What you are recommend in office may be different than what is written below. Always follow what your provider recommends in office.

Essentially, gentle strokes upwards on the diamond shaped wound, a few times a day, will keep the wound open and the edges from closing together. Keeping a diamond shaped wound that will slowly close over the course or 2-6 weeks is the goal. Many patients find it easiest to remember to perform these stretches after every diaper change. Ensure your hands are clean before starting.

To help your little one feel more comfortable and reduce wiggling during stretches, we recommend swaddling them beforehand.

With the baby swaddled, lay them down with their head facing the person performing the frenectomy stretches to ensure proper direction and force.

Lip Stretch: Stabilize the baby's head with your palms. Using your index fingers, start at the cheeks and move toward the upper lip. Lightly pinch the upper lip with your thumbs and index fingers, pulling it up toward the nose while ensuring the entire diamond (lasered area) opens. Hold for five seconds.

Tongue Stretch: Again, stabilize the baby's head with your palms. Use your middle fingers to apply counter pressure on their chin. Place your index fingers under the tongue, ensuring they touch, and gently push down where the frenum was while maintaining counter pressure on the chin. Once the diamond (lasered area) opens, hold for five seconds.

During the first couple frenectomy stretches, some bleeding may occur, which is normal and typically stops quickly.

Tip: Allow the baby to suck on your finger (nail down toward the tongue) between stretches for a calming effect. Doing this sucking exercise a few times a day can not only help calm an infant but retrain the tongue.

Pain relief: Tylenol or Ibuprofen can be used for children six months or older. For those under six months, Dr. Veerula has a natural aftercare pain management plan that is more age-appropriate, which can be discussed during your evaluation.

Dr. Veerula will provide a detailed informational sheet on how to properly perform the stretches and sucking exercises to help retrain the tongue. A follow-up with OMT, your Lactation Consultant, or Speech Therapist is recommended,