Lip Tie in Kids | Las Vegas Pediatric Dentist

What Does “Lip Tie” Mean in Children?

The parent can notice the upper lip frenulum when cleaning the child’s teeth or seeing the gap between the front teeth. The fact that there is a large and/or low frenulum can worry parents, but it doesn’t say anything about whether it’s problematic.

What Is the Upper Lip Frenulum?

Upper lip frenulum, alternatively known as the maxillary labial frenum, is a flap of skin that connects the inner upper lip with the gums. It is a normal anatomical structure and functions as a stabilizer of the upper lip.

There is no universal form of the frenulum, which means that it may look thin, thick, short, broad, or even attached close to the front teeth. The appearance and location of the frenulum may also vary with age as a result of dental development.

It is sometimes called an upper lip tie when the structure restricts the movement of the upper lip. However, its appearance alone cannot be sufficient evidence for this conclusion.

How Does Normal Anatomy Differ From a Function-Related Concern?

A frenulum may be quite obvious in a child without any effect on his daily routines. What is of greater importance is whether there is any issue with lip movement, comfort, cleanliness of teeth, gums, etc.

During a pediatric dental evaluation, a dentist may look at:

• How comfortably the upper lip moves.
• Whether the child can tolerate normal brushing.
• Whether plaque collects around the upper front teeth.
• Whether the nearby gums appear irritated.
• The position of the frenulum in relation to the teeth and gums.
• The child's age and stage of dental development.

Care must be exercised by parents when making a diagnosis based on pictures of lip ties or online evaluation scales. Studies have shown problems with appearance-based systems, and severity may not always equate to functional impairment.

What Might Parents Notice During Brushing or Everyday Activities?

This is because of some worries that parents may have about cleaning the upper front teeth because their children may show some resistance to this because they find it painful.

Other observations might include:

• Difficulty accessing the gumline with a toothbrush.
• Plaque collecting near the upper front teeth.
• Localized gum irritation.
• Discomfort when the upper lip moves.
• A noticeable gap between the two upper front teeth.

How Is Lip Tie Different From Tongue Tie?

A lip tie and tongue tie are different conditions in terms of affected tissues.

A lip tie is a condition when there are concerns regarding the tissue that connects the upper lip to the gums.

On the other hand, a tongue tie is called ankyloglossia, and it is a condition where there are restrictions in the tongue due to the presence of the frenulum under it.

This distinction is crucial since scientific evidence on tongue ties cannot necessarily be extrapolated to lip ties.

For instance, a parent might come across information that a procedure involving the frenulum might benefit certain infants with specific issues with feeding due to tongue ties.

However, this does not necessarily mean that the procedure involving the upper lip frenulum will have the same effect.

Scientific research specifically conducted on the upper lip concluded that visual signs of upper lip frenulum cannot predict the successful breastfeeding experience.

How Does a Las Vegas Pediatric Dentist Evaluate Lip Tie Concerns?

What Does the Dentist Assess Beyond the Frenulum's Appearance?

A children dentistry provider may begin by asking what prompted the parent to notice the area.

The evaluation may include:

• The child's age and dental history.
• When the concern first appeared.
• Whether the child has pain or discomfort.
• Lip movement and flexibility.
• Frenulum attachment and surrounding gum tissue.
• Oral hygiene around the front teeth.
• Plaque or inflammation near the gumline.
• Primary and permanent tooth development.
• Other possible causes of the child's symptoms.

The dentist may also want to know whether another dentist, pediatrician, orthodontist, speech professional, or feeding professional has previously assessed the child.

Parents can prepare for the appointment by noting a few practical details:

1. When did you first notice the problem?
2. Does brushing consistently cause discomfort?
3. Does your child resist normal movement of the upper lip?
4. Has the space between the front teeth changed as new teeth erupted?
5. Has another healthcare professional evaluated the concern?

These details provide more useful information than a photograph alone.

Does a Lip Tie Cause a Gap Between the Front Teeth?

A space between the two upper front teeth is referred to as a midline diastema. This is an area that is very prominent, which is why parents first notice the frenulum when observing the spacing of the teeth.

Frenulum prominence is sometimes linked with midline spacing, but midline spacing alone does not prove anything about the frenulum. Spaces occur naturally in many children's teeth.

The dentist may consider:

• Whether the child has primary or permanent teeth.
• Which permanent teeth have erupted.
• The size and position of the front teeth.
• Whether other dental factors contribute to the space.
• Whether an orthodontic assessment would be useful.

This is especially critical since some developmental discrepancies tend to reduce with the eruption of permanent teeth.

A systematic review established the presence of the relationship between certain frenulum attachments and maxillary midline diastema; however, caution was recommended when performing frenectomy at an early age, due to the fact that physiological spacing may resolve on its own during tooth development.

Thus, a lip tie release procedure cannot be used as a definite solution to closing the space between the front teeth.

What Should Parents Ask Before Agreeing to a Lip Tie Release?

Before deciding on lip tie treatment for children, parents can ask:

1. What specific problem is the frenulum causing?
2. What examination findings support treatment?
3. Could another dental or medical issue explain the symptoms?
4. What happens if we monitor it instead?
5. Why is treatment being recommended at this stage of development?
6. What improvement can reasonably be expected?
7. What are the risks, limitations, and alternatives?
8. Would an orthodontic or other professional assessment be helpful first?
9. What pain management and follow-up will my child need?

There are also instances where the parents will learn about more traditional surgery techniques and laser treatments. Just because a new technique is being used does not mean that the laser technique is superior. The technique should be chosen based on the patient’s needs, findings, treatment, and the clinician’s assessment.

Postoperative care also differs. In this case, parents should be guided according to the specific directions given by the clinician, rather than attempting to cut, open, or stretch the tissues.