Upper Lip Tie

October 02, 2015

  

Lip tie is the condition where the upper lip is attached to the upper gum in the centre with a band of tissue of varying thickness. This makes it difficult for the affected child to curl his lip upwards or flare out properly. This can be of concern while breastfeeding as the baby is unable to latch onto the breast properly. However, this problem arises only when the frenulum is too short or tight.

Tied lip symptoms

Often an upper lip tie goes unnoticed as it is hidden under the lip. Among the noticeable symptoms are:

1. The baby is unable to latch on to the breast properly, often chewing on the nipple.
2. Where the lip tie is too tight, the child may even find it difficult to feed from a bottle.
3. The baby may be prone to gas as he is likely to swallow excessive air while nursing. This is because he is unable to form a proper seal while nursing.
4. Nursing is likely to be prolonged.
5. The infant may exhibit poor weight gain due to unsatisfactory feedings.
6. Nursing may be uncomfortable for the mother.

Treatment

The only treatment possible is to remove the excess tissue that attaches the upper lip to the upper gums. Generally speaking, a lip tie release is easily managed for infants. If the child is younger than one year, it is a simple outpatient procedure. It can be snipped free under topical anesthesia either with scissors or laser. There is minimal bleedingand the resulting scab should clear in a week.

As far as aftercare is concerned, for an infant less than 6 months no pain relief is required. Pain relievers are prescribed by the doctor for infants between 6-12 months. It is better to breastfeed immediately as it distracts the baby and promotes healing.

There are chances of reattachment as the upper lip is in constant contact with the gums. However, it can be minimized by running a firm finger under the lip several times a day to prevent adhesion.

However, for older children a frenectomy may be required in which, the extra tissue is removed entirely under general anesthesia, instead of just snipping it free.

Dental implications of lip tie

Though a nominal attachment does not have any long-term implications, a thick band of tissue that is attached far down the gums can lead to space between the upper front teeth called diastema. However, most dentists agree that this space can close on its own as the child grows older and the permanent teeth come in. Therefore any dental intervention should be undertaken only after this stage.

However, in some cases the extended frenulum can create a pocket which allows collection of food debris, thereby increasing the chances of early decay of the teeth on either side of the tissue.

Difference between lip tie and tongue tie

A tongue tie occurs when a band of tissue attaches the bottom of the tongue to the floor of the mouth. This restricts the movements of the tongue. As the tongue doesn’t wrap around the nipple, milk is not removed fully leading to a child who is not able to feed properly as well as blocked ducts and mastitis for the mother.

On the other hand, a lip tie occurs when a band of tissue extends from the upper gums to the inside of the upper lip. This leads to improper seal causing intake of air. The infant also tires out easily and is often gassy.

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