Click here to view our sister website Tonguetie.ie for more information.
Dr Dermot Murnane releases tongue ties and lip ties every week. In Nenagh every Monday and Tullamore on Wednesday’s.
9 O’Rahilly St, Nenagh
Clonminch House, Portlaoise Rd, Tullamore
Phone – 086 1449583
E mail — firstname.lastname@example.org
Laser Safety Note:
The laser used by Dr Murnane will not travel through air.
It will only evaporate what it touches. This laser, unlike other types of laser poses no risk of damage to eyes.
People very close were protective glasses to protect from glare only.
It is not necessary to wear glasses if you are several feet away.
Protective glasses are provided for everybody.
It is very common for a baby to be born with restricted tongue movement, commonly called a “Tongue Tie”.
This is a congenital anomaly characterised by an abnormally short lingual frenulum, ( a piece of skin connects the tongue to the floor of your mouth and restricts tongue movement) the tip of the tongue cannot be protruded beyond the lower incisor teeth. It varies in severity between individuals.
Most babies who present with a tongue tie will also have a lip tie. This is an attachment from the upper lip to the bone of the upper jaw. This prevents the upper lip everting during sucking. This prevents a good latch and allows air to be swallowed while suckling. The release of a lip tie often has more of an effect than the release of a tongue tie.
Reports on its frequency vary from between one in every 10 babies born to one in every 20 babies born. It appears to be more common in boys and there also appears to be a hereditary element with several members of any family suffering from the condition.
The extent of the restriction varies with every infant from very minor and insignificant to a restriction so severe it will interfere with suckling and feeding and as the child develops further it may affect speech development, however there are differing opinions on this. Teenagers and young adults who have not had their tongue tie corrected are usually more worried about the restrictions it poses on kissing as the movement of the tongue is restricted.
Common Reported Symptoms include:
- Painful feeding for mum
- Inability or poor latching on resulting in baby becoming frustrated
- Prolonged feeding, with the baby remaining hungry and irritable
- Excessive dribbling (opinions differ on this point)
- Swallowing excessive amounts of wind (opinions differ on this point)
- Most tongue ties do not appear to affect speech, but each case must be individually assessed by an appropriate professional
The links bellow will bring you to the UK’s National Institute for Health and Care Excellence ( NICE) information web site on Tongue tie. Please read the information on these sites before considering the release of a tongue tie.
A tongue tie release is a small and simple surgical procedure, however like all surgical procedures especially on infants they should be avoided if possible. Every attempt to find a non surgical resolution should be attempted before considering a tongue tie release. You should consult a lactation consultant, or gp for advice on breast feeding difficulties before considering this procedure.
Dr Murnane insists that all babies are referred for this procedure. A referral from a lactation consultant or GP is required.
For the best results you should also see your lactation consultant after the procedure so help in adjusting breast feeding is given.
It is possible for a Tongue Tie to affect speech. It is not possible to predict if a particular child will have their speech affected by a Tongue Tie as all children adapt differently. Each case must be assessed individually and the opinion of a speech and language therapist must be sought.
A Soft Tissue Laser, which has transformed The Release of Tongue Tie and dramatically reduced the amount of post operative pain and swelling.
A soft tissue laser allows the procedure to be carried out while the child is awake outside a hospital.
A small amount of anaesthetic is given in the upper lip tie. No anaesthetic is used under the tongue.
The lip is held up and if the baby will remain still the upper lip is released in a minute or so.
Then either 2 fingers are placed into the mouth under the tongue or a tongue retractor is placed under the tongue. Most infants will cry while you do this and this facilitates the procedure as the mouth is opened for crying.
A tongue tie is released at this stage. It is expected that the child/infant will cry during this as they do not like having their mouth interfered with. This allows better access.
Baby is swaddled in a blanket and held firmly and snugly by mum or dad on their lap. Dr Murnane sits opposite mum/dad knee to knee, babies head on Dr Murnanes lap, baby looking at mum/dad.
The upper lip is held up and the lip is released. This is a very simple procedure as access is easy. The release of an upper lip will take a minute or two. Baby will cry during the procedure but will normally stop crying once the procedure is completed.
The release of the tongue tie is more difficult as access to the underside of the tongue is restricted. Some tongue ties are easier to access and other ties are more difficult to access. The length of the procedure depends on how easy it is to access the tongue tie and how still the baby is. But the release of a tongue tie will take between one and four minutes or so. Again baby will cry during the procedure and would be expected to stop crying once the procedure is completed.
It is best to allow an infant to suckle or to drink from a bottle immediately for comfort.
There is no guarantee that the release of a lip tie and or tongue tie will offer any improvement in feeding for any child. However most babies do improve the effeciency and speed of feeding, swallow less air and latch in a less painful manner. It is however not possible to predict these results for any individual child.
It can be quite difficult to watch your little baby have a tongue and lip tie released. Baby will cry, their face may go red and their may be baby tears. If you do not think you can cope with this then you should consider carefully if this procedure is appropriate for you and your baby.
- About half of all babies will settle quickly and feed very normally after the procedure and show little or no side effects.
- About half of all baby will be a little “out of sorts” for a period of time. Reluctance to feed for about 8 hours is often reported and possibly a bit grumpy and unhappy the following day. But most will be feeding normally within 24-36 hours.
- Rarely a mother will report that baby is unhappy/upset and slow to feed for several days. Feeding by syringe for several days up to one week as baby will not suckle has been reported. If a baby is very sore after the procedure and will not feed the only treatment available is comfort, analgesics, slow feeding by syringe and letting nature and time resolve the issues. If in doubt it is best to consult your gp/ public health nurse or lactation consultant. It is important that fluid intake and nutrient intake is maintained.
Most babies will show an improvement in breast feeding immediately. However many babies will need to re-learn breast feeding and as they do a more gradual improvement in feeding will also occur over 7 – 10 days.
You should seek advise from your lactation consultant after the tongue tie release.
Dr Murnane is not a breast feeding specialist, but an Oral Surgeon. Dr Murnane’s expertise is in carrying out surgical procedures in the mouth.
Initially the areas under the lip and tongue which has been operated on will have a grey / black almost charred appearance. This will turn into an ulcer over several days (a whitish area with a greenish surround). The area will heal completely and look pink and normal within 10 to 14 days.
Usually little specific post operative care is needed.
A little minor swelling in the upper lip is to be expected and this should resolve in several days
It is advised to clean under the lip with cotton wool soaked in warm salty water several times a day if baby will tolerate this. If baby will not tolerate cleaning its best not to persist.
It is often impossible to clean under the tongue with salty water but if it is possible it should be done.
You should see your lactation consultant in the days after the procedure for breast feeding advice.
You should contact your public health nurse or gp if you have any worries about your babies not feeding sufficiently.
Many mothers travel a considerable distance to have this procedure carried out and returning for a review appointment is difficult. Dr Murnane will phone you 2 days after the procedure to enquire as to how things are going. You will have Dr Murnane’s mobile number should you wish to talk to him, and you can return to see Dr. Murnane if you wish to at any time.
If you wish for a review appointment, it will be organised on the day. There is no charge for a review appointment.
The benefit of tongue exercises after the release of a tongue and lip tie is unproven and opinions differ on the issue. Dr. Murnane is not an expert in breast feeding and you should consult your lactation consultant for advise and help in breast feeding and specific exercises.
Reattachment of tongue tie does happen. It is not common, it is not predictable and it is probably not preventable. Tongue exercises such as sticking your tongue out to the maximum during the healing period may be of some help. However this may only work in an adult as it would distress a baby to have its tongue pulled it this manner. Re attachment if it happens is more likely to happen slowly over a period of several months.
If you do get re attachment Dr Murnane will release the tongue once more if requested. There is no charge for this. If a tongue re attaches a second time it is probably futile to attempt a third release of a tongue tie.
- General Anaesthetic is not needed.
- A scalpel is not used.
- There are no stitches
- There is no bleeding
- There is very little post operative swelling, usually in the upper lip.
- There is little or no post operative pain.
- Instant (or within several days) improvement in tongue function and feeding for many babies.
- The procedure is very quick.
The fee for this procedure is normally €350
If you have health insurance the fee is €250.
The insurance code for “Labial Frenectomy” is 2980 For “Tongue Tie ” is 1170
If you have any queries on this procedure please contact Dr Murnane via the contact page on this web site.