11601 US Hwy 290 West, Suite
B105, Austin, TX 78737

Laser Frenectomy

Austin’s Choice for Tongue-Tie & Lip-Tie Release

A tongue-tie or lip-tie might not seem like a big deal, but it can have significant consequences on a child’s healthy development and well-being.

In babies, it can make breastfeeding tough for mothers by interfering with the baby’s ability to latch, resulting in a lot of physical pain for mom or an ineffective or weak latch.

In older children, it can contribute to speech difficulties, or make it hard for the child to eat or drink quietly and without making a mess. It can also make oral hygiene more difficult and most importantly interfere with proper development of the dental arches, specifically the upper arch (including the palate).

Fortunately, this condition can be easily corrected by a procedure called a frenectomy.

For parents in the Austin area – and even far beyond – there is one pediatric dentist they can trust more than anyone to perform this procedure on their babies and children: Dr. Evy Guerrero, here at Green Apple Pediatric Dentistry. 

Dr. Evy was one of the very first dentists in the Austin/San Antonio area to provide this treatment and has since released more than 4000 tongue- and lip-ties in babies, children, and some adults. The majority of these patients are referred by her vast local network of pediatricians, midwives, lactation consultants, speech-language pathologists, other dentists, and related professionals. 

What is a Tongue- or Lip-Tie? 

If you point the tip of your tongue toward the inside of your upper lip, you can feel a thin bit of tissue connecting your lip to your gums. This tissue is called a labial frenulum.

Now, if you curl the tip of your tongue up, you can see and feel another thin tissue attaching the bottom of your tongue to the floor of your mouth. That is a lingual frenulum.

When the lingual (tongue) frenulum is so short or tight that it affects normal oral functioning, it is commonly called a tongue-tie; when the labial (lip) frenulum is affected, it is called a lip-tie.

The clinical name for this condition for the tongue is ankyloglossia, and poor latch or other breastfeeding issues are often the first clue that there’s a problem. Other common signs include symptoms of colic or reflux in the child and creased, cracked, bruised, blistered, or bleeding nipples in the mother.

What Do I Do If I Suspect My Child Has a Tongue- or Lip-Tie?

Since pediatric dentists are the specialists of the mouth, you can call our office and schedule a visit for your baby right away. However, it is also a good idea to consult with your lactation consultant, midwife, speech-language pathologist, pediatrician, or other professional you’ve been working with to rule out other problems. If there are none, you may be referred to us to have a full evaluation. Your baby can have the tongue-tie release or lip-tie release on the same day most of the time.


How is a Frenectomy Done?

The procedure itself is simple and non-invasive. Check out our youtube video https://youtu.be/pL3pI7mYVSw to see how it is done in our office.

If the child is younger than 14 months, they will be gently swaddled. Older children (age 3 and up) may be given an oral sedative if needed and/or nitrous oxide gas. In between those ages, it is usually best to wait until they are old enough for the oral sedative or for the child to be cooperative. If there is an urgent need for a revision to be performed during this age bracket other arrangements can be made.

Once the child is ready, Dr. Evy will administer a local, light, epinephrine-free anesthetic to numb the area she will be working on. She then will use a laser to remove the frenulum. 

Using a laser offers more predictable results than with conventional surgery. Because the laser simultaneously cauterizes the area, there is little to no bleeding, reducing the bleeding management for the parents.

What Happens After the Frenectomy?

You will be taught wound management exercises which you will start the day after the frenectomy is performed and for 2-3 weeks (on average) to support healing by secondary intention. These are crucial to do, as they lower the risk of wound contracture resulting in an optimal healing outcome.

Your child may experience some discomfort between the second and fifth days after the procedure, so you will also be taught ways of effectively addressing this.

Above all, if you are still breastfeeding, we recommend to let your baby latch as much as possible, as he or she gets used to the new way things feel now that the tie or ties has been released. Skin-to-skin therapy should also be done during this time.

Is Frenectomy Enough?

We have found that symptoms improve by 85% within the first week. While the frenectomy corrects the anatomical problem, your baby also needs other therapy support to fully rehabilitate the tongue, lip, and other oral structures. Lactation consultants are key in achieving a successful latch leading to a long lasting breastfeeding relationship. As a leader in her field, Dr. Evy has built up a large local network of specialists she can recommend to you as needed, including lactation specialists, myofunctional therapists, speech therapists, chiropractors, pediatricians, craniosacral therapists, and more.

Is Frenectomy Only for Babies?

In a word, no. Frenectomies can correct tongue and lip ties in affected children and adults as well.

For children, once the oral restrictions are addressed, they need to see other specialists such as myofunctional therapists or speech language pathologists. These therapies can help your children retrain their facial muscles and unlearn old parafunctional habits that they may have developed over the years to compensate for the mobility limitations.

For more information on tongue and lip-tie release, including links to the science supporting its efficacy, check out our frenectomy FAQ.

Interested in seeing whether your baby, child – or you, yourself – might benefit from this procedure? contact us now to schedule an evaluation.

Common Symptoms of Tongue/Lip-Tie in Babies Include…

  • Difficulty latching/maintaining latch
  • Gums or chews nipple while nursing
  • Easily falls asleep while nursing
  • Nurses an unusually long time
  • Colic or reflux symptoms
  • Poor weight gain
  • Heart-shaped tongue
  • Constant white tongue from milk coating

Common Maternal Symptoms That Suggest Tongue/Lip-Tie Include…

  • Creased, flattened, or blanched nipples after nursing
  • Cracked, bruised, blistered, or bleeding nipples
  • Severe pain when infant tries to latch
  • Poor or incomplete breast drainage
  • Plugged ducts
  • Mastitis or nipple thrush