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Adult Frenectomy For Pain Relief: Osteopathic Considerations

Why I Opted To Do The Frenectomy

 

Tongue Surface AnatomyI decided to consider a frenectomy for a tongue tie (ankyloglossia) after doing it for my daughter, Viviana, when she was 2 months old. Seeing how the shape of her face immediately changed, how she was immediately able to open her mouth wider, how she was finally able to bottle feed pumped breast milk for the first time, and she was able to breastfeed more efficiently instantly, I began to wonder if this would be helpful for an adult. It is generally thought that once one is fully grown that the structure can no longer adapt. Understanding the human body is a dynamic, I felt there could be a huge benefit for adults. It was after her procedure, that I realized that I had a tongue tie as well.

 

You see, my wife had pointed out the tongue tie in Viviana, but it is generally not recommended to do anything unless there is an inability to gain weight. Well, our daughter was quite a large baby so it was not recommended. However when my wife went back to work, Viviana was unable to drink from a bottle so my mom was having to feed her with a dropper. “That is like trying to feed an elephant with a dropper,” commented a family member.

 

That was the moment when we decided to pursue the frenectomy for Viviana. The research we had done suggested that her tongue tie could be the real problem preventing her from being able to use her tongue to bottle feed. We took her to an ENT named Linda Dahl, M.D. who has become a leader with this for infants. The results were immediate and although it was a few days afterwards that we tried bottle feeding for the first time, she no longer had a difficulty with it to our relief.

 

I tried researching to see if there was benefit for doing a frenectomy in an adult. The general consensus was “no.” There was great information for infants and children. If the child or adult appear to be doing well and are growing, there is no reason to do a frenectomy. There were some accounts I came across of adults who opted to do a frenectomy, but they did not notice any changes other than stating they could stick their tongue out further.

 

Because of the line of work I am in, I have not bought into the idea that once an adult is fully grown, there is no point in addressing these problems because we are no longer growing. The tension produced by the tongue tie could still be present wreaking havoc in adults. Specifically, I wanted to know if this could help with pain relief to see if this was something I should be paying attention to for my patients. I also tried to understand anatomically how releasing the tongue would allow one to open their mouth wider in which I did a great amount of research for.

 

Once I decided to do the frenectomy to correct the tongue tie, I did a search and found a dentist near me who performs them with a laser. Using a laser has many benefits including faster healing time, no stitches, and less pain after the procedure. In the meantime, I met with an Orofacial Myofunctional Therapist, Dana Hockenbury, SLP, who evaluated Viviana but also confirmed that I did have a tongue tie. Orofacial Myofunctional Therapy (OMT) deals with teaching proper swallowing and proper use of the muscles of the mouth. She was excited to hear that I had elected to do the procedure.

 

She had me open my mouth as far as I could with the tip of my tongue on the roof of my mouth. She took a measurement and also swept a finger across. She said tongue ties feel like a “guitar string” when she moved her finger back and forth across the structure called the frenum. Then she had me open my mouth as far as I could and measured the difference. So it was confirmed. The next step was doing the procedure.

 

The Procedure

 

A few weeks later I went to see Robert Convissar, D.D.S. who would do the frenectomy. I did not have any major indications. I did not have considerable speech problems except for being told I mumbled a lot most of my life and I would lose my voice in a crowded room within 20 minutes the last couple years. The tongue tie did not appear to cause any other problems. I did not mention that I was there to do a self experiment.

 

The procedure was very quick. I was at Dr. Convissar’s office a total of 30 minutes. When we were done, he told me that my tongue was more mobile but not sure if it would help my other problems. My mouth was numb but I know if there are going to be changes, many will be instant. Right away as I walked out I could feel my wind pipe felt more “open.” I felt this would be a success but the results were incredible.

 

The Results

 

As I was on my way out, I stuck my tongue out and saw with my camera that it deviated to the right. My first concern was that there was a nerve issue. However, I looked under my tongue and could see that the correction was more complete on the left side and there was still a small amount of tissue on the right that was anchoring the tongue down a little on the right. (Dr. Convissar later told me he tends to under-correct because that can always be revised, but over-correction is irreversible which is perfectly reasonable).

 

The interesting thing about this is that it made it so that I could compare right and left sides. I will plan on going in for a revision soon and will write another post to demonstrate the changes. Having said all this, the changes were nothing short of remarkable. I will attempt to explain things anatomically in another post. However, I believe osteopaths, orofacial myofunctional therapists, and dentists should be checking for this and having patients corrected, including adults.

 

Here’s The Changes Noticed:

  • Tongue is much more relaxed

-Left side feels completely relaxed whereas right side is more hypertonic and sensitive

DL RL comparison

-Floor of mouth relaxed and less sensitive on left side

-Tongue visually wider and more relaxed on left than right

  • Trachea felt more open and vocal cords felt relaxed

-Trachea glides better to the right than to the left

  • Hyoid bone dropped and more side to side motion

-Hyoid bone glides better to the right than to the left

  • Less tension in the front of the neck down to rib cage

-Longus colli muscles are not sensitive on left but hypertonic and sensitive on right

-Vertebrae on the left deeper and more mobile than right

  • Back of upper neck feels more relaxed and more ease during range of motion DL Tongue In - 1

-Subocciptal muscles more relaxed – more hypertonic and sensitive on right

-Occiput has moved posteriorly on atlas more on left than on the right

  • Hump at base of neck straightened dramatically (diminished exaggerated kyphosis)
  • Structural changes in the head and face

-Left side of head in more pronounced flexion (osteopathic term)

-Hypertonicity in facial muscles such as buccinator, levator labii superioris and zygomaticus minor no longer present on left but still palpable on right

  • Swallowing very different

-Tongue able to rest comfortably on roof of mouth while drinking a cup of water without having to lower it completely with each gulp (my wife said I was quieter drinking from a cup)

-Swallowing much less effort

  • Low back tension released with sacrum feeling softer and more mobile

-Psoas muscles more relaxed

-Pain at L5-S1 relieved

-Greater ease with forward bending and during range of motion

 

Conclusion

 

The implications that tongue and lip ties produce in adults has yet to be studied. This is the most powerful release I have experienced to date. Based on this experience, it feels like the frenulum, even mostly corrected, acts like a “fascial vortex” that binds the tongue or lip and many seemingly unrelated structures. It can affect development in children and have orthodontic implications and can affect the shape of the skull in an adult. I believe an unresolved tongue and lip tie in adults also has profound implications not just in the tongue but throughout the body. This should become a consideration for anyone coming for osteopathic treatment. This will be evaluating and referring for when appropriate in the future. In another post or posts, I will go through the anatomy in detail to explain the related changes as well as post an update and comparison after the revision.

 

Frenectomies are not without potential complications. If the frenectomy is under-corrected, the full benefit may not be realized and would require more revisions. An over-correction, although rare, can have irreversible implications or longer term complications. The same is true if damage is done to the salivary glands, which lie at the floor of the mouth

 

Daniel Lopez, D.O.

Author Daniel Lopez, D.O.

Daniel Lopez, D.O. grew up with a lot of pain trying many things that did not help. Realizing that if he could not help himself, he would be unable to help others effectively, he dedicated himself to finding real answers. Since that time, Dr. Lopez has found a unique but powerful style where he has patients from around the country and the world that travel to see him for headaches, TMJ issues, eye issues, neck pain, back pain, and more. Daniel Lopez, D.O. is an osteopathic physician with Osteopathic Integrative Medicine. Prior to that he had a private practice in NYC for 6 years. He is the author of the Amazon best seller "Unwinding the Body and Decoding the Messages of Pain: An In-Depth Look into the World of Osteopathic Physicians and How They 'Magically' Use Their Hands for Healing." He lives in Aurora, CO with his wife and daughters.

More posts by Daniel Lopez, D.O.

Join the discussion 65 Comments

  • Dawnne Donovan says:

    I think your self study is both remarkable and yet perfectly identifiable with rational findings, in hindsight from reading your article. Thank you so much for sharing! I look forward to both sharing and discussing this further with my colleague’s! Having an open mind to conditions once considered simply as “variants” of normal, as possible life altering conditions, once many related variables have been identified, is what it is all about! I remember identifying a patient’s tongue thrusting, macroglossia, and mouth breathing as a respiratory/airway related problem/issue. I encouraged the parents of the patient to seek further guidance from an ENT. The next time I saw the patient, it was like a different person! Just the difference in posture alone was amazing! The parents were thrilled with the resolve of so many other issues and I remember being somewhat awed as this had been ignored by many for far too long. I became much more proactive in recognizing airway compromise and related dental and maxilofacial development markers. So thanks! Excited to learn more, so please keep sharing in this experience and others! (I see ankyloglossia and high frenum connectivity, literally every day.)

    Respectfully,

    Dawnne Donovan CDA, RDH, BHS

    • Daniel Lopez says:

      Thanks for the great input. I’m realizing the problems from intact frenulums, even those that appear to have not impact, can have huge implications in the overall body structure. That being the case, problems with frenulums are highly undiagnosed and treated. I’ve been learning a lot about this recently and will certainly be writing more about it.

      Thanks,

      Dr. Lopez

      • Mario says:

        Hello Doctor quick question, I fear that if I get a frenectomy (because sharp teeth cut it a lot) I will swallow my tongue at night and die, will that be a possible outcome or am I safe from that ever happening?

        • Daniel Lopez, D.O. says:

          Hi, that is not possible anatomically. Your tongue is anchored to the floor of your mouth. The frenulum is not the reason you cannot swallow your own tongue. I hope that helps.

          -Dr. Lopez

  • Joanne Ahola says:

    Hi Dr. Lopez,

    I am also a physician working with Dana Hockenbury and just had a frenectomy three days on her recommendation with the excellent Dr. Paul Calat. Your post in fascinating and I hope you post further on your observations!
    Joanne

    • Daniel Lopez says:

      Hi Joanne,

      Thanks for your message. I will have a lot more information coming up as I am doing a lot of research. Hope to have some things out soon.

      Daniel

  • Loree Christianson says:

    Hi Daniel,

    Great to hear you discuss and sharing your benefits of your procedure.
    Can you post pictures of before your procedure.
    That would be great!
    Look forward to reading about your continued benefits from the procedure.

    Respectively,
    Loree Christianson, RDH   
    Orofacial Myofunctional Therapist
    Breathing Educator – RBBE

  • We have been recommending revision of all tongue ties from Grade 1 upwards. Lots of research has been done on babies (lactation / feeding problems) and children with speech problems. Unfortunately not enough data /research has been correlated on the benefits of adult TTie release.
    It is imperative from a dento-facial growth aspect that the tongue function is optimised, and nothing inhibits its unique action, particularly its “resting posture”.in any way.
    We have seen all our patients have improved tongue function post frenectomy, but many (approx 40%) who have benefited positively in other ways including neck, shoulder, and back pain relief, postural improvements, airway enhancement, reduction or resolution of bruxing and clenching, gag reflex resolved, improved sleep etc. etc
    We should really be putting our findings together to help advance research and make the benefits and importance of frenectomy known to all.
    Keep up the great work.

  • Hi David, Great work and thanks for sharing. I have a particular interest because you describe similar symptoms to me and i have a poor head posture and posture in general has got worse. Do you do and release of the muscles around/under the tongue? digastrics etc? If so do you find this affective? I find also the tongue affects my shoulder girdle and upper thoracic spine. After reading your post and releasing my own digastrics and doing some simple neuromuscular inner core and postural exercises i generally feel much better and my posture has improved and as you say… quickly. Any thoughts on release work before going to frenulum? i don’t wasnt the scar as i find they also can cause problems with motor control. Thanks

  • Liz May says:

    Dear Doctor Lopez, I’ve also recently realised that I too have a tongue tie and am considering a revision. Can I ask did you snore before the procedure was done and did the procedure reduce snoring/ apnea? Secondly, did you have excessive saliva prior to the procedure and has this reduced post operationhttp://www.unicef.org.uk/BabyFriendly/Parents/Problems/Tongue-Tie/Locations-where-tongue-tie-can-be-divided/? Lastly, Do you have a high palette and do you have overcrowded teeth?
    Looking forward to you replies and also reading your research.
    Kind Regards
    Liz May

    • Daniel Lopez, D.O. says:

      Hi Liz, thanks for your questions. I did not snore and I actually did not have any particular symptoms like you describe. The first thing I noticed getting off the chair was how “open” my wind pipe felt. It felt easier to breathe. I do not have a high palette and some overcrowded teeth on the bottom. My tongue tie was considered mild and I really did not know what to expect. My reason for trying it was to see what effects it could have on my head, neck, and body in addition to swallowing. Post operation, I have had an easier time swallowing and far less pain. I hope that helps.

    • Mark says:

      Hi Liz May, i’m also tongue tied and have problems with excessive saliva.
      Did you have a frenectomy? Did it help with your excessive saliva production problem?Thanks!

  • M Dolbear says:

    Very interesting and informative article! I am having my tongue tie revised on 1st December and I’m very excited to feel the results.

  • Satra says:

    Thanks so much for sharing your experience. Personal accounts of adult frenectomies are hard to come by. I am in my 40s and am considering the procedure. However, like you, my current symptoms are mild/manageable. What risks do you know of regarding the laser frenectomy procedure? Is there ever prohibitive scar tissue or worsening of symptoms or new symptoms post-op? Would you be able to provide an update and/or before/after pictures? Your account is especially compelling because you are also a healthcare expert. Would love to hear how things are going for you now. Thanks again.

    • Daniel Lopez, D.O. says:

      Hi sorry for taking so long to respond. As far as I know laser frenectomies have low risks but probably the main one would result from overcorrecting the frenulum. Scar tissue will form and I generally still stretch my tongue on a regular basis to help prevent the contraction. I haven’t had worsening of symptoms and none of my patients having undergone it have either other than scar tissue tightening. I’m sorry I haven’t written an update but have had too much on my plate and writing has been put on the back burner. Unfortunately I was unable to find a good quality before picture so I haven’t posted. At this point, I have still felt the frenectomy was helpful. Eventually things that felt great normalized so they don’y feel “amazing” anymore but I don’t have pain and tension and that’s what matters. I hope that’s helpful for now.

  • Mo says:

    I thought the rule of thumb was to stop when you see the diamond shape in the mouth. Did you have a diamond upon revision? I have been reading a lot online (like Dr. Ghaheri’s blog) and bouncing questions off of periodontists and dentists (which I have found don’t all see eye-to-eye on the subject). I am curious about the posture as I wonder if it would help mine. Mostly I am considering the procedure for myself to deal with jaw issues/clenching, grinding. Not sure if the headaches I get sometimes are related or not but they may be.

    Did your daughter have any other before/after symptoms like reflux, gas? We are researching the matter as I would like to get my daughter’s lip and tongue tie corrected for multiple reasons.

    • Daniel Lopez, D.O. says:

      Hi, thanks for your comment. I did have a diamond. I found the frenectomy helped my posture quite a bit and same with my mother. Others haven’t had the same experience so it would be impossible for me to say. The procedure may help with jaw issues, but there may be other factors involved. I would consider if you haven’t to see an osteopathic physician that does cranial work (www.cranialacademy.org) to make sure your temporal bones, jaw, and other cranial structures are working properly.

      My daughter did not have reflux but she did have some gas which improved once her latch improved. Good luck with the whole process and I hope it helps you.

      • Mo says:

        We don’t have a lot of osteopaths around here from what I can tell. I got zero matches for both my zip code and my parents’ (who live in another part of the same state) using a search of a 300 mile radius. But, my father sees a CST that I may see next time I go visit. Thanks for all the feedback.

  • Joyce Vallejo says:

    Firstly, I want to thank you for the insight, the observation to impact on whole body is often dismissed.
    I have similar problems as you had; however, I’ve always expected that it was due to the uneven bite and alignment of my jaw. I had many difficulties around neck and shoulders, and received osteopathic manipulation often to correct the problems. Recently, I found out that I have TMJ as well. I’m starting to wonder if the tongue tie could have promoted TMJ. I am hoping this small surgery will help diminish all of these problems.
    after reading this, I am looking forward to my upcoming operation.
    Thanks again

    • Daniel Lopez, D.O. says:

      Thanks for commenting. From my experience, I did find the tongue tie was having an effect on how my TM joint worked so it’s possible. I wish you the best of luck and hope it goes well for you.

      • Sophie says:

        Dear Daniel , can you please remark on your mumbling that you say your wife has always remarked on? Mumbling is a huge thing for me.

        • Mumbling is something people have said about me for a long time. I would say it comes from your tongue having to work extra hard to speak and a relaxed talk tends to come across as mumbling. I think it also tends to put extra pressure on your vocal cords to have to exert extra effort. Although it was easier to speak afterwards and it is less exhausting, the frenectomy certainly probably didn’t make a huge difference in that that I have noticed. If you’re tongue is really anchored down though, freeing it up could potentially help.

    • Jo says:

      Hi Joyce-
      Did it help

    • Donna says:

      Yes, Joyce. Please give update!!

      Following,
      Donna

  • Miike B says:

    Dr Lopez, I see you haven’t blog on this in a year. How are your feeling from this tongue tie surgery? I only ask b/c i’m thinking myself in doing it. But I’ve heard the results are only temporary and any relief goes away in about 3 months.

    • Daniel Lopez, D.O. says:

      Hi, sorry for the delayed response. With a baby, it’s been harder to write regularly. Anyway, I have felt good from the tongue tie surgery. I have continued to work to stretch my tongue since having the procedure. It has not necessarily been my experience that the results are temporary, but eventually the feelings of relief wear off as they just become the new normal.

  • Heather says:

    I am an adult who just had a frenectomy. Today is day 5 since my surgery. I am experiencing a lot of pain at the site and on the tip of my tongue. When I do my stretching exercises and after, my tongue feels like it has a wire running to its tip that is very tight. My tongue tip bothers me more than the surgery site. Today I also feel more saliva in my mouth. Are either of these conditions abnormal? I would really appreciate your thoughts.

    • Daniel Lopez, D.O. says:

      Hi Heather, this is not normal as far as I know. You may want to contact the person who did it and discuss it with them. It sounds like a nerve may have been affected.

    • Jo says:

      Hi Heather, I had my frenectomy done three and a half days ago, and am experiencing the same symptoms as you reported in October last year. Any chance you could give me an update of how you are feeling and what happened after you posted? Hope all is well!

      • arjun says:

        I had my tongue tie surgery 2 days before using laser… I too feel some symptoms as HEATHER mentioned.. tip of my tongue is still numb and I can’t feel anything..
        my tongue is still hurting .. when will I recover fully? tell me about your post surgery condition.. how do you feel now after a month ? i cant speak intelligibly.. at first my surgery site looks white..now it is turning yellowish.. i read somewhere that we must gargle with salt water..is that necessary?

  • Don says:

    Sir
    interesting article. I am a dentist of 35 years experience and in the 80s I use to refer all patients with high lingual Frenum attachments to periodontist or oral surgeons for frenectomy and I use to see a lot of gradeschool children with speech difficulties referred to me by speech pathologists for the same issue ….but insurance company’s got involved and someone figured it was an elective procedure so now it’s not nearly done as often not as it should be. With the new lasers and electrosurge units out now it’s even easier to do the procedure, almost bloodless and without sutures. Its really easy to do when patients are sedated and having their third molars extracted. I still see patients monthly that need the procedure so I still refer them ….an idea to ponder…does adults with ankyloglossia snore or have lower incidence of sleep apnea since the tongue is more securely attached to the anterior part of the mandible ???? I have treated nearly over 100 patients whom snore or have some type of obstructive sleep apnea and I don’t recall any with ankyloglossia. …..More to come on this subject I am sure….

    • Daniel Lopez, D.O. says:

      Hi Don,

      Thanks for the comment. Sorry for the delayed response. I’ll be curious to hear what you find regarding the sleep apnea. Keep up the good work.

  • Flora says:

    Hi Daniel,

    For someone who has a tongue tie and forward head posture with a bony bump at the base of the neck, would you recommend a frenectomy? A sedentary lifestyle may have contributed to the forward head posture and the bump, but then again many people have a sedentary lifestyle without having these problems.
    Many thanks,
    Flora

    • Daniel Lopez, D.O. says:

      Hi Flora,

      It’s very possible a frenectomy would help. It just depends on whether or not it’s a reason for your forward head posture. It very well could be.

      Thanks,

      Daniel

  • Grant says:

    Dr. Lopez,

    Very nice post and thread. I just had an adult frenectomy performed yesterday the old fashioned way (laser was not available for me) for a very different reason that may affect a few other people. I am a professional musician and have been playing saxophones, clarinet, and flute for about 27 years. Each instrument requires several different tonguing positions. Sometimes the tongue needs to get out of the way and sit on the roof of the mouth to allow the air to more directly flow into the instrument. I have always had a labored tongue for doing fast exercises so when I went in for a wisdom tooth extraction I finally had this done. I was nervous for some of the reasons you have pointed out, possible nerve damage or a worse ability to move the tongue. Obviously, I still have soreness now but my first observation was that I can move my mouth much wider now. 2nd observation is how tired my tongue is with the newfound extension. I will wait a few days and then try to play my instruments. Hope this might aid other musicians thinking about this procedure. So far so good.

  • What a great article! And your responses to your commenters are amazing, I just want to give you kudos for not only going forward with the work you did, but also sharing it with your audience!

    As an oral health coach I am always seeking out practitioners willing to think outside of the box and engage with their clientele. It’s a breath of fresh air when I find them! I just recorded a podcast with an OMT/RDH therapist on my podcast. Please let me know if you’d like to listen and offer feedback.

    Looking forward to keeping up with what you are doing. Thanks for writing a great article. I’ve shared it on my professional fb page!

  • Gillian says:

    Hi,
    Thanks for sharing this! I have a tongue tie and just diagnosed with significant scoliosis. I am wondering if they might be partially linked. I am 38 yrs old. I’m considering a frenotomy. I appreciate any of your thoughts regarding a link between scoliosis and tongue tie.
    Thanks,
    Gillian

    • Daniel Lopez, D.O. says:

      Hi Gillian, It’s possible that a tongue tie could be related to scoliosis, but there’s a lot of factors in my opinion that can be involved with scoliosis so I would not be able to say for certain if it would help at all. The best I can do is say that it could be possible. Best of luck.

      Sincerely,

      Dr. Lopez

  • Luisnani says:

    Dr I just did a tongue tie relief surgery,but have been told that my voice is still not clear,having been using TAB ORELOX 200mg

  • Ryan says:

    I am looking to travel to have someone preform this (but having difficulty with offices getting back to me). Hoping it’s one more peice of the puzzle in improving health and the quality of life.

    I have a question though, vain as it may sound, I’m still interested in understanding it functionally. You say the hyoid drops, I take that to mean vertically. If so would that also make a more obvious a double chin? Right now when I try to get my posterior tongue to the roof of my mouth it externally visually appears to suction up my chin and define it. I can also conversely if I want, like what a frog does with its neck, push down the floor of my neck and exaggerate a double chin. I’ve never understood functionally or what muscles I’m activating in order to push downward, but I feel I breathe deeper with it pushed down like that.

    My impression was that proper oral function also had the consequence of a more defined jawline, but a dropped hyoid doesn’t fit that impression.

    • Hi Ryan, thanks for the question. It shouldn’t produce a double chin and I haven’t heard of that happening. The goal of the procedure is to normalize the hyoid bone and the muscles in the area, not to have it drop down vertically. If it’s pulled up beyond where it should be, then having the hyoid bone drop would be helpful. It’s the normalization of the balance between the muscles above and below the hyoid that matters. The muscles would relax but that does not mean that the result is a double chin.I hope this helps.

      -Dr. Lopez

  • Corry Jankowski says:

    This post is so enlightening to me. I happened to find it while researching potential causes of early hip problems and leg length discrepancy. I am 35 years old and have always had discomfort in my hips, knees, and extreme shoulder tension. Recently I visited an orthopedic specialist who is recommending hip surgery due to an impingement likely caused by leg length discrepancy. I know that I have a significant anterior and posterior tongue tie but until reading this did not realize that it could be affecting even the lower back. In your opinion, could a TT affect even the hips? Although the hip surgery will be covered 100% by insurance, I’d be willing to explore revision as a possible alternative, especially since I suffer from other symptoms of TT, like chronic hiccups, poor digestion, and swallowing “the wrong way”. I’d love to hear your input and if you’ve noticed further improvement since your revision!

    • Hi Corry, potentially the frenectomy could help if it’s involved and it would be easy enough to try, but it would be impossible to say for sure. If you’re case is as severe as it sounds, I think it would be a possibility. I haven’t personally had anything else improve after the revision, but I wouldn’t expect it to necessarily. The improvements are generally noticed the most strongly after the revision and eventually your body would adjust. I would also see an osteopathic physician that does cranial work for both your hip and tongue before and after the procedure.

      Best,

      Dr. Lopez

  • Ken says:

    Hi Daniel,

    I’ve had two frenectomies and am considering going for a third as my dentist tells me im still tied posteriorly, preventing a proper swallow (with base of tongue on roof of mouth).

    One thing i found particularly interesting about your post was that you mentioned that you lost your voice after 20min when talking in a loud room before the operation. Did that improve? My biggest problem is that my voice has lost a lot of resonance due to my problem and im wondering if releasing this should improve it.

    • Hi Ken, thanks for writing. I apologize for the delayed response. To answer your question, yes, the losing my voice did improve. One of the first things I noticed after the frenectomy was a profound relaxation in my throat. Unfortunately, I cannot say what will happen with the resonance in your throat, but if the frenctomy was done properly, I would be cautious about redoing the procedure because the scarring can also cause problems. If it was not performed properly and specialists feel that it was incomplete, then I would consider doing a revision. Best to you.

      Sincerely,

      Dr. Lopez

  • Joy says:

    Hi Dr. Lopez
    I’m considering a frenectomy. I am 37 yr old diagnosed with mild sleep apnea. I had no idea that this even existed until two kids were diagnosed with tongue tie. Both had surgery and are doing better. Still going through therapy. The therapist saw me too and said they got it from me. Do you know if there is a connection between sleep apnea and tongue tie? I am definitely tied on my shoulders and been told my left hip is higher than the right one. I’ve been reading the recovery in adults takes longer. What’s your point of view?

    • Hi Joy, I do believe there can be a connection between tongue tie and sleep apnea. From my perspective, it’s worth trying. Especially since you have potentially other signs of it. It’s a simple procedure to do, but make sure you go to someone who does it well. Neither I nor my patients have had terrible recovery times. It does take longer, but mostly it was just some soreness in my mouth. I didn’t alter the way I ate or anything like that from it.

      Best,

      Dr. Lopez

  • Holly says:

    Hi Dr Lopez wow! what a great blog post. I am 42 and in dealing with sleep apnea, tongue tie, neck, shoulder, tmj, lower back, hip, teeth grinding, issues I found this and the comments quite interesting. I was learning all about sleep apnea and wondered if I had a tongue tie and it turns out I do. I had no idea as like you no speech problems but I did get a sore voice after loud speaking. the comments here tells me this could all be related. Did you correct the right side? The difference in the pics are quite remarkable . I have my apt for the frenectomy is four days and I am nervous but excited. It will be done without laser. was yours done with laser? I am wondering if it is worth it to find a dr who will use a laser in stead. if possible will you expand on the info you have found on sleep apnea and TT? there is very little out there. I was on the fence about going through with it till I read your post. Thanks for keeping up with all the comments. Holly

    • Hi Holly, thanks for the comment. I haven’t found much information about tongue tie and sleep apnea although anecdotally I have heard from some people that it has helped. Unfortunately, that’s the best I can do but I wouldn’t be surprised if it does provide at least some benefit. Anyway, I did correct the right side. It did not have as dramatic of an effect, but still did provide some more relief. I also had mine done by laser. I do recommend to do the post surgery tongue stretches for far longer than they recommend after surgery to keep the soft tissue from contracting.
      Best,

      Dr. Lopez

    • Hi Holly, I apologized. I just realized that I never responded to this post. Anyway, I did correct the right side more but the results where minimal compared to the first time. Honestly after that, I also realized the issue on the right would be more difficult to release. I haven’t found much literature on tongue tie and sleep apnea. I hope you have found it helpful. I often also find that I need to address the palatine bones of the hard palate in patients with sleep apnea. You may try to seek out an osteopathic physician that performs cranial osteopathy for that (www.omtdirectory.com) or (www.cranialacademy.org). I hope you had good success with your procedure.

  • Katrina says:

    I have suffered from severe migraines for as long as I can remember. I have had scans done and nothing come up. I am tonguessing tied to where it’s almost attached to the tip of my tongue. In your opinion if I were to get the frenectomy done could it possible help with my migraines and neck tension?

    • Hi Katrina, I couldn’t say for certain, but I would not be surprised if your migraines did get better if your tie is near the tip of your tongue. That would put a lot of tension in your mouth, jaw, and the rest of your head.

      Best,

      Dr. Lopez

  • Erica Zolnierczyk says:

    Dr. Lopez – Have you/will you ever posted after pictures of your face and tongue with the changes that you noted? Thanks.

  • Donna Carneal says:

    Oh my!! I am 60 years old. Just discovered my TT about two years ago when the topic became an issue when one of my grandchildren was having trouble nursing, and the doula suggested TT. So long story short, I’ve had 2 grandchildren who have had their tongue tie clipped, and I now realize that I and my 4 grown sons have TT. About 8 years ago I developed a swallowing problem (food stuck in esophagus) and am now wondering if TT clipping might help. The doctors have only confirmed that the muscles on side of esophagus are squeezing the opening and have no suggestion except to have my esophagus stretched. UGH. So I have a tentative appointment in Raleigh, NC on Friday. After reading these posts, I’m getting apprehensive because I’m hearing “voice problems,” scar tissue problems, tongue numbness, uneven clipping……oh my! And yes, I was also glad to hear of the positive results, but …….not sure what to do. Wish there was more info on this topic.

    • Hi Donna, I’m sorry for taking so long to respond. I’ve had some technical difficulties. I’m not sure if you ended up getting the procedure. Yes, unfortunately, there isn’t a lot of information on this topic. The best thing you can do is make sure that you’ve done your research about the person performing the procedure. Otherwise, best to you on your journey.

      • Donna Carneal says:

        thanks so much for responding!! The dental assistant in NC recommended that I first see an ENT. The ENT knew very little about tt except in regard to speech problems. She scoped from nose to esophagus and saw nothing, except perhaps some acid reflux. She referred me to a Gastroenterologist who today suggested I return for an upper endoscopy, checking area from throat to stomach and then putting a “balloon” in esophagus and stretching it open. I just can’t somehow feel good about this. Can’t get Dr Wuertz’s office in NC to return my calls regarding frenectomy. I’m amazed in reading through the previous posts that someone had connected tt to leg length, since my right leg is shorter. Would love to think frenectomy could flatten the hump at back of my neck. Do you have any doctor/expert recommendations? Amazing topic!! But why would my swallowing issue suddenly appear at the age of 53? One son has always had swallowing problem. Another son has lower jaw that badly recedes. Crazy!! Have you read the book Tongue Tie: From Confusion to Clarity by the late Carmen Fernando?

        • Hi Donna, I don’t particularly have a doctor recommendation in the area. If you were willing to travel, I would recommend you see Robert Convissar, DDS. He did mine and my patients. Frenectomies are very interesting. I don’t know why your swallowing issue would start now. It’s possible your body could compensate for it prior, but something changed and now it cannot. I haven’t read the book by Carmen Fernando but I’ll check it out when I get a chance.

  • Heather says:

    Hi Dr. Lopez, Thank you for your article! Did you notice any brain changes after this? Proprioception, mental, emotional or mood-related changes? I’m curious about some of the neurological changes some of the other tongue tie experts are talking about. I appreciate hearing your personal experience going through this!

    • Hi Heather, thanks for the questions. I apologize for taking so long to respond. I’ve had some technical issues with the website. The only brain change that really stood out to me was improvements in headaches I was getting. However, that also helped my mood. I didn’t necessarily notice any other changes than the ones I discussed in the article, but the way I see it those are neurological changes leading to body wide releases.

  • Danielle says:

    I’m considering getting my tongue tie and lip tie revised by laser. 3 of my 4 children had to have their’s done in the past. I might have to get my youngest child’s revised at some point. I had her’s done twice already. Once when she was 2 weeks old and once when she was under 6 months – can’t remember exactly when. Hers was really bad. She could not breastfeed at all even after it was revised and was really slow with bottle feeding.
    I didn’t even realize I had a tongue and lip tie. But, it explains some issues I have. I have a jaw that pops if I open it too far and my jaw is a bit misaligned I believe. I often bite my cheeks. I can’t open my mouth very wide. I have some breathing issues, that might be linked with it somewhat. My upper teeth are crowded and I have tension in my jaw. I often breath with my mouth open. I think maybe because of the ties, my facial structure is restricted and this also causes some issues in my nasal cavaty and wind pipe areas probably – like you were saying. I am considering my lip tie getting done because I may need dentures when I’m old and I think it is low enough that it would possibly interfere with the proper fitting and we all know we don’t heal as well when we are older. Any thoughts? I’m a bit nervous about getting it done as I definitely hate pain and this is like signing up for pain, but maybe it would be worth it. I feel bad that my kids had to go through it, but felt like it would be worth it. I think it has helped my oldest to be able to pronounce his words better. He still had a bit of a baby talk sound to him before I got it done when he was 6 and it went away afterwards.

    • Hi Danielle, thanks for the comment and questions. I apologize for the delay. I’ve been having technical issues. It very well may be helpful to have your lip and tongue tie revised, especially if you’re seeing it in your children. If you have that much tension, I would also considering looking for an osteopathic physician that does cranial work (www.omtdirectory.com) and having them work to correct many of these areas in addition to having the lip and tongue tie.

  • Laila says:

    Hello
    Ive just stumbled across your blog as ive booked myself in for a tongue tie release next week.
    Ive had chronic lower back pain, neck tension, tmj, heck my whole body feels like it is overcommensating. Ive been assessed and my tongue is 50% stuck down. Im getting it snipped rather than lasered. The surgeon who preformed the surgery on my baby does it this way and said this is how you get the best results.
    Did your back pain, mood improve? Did you have any post operative cranial work done or physio?

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