Tongue tie

[mickey frankl]

Hi all

I never did nor thought I would do a frenectomy,but last week I treated a 26yrs old lady woe had never been to a dentist(she came from India),and found her tongue to be tied in a way that realy restricted her.
So I used my Erbium laser with topical and excised the tie.No bleding!I was very impresed(even more than she was).
Any coments
Mickey

[ASI]

Hi Mickey,

Looks great. It will make a significant difference in her life.

One of the first ones I did brought a comment from a patient who said, “You changed my life!” A pretty powerful statement not often heard from patients inspite of the many other more important and much more difficult things that I thought I had being doing all these years but rarely elicited a similar reaction. Things like that seamless crown margin, that text book perfect endo shaping and obturation, that optimal composite interproximal contact, that asymptomatic pulp exposure treatment to save them an endo, the hardly detected injection of a local anesthetic, the management of emergency during and after office hours, that well fitting prosthesis, that dramatic enhanced and improved smile, that reduced periodontal pocket, that beautiful surgical procedure….. Well, you get the general idea.

Not that patients don’t appreciate all these thing that we do and not that they don’t express their gratitude in many ways. They do. However, there is also a level of expectation that all these things that we do are the norm, regardless of how we sweated over them to provide the end result.

Yet a simple procedure like a release of a tongue tie will provide an immense change to a patient who swallows hundreds of times each day for the rest of his/her life. That patient will be less likely to choke in swallowing, will be able to take a vitamin tablet easier, will be able to speak more clearly and freely…. As I tell my patients about lingual frenectomy: You don’t know about the freedom until you have it. And once you have it, you won’t want to lose it.

The laser gives us the power to provide all that in such a patient friendly, noninvasive and comfortable manner.

Cheers,

Andrew

[Glenn van As]

Mickey: clap clap clap..nice stuff.

Really nice no bleeding as well……..what a nice service to the patient.

PS now you have done this you can do the occlusal that is needed on the lower right first molar with the erbium of course!!!

Glenn

[Swpmn]

Great case Mickey and a wonderful service to your patient. Thanks for sharing!!!!!!!!!

Al

[Robert Gregg DDS]

Well done Mickey. Nothing I could add.

Well said Andrew. Profound observations.

Bob

[jetsfan]

I did a lingual frenectomy on a 16 year old less than 1 week ago. I used waterlase at .5W 11%A with topical.
He tolerated procedure well and both he and mother were quite pleased with immediate post op results. Patient came in today for follow up and said he had pain for a few days and now he can’t stick out his tongue very far. This was surprising to me as I disected quite far .
Although there is an improvement from pre op, there has been some relapse. How do you prevent that from happening?

Robert.

[whitertth]

Hi Robert,
Hope all is well…Have u been using the DRKLIQUID?
Try the new chocolate flavor….I would venture to say that the relapse is from being alittle too conservative and not removing the deeper muscle attachemnts? what do u think gang?

[Glenn van As]

HI there……..I know my friend Larry Kotlow puts one suture in to prevent reattachment in certain cases.

I might be able to find out where he puts the suture…..

I will copy him on it.

Glenn

[jetsfan]

Glen,
I thought I remembered seeing something about a suture in a post a while back. It would be helpful for me, and other,I suppose , to learn his technique.

Ron,
All is well in Rockland county. I will be at the NYC WCLI next Friday. Will I see you there? We all love the topical in the office. My hygienist uses it more than I. I just received two more bottles, One cherry and one chocolate.
As far as being too conservative, I thought the opposite was true. I went quite deep , in fact I thought I went deeper than I needed to go. I am going to get him back in next week for follow up photos. I will post pre , immediate post op and 1-2 week post op.

Robert

[Glenn van As]

Larry Kotlow took time out of his busy schedule to email these photos to me………

Hope they help, and I think they are captures from his scope of video he has taken.

They are of him placing a suture in the tongue tie release prior to releasing the patient to prevent the reattachment process. Note the lack of bleeding. Laser used was a Delight with soft tissue tip probably at 30Hz and 50-80 mj, with anesthetic.

Take care

Glenn

[dkimmel]

Nice cases. Have yet to do one.
David

[jetsfan]

Here are the photos of the frenectomy I spoke of 2 weeks ago. You can see  that in the immediate post op the tongue was freed up nicely.  The 5 day post op he had pain and noticed it was tightening up again. The 2 week follow up shoes it healed, with a thicker attachment than before and clearly not as free as the immediate post op.
Aside from the suture technique, any comments( I have thick skin).

Robert’

[Anonymous]

QUOTE

Quote: from Glenn van As on 10:13 am on June 14, 2004
Larry Kotlow took time out of his busy schedule to email these photos to me………

Hope they help, and I think they are captures from his scope of video he has taken.

They are of him placing a suture in the tongue tie release prior to releasing the patient to prevent the reattachment process.  Note the lack of bleeding.  Laser used was a Delight with soft tissue tip probably at 30Hz and 50-80 mj, with anesthetic.

Take care

Glenn

Note to all-
Recieved a report to moderator about this thread- the suture was placed after release of the frenum. per Larry

[Dan Melker]

Having done these procedures with a scalpel-what a mess. Seeing consistent beautiful results using the laser makes me realize I will being sending my patients that need these procedures up to Davey Kimmel.
Awesome use of the laser!
Thanks for the thread,
Danny

[Anonymous]

Hi all, I’ll add one from today.
Started seeing this 6 year old 2 years ago. 2 years ago we could not get his tongue lifted above his primary incisors to get any access so we waited until the primaries were out of the way.
Used BLT topicaland infiltrated a couple drops of septcaine.
er,cr:YSGG .75W 11/7 Tapered 9mm tip

Preop- still couldn’t ‘stick tongue out’ sorry picture doesn’t show this better and is a little blurry.

[img]https://www.laserdentistryforum.com/attachments/upload/ce1.JPG[/img]

[img]https://www.laserdentistryforum.com/attachments/upload/ce2.JPG[/img]

[img]https://www.laserdentistryforum.com/attachments/upload/ce3.JPG[/img]

[img]https://www.laserdentistryforum.com/attachments/upload/ce4.JPG[/img]

Interesting that this little guy went around the office sticking his tongue out for everyone when we were done. First thing his mom did was ask him to say ‘love’ and she was thrilled when it sounded like love and not ‘blove’. Made my day!

2 questions-

Would you have also released this where it attaches to the attached gingiva, lingual to the incisors?

2.There had been earlier discussion re: suture, anyone beside the guy Glenn mentioned, routinely placing them?

[Author]

Posts