The term dentoalveolar surgery refers to all other surgery related to the tooth structures and related gums and bone. These procedures include surgical removal of teeth, management of dental and maxillofacial infections, apicoectomies, exposure of impacted teeth for orthodontics and preparation of the mouth to receive dentures. In working with your general dentist, the doctors will help determine which procedures are appropriate for you.
Infant frenectomy ( Tongue-Tie and Breastfeeding)
Successful breast-feeding depends on multiple factors. One issue that can adversely affect the newborn's ability to obtain a correct latch is the presence of a tongue or a lip tie. The flap of tissue under the upper lip and under the tongue is called a frenum. The attachment under the upper lip is the maxillary labial frenum and the one under the tongue is the lingual frenum. An overly attached frenum may cause nipple pain, compressed or injured nipples and even mastitis. In addition, the newborn may make clicking noises with nursing, may have prolong feeding sessions, may have inadequate weight gain or may demonstrate irritability during and after breastfeeding.
In newborns, the lip or the tongue frenum can be removed with a procedure called a frenectomy. The use of a laser to perform this procedure reduces discomfort and bleeding during and after the frenectomy. In the newborn, a topical anesthetic is sufficient to complete the procedure. In older children, a local anesthetic may be used. It is not necessary to put the child to sleep with a general anesthetic to have the frenum removed. Rarely does the child need any type of pain medication afterwards.
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frenum Surgery ( Tongue-Tie Surgery)
The frenum are bands of muscle attaching the lips, cheeks, and tongue to the bone in the mouth. Since no significant functional problems are encountered when a frenectomy (removal of the frenum) is completed, there is a minimal role in the function of the tongue or muscles of facial expression. Individual needs or problems may dictate when and if a frenectomy should be preformed. For the upper front frenum, a frenectomy is often postponed until the permanent lateral incisors and permanent canines erupt (permanent canines usually erupt about 11-13 years old). This recommendation is based on the fact that when the laterals and canines erupt, they will generally close the diastema (space) between the permanent central incisors. When a frenum is especially large, it prevents the closing of this space. If the diastema is not closed by the normal eruption of the upper anterior permanent teeth, a frenectomy may be helpful, although orthodontics may also be necessary. A large and highly attached frenum could also cause gum recession in adults. Newborns with enlarged upper frenum may have difficulty breast feeding and cause pain for the mothers.
An upper frenum problem does not seem to affect speech patterns. On the other hand, the lingual or tongue frenum, which is attached to the underside of the tongue, may interfere with speech. Generally, this will become apparent when child begins to speak. If notching of the tongue is noted when the tongue is protruded, it is generally recommended to have the frenum removed. Speech therapy may also be required in conjunction with the surgery.
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