Short lingual frenum in infants, children and adolescents. Part 1: Breastfeeding and gastroesophageal reflux disease improvement after tethered oral tissues release

Authors

  • P Hand Institutions Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli – IRCCS" School of Dentistry, Università Cattolica del Sacro Cuore - Master Laser Dentistry
  • G Olivi Institutions Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli – IRCCS" School of Dentistry, Università Cattolica del Sacro Cuore - Master Laser Dentistry
  • C Lajolo Institutions Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli – IRCCS" School of Dentistry, Università Cattolica del Sacro Cuore - Master Laser Dentistry
  • G Gioco Institutions Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli – IRCCS" School of Dentistry, Università Cattolica del Sacro Cuore - Master Laser Dentistry
  • L Marigo Institutions Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli – IRCCS" School of Dentistry, Università Cattolica del Sacro Cuore - Master Laser Dentistry
  • R Castagnola Institutions Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli – IRCCS" School of Dentistry, Università Cattolica del Sacro Cuore - Master Laser Dentistry
  • M Cordaro Institutions Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli – IRCCS" School of Dentistry, Università Cattolica del Sacro Cuore - Master Laser Dentistry

DOI:

https://doi.org/10.23804/ejpd.2020.21.04.10

Keywords:

Breastfeeding, Laser frenotomy, Gastroesophageal reflux, Visual Analogue Scale, Ankyloglossia, Posterior tongue-tie, Lip-tie, Buccal-tie

Abstract

AIM: This study aimed to determine the impact of laser surgical tongue-tie, lip-tie, buccal tie release on breastfeeding and Gastroesophageal Reflux Disease (GERD) in a prospective cohort study conducted from June 2019 to June 2020 in a private general dental practice. METHODS: Preoperative, one-week and one-month postoperative surveys were completed, consisting of Visual Analogue Scale (VAS) for nipple pain severity, Breastfeeding Self-Efficacy Scale Short Form (BSES-SF), and the Revised Infant Gastroesophageal Reflux Questionnaire (I-GERQ-R). All study participants were breastfeeding dyads (0–12 weeks of age) with untreated ankyloglossia and/or tethered maxillary/buccal frena. The laser surgery was completed using 2 different near-infrared diode lasers with 300µm diameter fibre: a 980 nm wavelength diode laser (Lasotronix Smart Pro, Piaseczno Poland) was used at 4.0 W, gated with 100 µs t/on and 100 µs t/off, and a 1470 nm wavelength diode laser (Pioon S1, Wuhan Pioon Tech Co Ltd., Wuhan, China), used at 3.5W, gated with 50 ms t/on and 50 ms t/off. CONCLUSION: This study confirms the need for functional assessment of tongue and lip movement for this significantly affected cohort. Laser surgical release (frenotomy) of tongue-tie, lip-tie, buccal-tie resulted in significant improvement in breastfeeding outcomes. These improvements (VAS, I-GERQ-R and BSES-SF) in breastfeeding outcomes were found for cohorts of the classically recognised anterior tongue-tie and the less obvious (without functional assessment) submucosal tongue-tie were found.