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

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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.

Results

Statistically significant improvement was noted in
VAS, I-GERQ-R and BSES-SF comparing preoperative scores to both one-week and one-month scores. The study had 132
breastfeeding dyads enrolled. Posterior tongue-tie was noted in 71% of this cohort.

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.

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